Posts tagged: mrsa infection

What’s Up Doc: Why are only half of you complying with hospital hand hygiene rules?

“The critical thing that all of us as healthcare providers can do is clean our hands between patient contact: and that is the number one, two, and three action to keep our patient safe,” said Dr. John Embil, Director of Infection Prevention and Control at Winnipeg’s Health Sciences Centre, in an interview (beginning at the 12:54 mark) at a recent conference on infection control at the HSC.

Patient safety is a live issue because hospital-associated infections (HAIs) are the most common serious complication of hospitalization in Canada, affecting 10% of all patients in acute-care hospitals and are the fourth leading cause of death. And crucially, the contaminated hands of healthcare workers are the most common vehicles of transmission in most settings. In other words, HAIs are preventable.

The solution is literally at our fingertips: just wash your hands. As simple as that seems, the data is telling us that not only is that not happening, it’s also telling us that doctors, of all people – the leaders and role models in the hospital environment – are the biggest offenders.

The hospitals themselves are reporting low hand washing compliance rates of about 65% for nurses and less than 50% for doctors. For example, the Vancouver Island Health Authority reported physician compliance rates as low as 18%.  Yet some people say even those numbers are too high because they are gathered at a time when staff are told they are being monitored. Thus, they argue, the true rate is anywhere between 10 and 30%, with anecdotal evidence suggesting – stunningly – that doctors never wash their hands, outside of surgery.

Physician non-compliance so concerns the medical community that it will be the focus of an upcoming Canadian study that was announced this past February: i.e. why aren’t physicians washing their hands and what can be done about it? In a literature review conduct by the researches in advance of their own investigations they have identified several reasons specific to doctors: namely, physicians reported not ‘remembering to perform hand hygiene;’ ‘high workload or feeling too rushed;’ educational gaps in infection control training among physicians; a perception among physicians that their compliance is much better than it actually is; the development of a more cavalier attitude towards infection control as clinical experience increases, with an associated drop in compliance rates; and the lack of positive role models among physicians who are part of a healthcare team.

Healthcare worker hand hygiene as defined by Dr. Embil above is a hospital Required Organizational Practice, what Accreditation Canada considers an evidence-based best practice that mitigates risk and contributes to improving the quality and safety of health services.

So what’s up doc? If you aren’t getting something  as simple as the hand washing thing right, should patients and their families be asking what else you might not be getting right?

Antibiotic Usage needs to be Studied for Long Term Harm

Apart from the creation of superbugs, overuse of antibiotics has negative consequences including killing many of our beneficial bacteria.  In the grand scheme of things, little is known about the bacteria we live with, and how they individually as a species, and collectively in combinations forming biofilms, get affected by various exposures to our antibiotics.  Insufficient research is being conducted to help us find the answers.

Some research has suggested that antibiotic use may play a role in conditions that lead to obesity, Type 1 Diabetes, inflammatory bowel disease, allergies and even asthma, a common chronic airway disorder. Patient populations suffering from all of these chronic diseases appear to be increasing in prevalence, but very little is being done to understand if anything in contributing to all of these conditions as a group instead of just individually.

In agriculture, antibiotics have been used as “growth promoters” enabling farmers to increase their livestock yield, as their animals can gain more weight with less food. The influence of these antibiotics on the livestock we eat is likely to have some impact on our own bodies but this field has not yet been adequately investigated primarily due to lack of financial motivation. In Europe, where usage of antibiotics in livestock as growth promoters has been banned, it was determined that the same dollars spent on extra food resulted in the same growth as yielded by the additional antibiotics.

Given that antibiotics are a critical part of our medicinal arsenal, it is not likely that antibiotics will be replaced any time soon. However, it is important to start asking the questions and dedicate more resources to learning more about how the antibiotics we use directly and indirectly are truly affecting us. Once we learn more about this impact, then we can start to make progress in influencing the development of new alternatives and better approaches to antibiotic usage.

When the future becomes the past: MRSA and microbial resistance

Let’s step into a time machine for a moment. Acquire some plutonium, unlock the Delorean, rev it up to 88 miles per hour and we’re good to go.  Destination: 1770.

The late 18th century was a pretty great place. Nations were being thought up and defended, women piled their hair into fantastic curly creations complete with white powder and men could sport walking sticks without looking like a try-hard hipster.

Sounds great right?

Unfortunately, it was also a time when the result of contracting a minor cold was often death.

Back to the future… (get it?).

This is the scenario (albeit somewhat exaggerated) that awaits us as a society if we do not tackle the problem of antibiotic resistance, according to the top health official in the UK.

Sallie Davies, chief medical officer for England, called for a global fight against microbial, or antibiotic, resistance, as well as a push to fill a drug “discovery void” to treat mutating superbug infections like MRSA, the National Post reported Wednesday.

According to the same report, new antibiotics are few and far between, and only a handful have been marketed in the past few decades. This means that when a new strain of resistant bacteria emerges, there is very little we can do to treat against it.

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How Much Is Your MRSA Death Worth?

Traditionally, disease has been presented as an army of creepily crawly microbes, lurking on every surface and wafting through the air, waiting to jump up onto our skin or sneak into our nostrils to infect us.

But in an eternally ironic twist of circumstances, the very thing that we use to fight off the bacterial invader might actually be our most fickle foe. According to the medical journel Lancet, antibiotic resistance is now “a global health concern.”

With friends like that, who needs enemies?

The increased exposure to all sorts of antibiotics in our everyday lives has made it so that bacteria that used to be wiped out by a dose of antibiotics have developed resistant strains.

