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MRSA Infections; Mayo Clinic (3 articles; a book + CDC Poster)

Doctor says patients contracting MRSA during MRI screenings

One of the world’s foremost MRI experts, Dr. Peter Rothschild, is telling the public about the risk of contracting the “Superbug” MRSA during medical imaging studies.

Many patients have developed “Superbug” infections that are resistant to conventional antibiotics after their MRI. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common superbugs that patients have contracted after undergoing an MRI scan.

The most famous of these cases is that of 15-year-old student Nile Moss, who died from an MRSA infection after an outpatient visit to a hospital where he underwent an MRI. After leaving the hospital, Nile developed a high temperature.

Just days after being admitted to the hospital, he died.

The Centers for Disease Control and Prevention (CDC) reports that 1.7 million people in the United States contract a hospital acquired infection each year, and more than 100,000 people die each year as a result of these infections. Reports show that, in 2005, nearly 19,000 people died from hospital acquired infections. Hospital acquired infections are killing more people each year than AIDS.

– by Gene J. Koprowski, Editorial Director and Nancy Bruening, Executive Editor

Academic medical centers continue to prescribe broad-spectrum antibiotics, ignoring risks

Antibacterial drug use appears to have soared at academic medical centers between 2002 and 2006, driven primarily by increased use of broad-spectrum agents and the antibiotic vancomycin.

Use of antibacterial drugs dramatically increases the risk that pathogens will become resistant to their effects.

Infection with drug-resistant bacteria is linked with greater illness and death and higher health care costs than infection with bacteria susceptible to antibiotics. “Many professional societies and national agencies have recommended monitoring antibacterial use and linking patterns of use to resistance,” the authors of the new study, funded by Bayer.

Amy L. Pakyz, Pharm.D., of Virginia Commonwealth University, Richmond, and colleagues measured antibiotic use documented in claims data from university teaching hospitals between 2002 and 2006.

Statistics available from 35 hospitals in 2006—that year, a total of 775,731 patients were discharged, with 492,721, 63.5 percent, receiving an antibacterial drug.

The average total antibacterial use at the 22 hospitals providing five-year data increased from 798 days of therapy per every 1,000 days patients were in the hospital to 855 per 1,000 patient-days in 2006.

When doctors examined the drugs by class, fluoroquinolones were the most commonly used, and their use remained constant. “The other change contributing to the increase in total use was the marked increase in the use of vancomycin,” the authors write. “During five years, the mean [average] vancomycin use increased by 43 percent.”

“With few new antibacterials in development, antimicrobial stewardship programs in concert with aggressive infection control efforts represent the best chance for control of resistant pathogens,” the authors write.

– by Gene J. Koprowski, Editorial Director, and Nancy Bruening, Executive Editor

Doctors, nurses and other personnel at academic medical centers continue to dole out antibiotics.

Seven babies born with MRSA at suburban New York hospital

A suburban New York City hospital says that seven babies born in recent weeks developed skin rashes from the staph infection known as MRSA.

None of the children became seriously ill and Westchester County Health commissioner Joshua Lipsman says other patients at St. John’s Riverside Hospital in Yonkers should not be afraid.

Though MRSA is resistant to penicillin and related drugs, it can be treated with other antibiotics.

The hospital’s chief executive officer Jim Foy says the first case came to light on Sept. 24 and the most recent was found on Sunday.

Foy said yesterday that the maternity and nursery wards have been cultured and disinfected and area pediatricians have been asked to watch for cases.

– by Gene J. Koprowski, Editorial Director, and Nancy Bruening, Executive Editor

Newborns at risk for MRSA.

Doctors develop new technique to stop colonization of MRSA pathogens

Killing drug-resistant staph in the noses of wrestling-camp counselors slashed the rate of potentially deadly skin infections 58 percent at the camp, compared with a year earlier, a new study shows.

MRSA often lives in people’s noses without infecting them, growing and multiplying. This is called colonization. These colonized patients can spread MRSA to others, or can become infected through a break in the skin. The nostrils of the camp counselors and coaches were cleaned out using topical antibiotics called mupirocin and chlorhexadene for five days.

