Category: MRSAid For Nasal Decolonization

Vancouver General Hospital Trial Proves Safety, Efficacy and Work-Place Integration of MRSAid™ Photodisinfection Therapy

MRSAid ApplicationRecently published in the Journal of Hospital Infection, the Vancouver General Hospital’s inaugural deployment of Ondine Biomedical’s MRSAid™ Photodisinfection in a universal decolonization study concluded that it was successful in its ability to decolonize Staph aureus and MRSA from the noses of pre-surgical patients. Given the size of the treated patient population, the study was able to demonstrate both clinical and statistical significance.

In addition to proving MRSAid’s safety, the 3,068 patient trial involving elective cardiac, orthopaedic, spinal, vascular, thoracic, and neuro surgical patients demonstrated antimicrobial impact and a 40% reduction of the surgical site infection (SSI) rates. The SSI rate was reduced to 1.6% vs 2.7% (p=0.0004) for the preceding period of 4 years (historical comparison study). Most noteworthy were the 55% reduction in the surgical site infection rate of the spinal patient group, the 61% reduction in the orthopaedic group and the 80% reduction in the thoracic patient group.

From the untreated sub group, the study demonstrated that patients were 4 times as likely to contract a surgical site infection without MRSAid™ nasal decolonization as compared to having the Photodisinfection treatment. Excellent patient compliance (94% of patients) and ease of work-flow integration within the pre-operative ward were significant advantages that contributed to VGH’s adoption into standard infection control and patient safety practices.

The Need for Universal Pre-Surgical Decolonization: Overcoming the Disadvantages of Antibiotics

Up to 30% of patients are carriers of Staph aureus. Colonization rates of the serious antibiotic resistant version of Staph aureus, known as MRSAid (one of the 3 major superbugs), range from 2% in Canada to 80% in Shanghai Ordinarily, these pathogens do not impact patients until they are weakened by illness or surgery. Post-surgical infection is a risk for patients colonized with this pathogens and therefore has led to the need for removing or reducing the bacterial load carried around by these patients just prior to surgery.

MRSAid ApplicationDisinfecting the skin prior to surgery has long been a standard of care. Whether with iodine, chlorhexidine washes or other antiseptic surfactants, reducing the bacterial load on the skin surface has been established as an important mechanism to control the rate of post-surgical infection. The nose, which is a warm, moist environment ideal for bacterial growth, however had been difficult to decolonize.

In several studies, the nose has been identified as the key reservoir of Staph aureus and MRSA, representing 40% of the bacteria load in one small area. Because the nose is not washed on a regular basis, unlike other body parts, Staph aureus can easily flourish in the nose and become a source of contamination for other body parts. Because of delicate mucosal tissue and the presence of cilia in the nose, the antiseptic washes used for hardier skin surfaces are not appropriate for use in the nose. Instead, nasal decolonization has been done by topical antibiotics such as mupirocin.

Topical antibiotics have 3 significant disadvantages that have resulted in many infection control experts rejecting pre-surgical nasal decolonization protocols. With sub-optimal patient compliance, infection control experts fear the resulting antibiotic resistance formation brought about by sub-optimal doses of antibiotics that occur when patients stop mid-way through their antibiotic treatments. Poor patient compliance, despite advisories about the severity of MRSA and Staph aureus infections, is the leading disadvantage of antibiotics.

The problem is the inconvenience and unpleasantness of antibiotic creams in the nose. Patients are known to dislike the thick viscosity of mupirocin and often do not comply with the 3 times a day for 5 days treatment protocol. Incomplete doses of antibiotics leads then to antibiotic resistance which in turn adds to, not subtracts from, the risks already present with patients colonized with Staph. This is the primary reason why many hospitals have not opted for nasal decolonization protocols despite the 30-40% reductions in surgical site infection rates demonstrated in clinical trials.

The second disadvantage of antibiotics is the time required to decolonize. On average, decolonization using topical antibiotics requires about 5 days which implies that patients need to be screened and identified early enough for the efficacy of antibiotics to kick in.

The third disadvantage of antibiotics, however, is the inconvenience to patients and the costs to the health care system to culture for and identify Staph aureus and MRSA carriers.  Because of antibiotic resistance concerns, only carriers of Staph and MRSA are given nasal decolonization therapy. New rapid diagnosis technologies have emerged, but prior to Photodisinfection, there was little acceptance of these rapid diagnostics because antibiotics, the decolonization remedy, still required 5 days treatment for effect. The saving of 2-3 days prior to a 5 day treatment protocol did not justify, to many, the additional cost of same-day rapid diagnosis.