One of the most common – and most serious – of these is Methicillin-resistant Staphylococcus aureus (MRSA), the resistant strain of the staph bacteria most commonly found in health-care settings. Read more »

Which Country Leads The World In Infection Surveillance?

The Centers for Disease Control and Prevention (CDC) estimate that healthcare-associated infections cost the United States approximately $45 billion and claim the lives of thousands of patients annually. Surveillance of infections have become an enormous challenge for the healthcare systems across the world, and have become increasingly problematic due to antibiotic resistance. So which country is leading the world in this area?

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MRSA Rampage: Two Stories of Infection In The Community And Hospital

Mentioning MRSA to someone outside of the medical field often elicits a blank stare or a vague look of confusion and mistrust.  In fact, going so far as to mention Methicillin Resistant Staphylococcus Aureus (MRSA) is usually enough to end a conversation completely.  For the most part, the destructive, life-altering scope of MRSA isn’t known to the general public—nor is the risk of acquiring MRSA in the hospital.  Knowing many patients and health care workers, I’ve seen prognoses that have varied from life-threatening and permanently disabling, to non-deadly, but career ending.  This is the story of two acquaintances of mine: one who contracted MRSA in the community at large, and another who contracted MRSA while at the hospital.

Down on her luck, living in a small, government subsidized apartment, my first acquaintance was forced to share her space with several other near-homeless individuals.  Crowded in a tiny room, many of her roommates were poorly fed and suffered from mental illness.  As is the case in many situations of extreme poverty, drug abuse and poor hygiene were rampant—as were skin infections.  Such close-knit quarters were a breeding ground for CA-MRSA, or Community Acquired MRSA.  Community Acquired MRSA differs, in that it’s a) often more aggressive b) less resistant to antibiotics than its hospital counterpart.

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Are MRSA Vaccines The Only Solution To Preventing Superbug Infections?

In an attempt to find new ways to prevent cases of MRSA, researchers have been working to develop a new vaccine. Several pharmaceutical companies have attempted to create vaccines for MRSA in the past, but such endeavors have not been successful. The main reason for this is that it is not known what makes individuals immune to the disease. Current research into a MRSA vaccine is in the very early stages, and even if a successful vaccine was developed, it would take years to receive approval.

We often blog about the importance of preventing surgical site infections. An effective vaccine to combat MRSA would be a major milestone in the fight against antibiotic resistance. This is because powerful antibiotics are used to treat active MRSA infections, and each time such therapies are used, the more likely it becomes for the bacteria to develop resistance. Thus, the most optimal treatment would be to prevent MRSA before it occurs. If a successful vaccine was to be developed, it would likely be given prior to surgical procedures, and in those with compromised immune systems. But, why wait years for a MRSA vaccine to be developed when there are simple solutions available right now? Read more »

Can Honey Really Kill MRSA?

As antibiotic resistance becomes an increasing issue, researchers are busy investigating natural alternatives to fight deadly infections. Researchers in Liverpool for example, investigated the effects of using honey as an antibacterial agent for post-operative wound care in the fight against MRSA. Patients that had honey applied to their wounds had 36% fewer incidences of infection, and spent around 25% less time in the hospital compared to those who were not administered honey.

Lead researcher, Dr. Val Robson, explained that honey has antibacterial properties because of its high sugar content, presence of hydrogen peroxide, and low water content. Robson has since dubbed the honey utilized in this study “Medihoney.”

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The Human Microbiome Project: When Bad Bacteria Turns Good

When we think of antibiotic misuse, we often think of how it contributes to big name superbugs such as C. diff and MRSA. But what often goes overlooked is how antibiotic misuse affects the many microbes that are beneficial to our health. While the Human Microbiome Project is a step in the right direction towards learning more about combating horrible diseases like C. diff, it is also a huge advancement in terms of understanding which microbes truly benefit us—and which ones we may have been too quick to label as hazardous to our health.

Take for example the germ H. pylori. During the 1980s, it was discovered that H. pylori was a causative agent for peptic ulcers. While this major discovery resulted in the treatment of such individuals by aiming to eradicate H. pylori microbes from the stomach, researchers are now discovering possible adverse implications of this.

Before I begin discussing how the Human Microbiome Project has already impacted our knowledge of H. pylori, I want to make it clear that I am not by any means suggesting that this particular microbe is not hazardous to our health. In other words, I’m not suggesting you go and ingest H. pylori as Barry Marshall did in order to validate his theory about H. pylori and peptic ulcers. Read more »

1 In 3 Nurse Bags Carry Deadly Superbug MRSA

Lipstick? Check. Wallet? Check. Car keys? Check. Deadly bacteria???

Sometimes, we carry around more than we think in our bags; such is the case for hundreds of mobile clinicians in the UK and around the globe. Studies show that 55% of nurses’ medical bags that have been used to deliver community care – that is, at home medical care – in the UK are never cleaned. A mere 6% are said to be cleaned weekly. And yet, a nurse visits an average of 17 patients a day, the majority being for wound care. Plug all these stats in, and it is not surprising to hear that one third of all medical bags are said to carry the MRSA bug. There doesn’t exist any official cleaning standards for nurses` bags, and as a result, traditional bags are often outdated, unsafe, simple rucksacks made from absorbent material. They’re full of pockets, buttons, zippers, and folds that are difficult to clean and that can serve as perfect housing and free public transit for bacteria, particularly MRSA.

My grandmother, a community nurse in her day and a hand sanitizer-aholic, recounts that even in being conscientious of cleaning her bag regularly it was nearly impossible to get every surface, for all the snaps and crevices prevented thoroughness. She could sterilize until the cows came home, but the deepest corner of the side pocket, or the underside of the zipper, or the crease in the fabric were forever vulnerable to bacteria.

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