Methicillin-resistant staphylococcus aureus, or MRSA, infected 25 percent of the wrestlers at a Minneapolis wrestling camp in 2006. Last year, researchers tested coaches’ and counselors’ noses for MRSA and found about half were carriers. Once doctors removed the contaminant, infections dropped.

Killing bacteria from carriers in other situations involving close quarters also may help slow the spread of the disease throughout the community, the researchers said. MRSA infected 94,360 people in 2005, killing 18,650, according to the U.S. Centers for Disease Control and Prevention.

Counselors “show them the moves and have a lot of direct contact with the kids,” said Bruce Anderson, the study’s author and a researcher at the University of Minnesota in Burnsville, said. “When we found the rate was that high among the counselors, that was amazing to me.”

Anderson reported his findings last week at the Interscience Conference on Anti-Microbial Agents and Chemotherapy in Washington.

Nearly 14 percent of MRSA infections involve those who acquired the disease outside the health-care system.

– by Gene J. Koprowski, Editorial Director and Nancy Bruening, Executive Editor

Swabbing the nose with this ointment can stop MRSA.

Doctors question wisdom of mandatory MRSA screening

Epidemiologists are downplaying calls for mandatory, universal nasal screening of patients for MRSA. The researchers at Virginia Commonwealth University argue that proven, hospital-wide infection control practices can prevent most of the potentially fatal infections.

In a report published in the November issue of Infection Control and Hospital Epidemiology, the team of Richard P. Wenzel, MD, Gonzalo Bearman, MD, and Michael B. Edmond, MD, of the VCU School of Medicine, said hospitals get “more bang for their buck” with evidence-based infection control prevention.

Many states, including Pennsylvania, Illinois, California and New Jersey, are requiring universal nasal screening for methicillin-resistant Staphylococcus aureus, or MRSA, in hospitalized patients.

MRSA is a strain of Staph bacteria that does not respond to penicillin and related antibiotics, but can be treated with other drugs.

“The key safety question today, since it is possible to reduce the total risk of hospital infections by half with a broad-based infection control program, is what is the incremental benefit of a component focusing on a single antibiotic-resistant pathogen?” said Wenzel.

Focusing on deadly bloodstream infections, the team modeled a focused-screening program that was assumed to be effective in reducing MRSA rates by 50 percent and compared it to a hospital-wide program designed to cut the rates of all infections by half.

According to Wenzel, past president of the International Society for Infectious Diseases, MRSA infections cause only 14 percent of hospital infections, and investing huge resources into their control would be less effective than implementing programs that would reduce the burden of all infections by 50 percent.

– by Gene J. Koprowski, Editorial Director and Nancy Bruening, Executive Editor

MRSA testing worth the effort?

Pandemic prevention is now top priority for Google

The altruistic arm of Internet search engine pioneer Google, Inc. this week said it had given grants of more than $14 million to support physicians working in Southeast Asia and Africa to prevent the next pandemic.

Mountain View, Calif.-based Google.org’s Predict and Prevent initiative is supporting efforts to identify “hot spots” where infectious diseases may emerge, discover new pathogens in animal and human populations, and react to outbreaks before they become global crises.

New lethal infectious diseases crop up every year, Google said, including variants of HIV/AIDS, bird flu and SARS, as well as drug-resistant strains of ancient scourges malaria and tuberculosis.

Google said three-quarters of new diseases are “zoonoses, meaning they’ve jumped from animals to humans.”

– by Gene J. Koprowski, Editorial Director, and Nancy Bruening, Executive Editor

Obama sparks controversy with remarks about Medicare

Dropping dramatically in the polls, Democratic presidential nominee Barack Hussein Obama today trotted out an old standby line for struggling left wing pols — the false accusation that, if elected, the Republicans will cut the federal health care program for the aged and poor, Medicare.“Sen. McCain would pay for part of his plan by making drastic cuts in Medicare – $882 billion worth,” Sen. Obama (D-Ill.) told a crowd in Roanoke, Virginia, today. “Eight hundred eighty two billion dollars in Medicare cuts to pay for an ill-conceived, badly thought through health care plan that won’t provide more health care to people, even though Medicare is already facing a looming shortfall.”