Photodisinfection eliminates the disadvantage of antibiotics thereby allowing for universal nasal decolonization. Because there is no resistance formation, it is safe for all surgical patients, even if they are not carriers of Staph aureus or MRSA. Not having to spend the time or cost to identify carriers of Staph is an enormous benefit to work flow integration and patient compliance rates. Because the Photodisinfection process is instant, decolonization can occur at the hospital in the minutes before a surgery. Because it is painless and effective and only lasts 5 minutes, the treatment is well tolerated by patients and compliance can exceed the 90% range as was the case in the Vancouver General Hospital study (94%)7.

Photodisinfection is the disruptive new technology that finally enables health care providers to universally protect their surgical patients. Universal pre-operative decolonization protocols can materially impact patient safety outcomes and should therefore, in my view, be integrated into standard of care.

Nasal Decolonization is Important for Patients Undergoing Major Surgery

People carry bacteria inside the warm, moist environments of the nose. In this location, bacteria can thrive since we do not wash out the insides of our noses. Hair inside the nose also adds to the ability of the bacteria to reside successfully in this location. One type of problematic bacteria is Staphylococcus aureus (MSSA), and its antibiotic resistant strain, Methicillin-resistant Staphylococcus aureus (MRSA).

Bacteria in the nose is difficult to eliminate safely. In the past, the medical community relied on topical antibiotics to eliminate nasal bacteria but this involved pre-screening patients and then pre-surgical treatment several times daily up to one week ahead of a surgery. In addition to the time and effort disadvantages, use of topical antibiotics for prevention of surgical site infections resulted in significantly higher rates of resistance to those antibiotics, in part, due to the low patient compliance rates of less than 35%.

Why is bacterial colonization of the nose an issue to patients about to undergo a major surgery? Patients who are recovering from major surgeries have a compromised immune system. When our immune systems are not up to par, bacteria can become opportunistic. They can sense when the host immune response is weakened and become more aggressive at a time with the patient’s body is much less capable of warding off a bacterial infection. For this reason, people who carry certain bacteria in the nose prior to surgery are more likely that others to succumb to a post operation surgical site infection.

Surgical site infections are infections that occur after surgery in the part of the body (whether on the surface skin area, or in deeper tissue such as organs and muscle) where the surgery was performed. According to the CDC, up to 3% of patients who have a surgery will develop a surgical site infection. In a number of studies, it was demonstrated that eliminating the bacteria in the nose prior to infections has a significant impact, typically cutting the rate of surgical site infections by half.  Non-antibiotic nasal decolonization approaches that do not require patient compliance are therefore of great importance to both the patient and the health care system. Photodisinfection is a non-antibiotic therapy that has been proven to be highly effective at safely eliminating bacteria from the noses of patients and has significantly reduced the rate of surgical site infections in its debut hospital deployment.

Why New Innovations In Infection Control Are Important To Our Future

Recently, a report from CTV’s medical specialist Avis Favaro and producer Elizabeth St. Philip highlighted our innovative technology being used at Vancouver General Hospital. After a year long project, the use of MRSAid nasal decolonization and chlorhexidine body wipes before surgery demonstrated a significant reduction in the number of patients contracting surgical site infections.

We are counting on public support to encourage early adoption of this important infection prevention technology in our healthcare facilities. Lives and better patient outcomes are at stake as so many of our current antibiotics have become less effective against a growing number of superbugs. Everyone now knows of someone who has died of an infection; this was not the case when I was growing up.

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Vancouver General Hospital’s MRSAid Pre-surgical Decolonization Team Wins BC Quality Award

“In addition to decreasing surgical site infections, the project raised awareness of the importance of preventing infections, increased communication and teamwork at multiple levels and across numerous services and departments, and also promoted antimicrobial stewardship” ~BC Patient Safety & Quality Council

Wow, we couldn’t be more excited by this news!

Dr. Elizabeth Bryce and her team at Vancouver General Hospital (VGH) have been awarded the BC Quality Awards in the Getting Better category for their work implementing MRSAid Photodisinfection System and body wipes into their perioperative center.

This award is given to an initiative focused on improving care for acute illness or injury. Between June 2011 and May 2012, the team at VGH decolonized the noses of 5,300 patients using MRSAid. This procedure was done just prior to surgery, destroying any harmful bacteria that resides in the patient’s nose, and thus reducing their risk of developing an infection after surgery.

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MRSAid Photodisinfection System Featured On Canadian National CTV News

So, we’re pretty excited about this! CTV ran a story this past weekend featuring our MRSAid Photodisinfection System.

In the article, “Hospitals Using Light Technology To Keep Patients, Room Bug-Free,” they discuss how using MRSAid at Vancouver General Hospital has led to a 39% reduction in surgical site infections, and a $1.9 million cost savings to the hospital.

“It takes less than five minutes and it’s not painful,” said Dr. Wong, one of the dedicated team members at VGH. “Photodisinfection has several distinct advantages. It is not subject to any type of drug resistance and it doesn’t develop drug resistance.”