As Infection Protection & Control’s San Francisco correspondent, Peter Menkin reported last month, Medicare has already been reformed during the last few years and the Bush administration is saving costs through new measures, for example, by reducing risk of nosocomial infection for patients whose health coverage is paid for by the program. If patients don’t get sick from an infection  from MRSA or C. Difficile when they are in the hospital for another reason, that saves the government money. A spokesman for Republican nominee, Sen. John McCain (R-Ariz.), called Obama’s charge about future spending cuts for Medicare an outright lie.“Unlike Barack Obama’s risky plan, John McCain’s plans for health care do not punish struggling businesses with fines and taxes, and they certainly do not cut a single benefit for Medicare or Medicaid – Obama is simply lying,” said Tucker Bounds, the spokesman. “It’s absurd for Barack Obama to label John McCain’s plans to trim spending for Medicare and Medicaid as ‘drastic cuts,’ only to then say that his own plans to make cuts will ‘strengthen’ those programs. For Barack Obama to talk about the hope of America and then proceed into misleading and hypocritical accusations only underscores what voters already know: Barack Obama is not who you think he is.”

According to a poll published today by the Associated Press, Obama has sunk drastically in the polls during the last week, since word of his Marxist-style plan to “confiscate the wealth” of Americans was revealed during his encounter with an Ohio plumber, named, Joe, on the campaign trail. AP says Obama leads now by 44-42 over McCain, and, with the error rate for polling taken into account, the race is statistically tied.

– by Gene J. Koprowski, Editorial Director and Nancy Bruening, Executive Editor

Doctors say MRSA infections getting so severe they have to be surgically drained

Doctors say that about 85 percent of MRSA infections may be traced back to a hospital stay and a total of two-thirds of the cases occur after a patient has arrived back home.

Many patients mistake the infection for a spider bite. The infection forms spots that look like pimples or boils, and it can deepen and then spread. Most of the time simple drainage is all that’s needed, but other times it becomes invasive and goes painfully deep into the surrounding tissues and even the blood stream.

A report in The Wall Street Journal this week indicated that a diabetic man in his 50s developed a MRSA infection on his chin recently. Doctors think a nick from shaving might have started the disease. The infection spread from his chin to the inside of his mouth. He developed another infection under his arm this year and had to have a surgeon drain it.

All people harbor skin bacteria. Some are worse than others. About 25 percent to 30 percent of people have staph bacteria on the skin or in the nose and can pass it to others.

Nearly 18,650 people died from MRSA infection and 94,000 others were seriously sickened in 2005, according to the Centers for Disease Control and Prevention.

Prevention is better than treatment, experts say. Finding drugs to cure MRSA infections is difficult. Bacteria are outsmarting the antibiotics science throws at them. There’s always a need for new weapons against the resistant bugs.

– by Gene J. Koprowski, Editorial Director

New report shows that nosocomial infections sparking interest in infection protection

A new report indicates that the increasing incidence of nosocomial infections has generated interest in development of new infection protection and control strategies all around the world.

The study, Pipeline Insight: Nosocomial Vaccines Minefield or Goldmine, produced by Report Buyer, indicates that S. aureus is the most frequent pathogen present in the hospital setting in most western countries.

An estimated 292,000 hospitalisations with a diagnosis of S. aureus occur each year in the U.S.

The pathogen is the most frequent cause of skin and soft tissue infections and affects a wide range of different patient groups.

Infections are associated with a longer hospital stay, a poorer clinical outcome and high treatment costs.

With S. aureus emerging as an increasing problem, considerable efforts are being made to reduce infection rates.

Hygiene-improvement strategies, such as hand-hygiene programs, thorough disinfection of medical devices and isolation of infected patients have been implemented in many countries.

Though some success has been achieved with these strategies, their overall impact on infection rates has been limited thus far, and they are unlikely to remain efficacious in the long run, particularly considering the rapid spread of S. aureus in the community setting.

As the reimbursement status for the cost of hospital-acquired infections is under pressure by payors, interest in preventing these complications at the outset is growing.

– by Gene J. Koprowski, Editorial Director