To watch this interview, click on the link below!

Dr. Elizabeth Bryce Awarded Champion For Change Award For Integrating MRSAid into VGH

Left: Carolyn Cross, our CEO and Chairman. Right: Dr. Elizabeth Bryce, Champion For Change

Today is a proud moment for all of us. We’re here to honor a visionary doctor for championing an unheralded change in infection control – Dr. Elizabeth Bryce. Dr. Bryce is the recipient of the inaugural Champion For Change Award for her outstanding leadership in championing the VGH-MRSAid quality improvement project.

“Congratulations to Dr. Bryce on her well deserved recognition. To us, she most certainly is a champion of change and innovation. Her dedicated team at Vancouver General Hospital did a superb job integrating a new protocol into their surgical procedures, trailblazing the path for better patient outcomes.” Carolyn Cross, CEO & Chairman of Ondine Biomedical Inc.

The award, given to her by the Women Presidents’ Organization and GroYourBiz, recognizes global leaders who envision better ways of benefitting their community. “I’m honored to be recognized … I’m even more thrilled about the evidence-based results we are seeing from the use of MRSAid to save lives – and time – and money. Our team’s achievements are a world’s first, an enormous breakthrough for infection control and a huge coup for VGH.”

Watch the video below to see Dr. Bryce and her dedicated team at VGH discuss MRSAid.

MRSAid Photodisinfection Technology Demonstrates Successful Results At Vancouver General Hospital

We did it!  After an intense year-long quality improvement project at Vancouver General Hospital, we’ve very excited to announce the successful results of this project.

Here are some highlights of the data:

  • Surgical site infections were reduced by 39%
  • Vancouver General Hospital saved ~$1.9 million
  • Readmissions due to surgical site infections decreased from 4 to 1.25 cases/month
  • 553 patient bed days were freed up
  • 138 more surgeries could be performed

In this project, patients were treated with MRSAid in their nose and given chlorhexidine body wipes prior to surgery. This was done in an effort to reduce the patient’s bacterial load and decrease their risk of developing surgical site infections.

Today is a very proud day for all of us. We can’t thank the amazing team at Vancouver General Hospital enough for their willingness to champion innovation and change. The results of this project mark a global first for photodisinfection as a non-antibiotic approach to reducing surgical site infections.

We have a very busy week ahead of us, so please stay tuned to this blog as we’ll be bringing you a lot more updates over the next few days.

To read the full press release, please click here: http://www.prweb.com/releases/OndineBio/12/prweb10229844.htm

And don’t forget to check out this video we did with some of the wonderful nurses at VGH:

MRSAid™ – High Hopes For A New Era In Infection Prevention

Over the coming year, the world will learn more about our MRSAid™ photodisinfection technology and its ability to prevent surgical site infections.  The last patients in the year long quality improvement program at Vancouver General Hospital (VGH) will be treated next month, giving us a chance to look retrospectively at how surgical site infections were affected at this major hospital. This program, involving over 5,000 patients at VGH, sought to reduce infections in all patients undergoing cardio, vascular, neurological, thoracic, breast, spinal and orthopaedic surgeries.  Data from this analysis is expected in the late fall and results are expected to be announced at Infection Control Conferences in 2013.

People who carry MRSA or MSSA are at much greater risk of self infection when they are immunocompromised and weakened after surgery. Up to 30% of patients are simply unable to defend themselves from the tenacious bacteria called Staphylococcus aureus which lie dormant in the nose, waiting for opportunities to invade the body. Eliminating the bacteria carried in the nose prior to surgery has been proven to reduce the rate of surgical site infections. From a number of other studies (including Bode et al “Preventing SSIs In Nasal Carriers of Staph”), we have learned that eliminating both MRSA and MSSA from the nose prior to surgery reduces surgical site infections (SSIs) by up to 56% and total healthcare-associated infections (HAIs) by up to 79% in non-surgical admissions.

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MRSAid Is Live-blogging from Canada’s Leading Microbiology and Infectious Disease Conference

9:04am: Today, the MRSAid team is live-blogging from the AMMI-CACMID annual conference. If you are one of Canada’s top clinical microbiologists or infectious disease specialists, this is THE place to be. We’re very excited to be attending this conference for the first time, and can’t wait to speak w/ some of the top professionals in the country.

10:18am: The AMMI-CACMID conference is meant to bring together students and professionals in the areas of microbiology, antimicrobial stewardship, infectious diseases, infection prevention and control, and public health. Judging by the turnout at the opening lecture, they’ve certainly done a great job bringing these people together. Just check out the packed room!

10:42am: Lectures this morning have been incredibly interesting and it is clear from the talks that MRSA problem is not going away. In fact, MRSA colonization rates in high-risk patients have been as high as 15%! Read More

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