Oprah's Dr Oz on MRSA

Dr Oz discusses MRSA on a recent Oprah show. See the MRSA safety tips on the Oprah web site.

Superbugs and Antibiotics: A Deadly Dance

Clostridium difficile, a contagious and potentially deadly pathogen, isn't just increasingly resistant to antibiotics. It's often triggered by antibiotic treatment.

An article in the Cleveland Clinic Journal of Medicine describes the bacterium, also known as C-diff, as a gram positive, spore forming bacillus that was first linked to disease in 1978 when it was identified as the cause of antibiotic-associated diarrhea and colitis. The February 2006 article, by Rebecca Sunshine, MD and L. Clifford McDonald, MD, says that more than 90 percent of healthcare associated C-diff cases occur after a patient has received antibiotic treatment for some other illness. The story is posted in the website of the federal Centers for Disease Control and Prevention.

Treatments with antibiotics are likely to disturb the bacteria that normally live in the digestive tract and colon. If a person's exposure to C-diff coincides with that that disruption, the C-diff bacteria flourishes and releases toxins that are harmful to humans.

An April 14 story in The New York Times by Tara Parker Pope reports that health authorities estimate C-diff causes 350,000 infections each year in hospitals alone, with tens of thousands more in nursing homes, and that 15,000 to 20,000 people die annually from the infection. C-diff spores are hardy and live on environmental surfaces and people's hands and clothing. They are not killed by alcohol based hand sanitizers and hospital cleaning agents. It takes bleach to kill them, which increases the difficulty of eradicating them.

A national prevalence study of C-diff conducted by the Association for Professionals in Infection Control and Epidemiology (APIC) indicated 13 of every 1,000 patients in US healthcare institutions are infected or colonized with C-diff. Based on that rate, on any given day at least 7,178 patients are infected or colonized, at a cost that could range from $17.6 million to $51.5 million. The APIC study, released in November 2008, reported the C-diff incidences rate is between 6.5 and 20 times greater than previous incidence estimates indicated. The Times story notes C-diff now rivals MRSA as one of the top emerging disease threats to humans.

While C-diff has become increasingly virulent and increasingly resistant to antibiotics, recent research findings may lead to better treatment. A March 1, 2009 story in ScienceDaily reports that C-diff manufactures different toxins, and that researchers may have focused on the wrong one. Dr. Dale Gerding, a co-author of the study, published in the journal Nature, explained that while researchers have focused on Toxin A, recent research shows the real culprit is Toxin B. Gerding and colleagues found that the organism was fully virulent and caused disease when Toxin A was knocked out, but did not cause disease when Toxin B was eliminated. Researchers think understanding the relative importance of the two toxins could help pave the way for new methods to combat deadly C-diff infections.

House Staff Gym Disinfected After MRSA Report

From NBC4 in Washington, DC -

The [U.S.] House of Representatives staff gym got some special attention after an employee caught MRSA.

The extra sanitization was a precaution, according to Karissa Marcum, a representative of the House. It's unknown how or where the employee contracted the infection, but since the employee is a member of the House Staff Fitness Center, the Office of the Attending Physician recommended the extra cleaning.

Read complete article

Reducing Healthcare-Associated Infections

From Congressional Testimony by Richard Besser, Acting Director, CDC

Committee: House Appropriations
Sub-Committee: Labor, Health and Human Services, and Education, and Related Agencies

CDC and its partners have translated successful pilot projects at the local level into regional and ultimately national implementation programs. CDC funded and collaborated with the Pittsburgh Veterans Affairs Medical Center to prevent MRSA infections using CDC recommendations. These efforts led to greater than 60 percent reductions in MRSA rates. Because of this success, healthcare facilities in southwestern Pennsylvania collaborated on the development of a regional MRSA initiative and subsequently, the Veterans Health Administration launched a national MRSA prevention initiative involving every Veterans Health Administration hospital in the country, modeled after Pennsylvania's success. In order to increase adherence to CDC recommendations, CDC is working with several groups to assess the effectiveness of many other successful implementation strategies, such as Positive Deviance strategies. These and other prevention implementation examples demonstrate the savings in lives and healthcare costs that can result from national implementation of evidence-based HAI prevention programs.

Read complete testimony (pdf)

Why MRSA?

Every year about 2 million people acquire an infection during their hospital stay and almost 100,000 of them die due to their infections. Alarmingly most of these infections are bacterial infections that are resistant to commonly used antibiotics, with MRSA being the most virulent and most rapidly growing infections.

In 2005[ the latest available data year] there were 386,600 cases of MRSA infections in hospitals and those who were infected with MRSA are hospitalized an average of 10.0 days, about 6 days LONGER than they needed to stay had they not contract the infection. And more than 94,000 of the MRSA infections are the most dangerous kind- the kind that attacks your heart, lungs and bloodstream.

Do you know how many people died? About 19,000- and according to the NYT- this is far more than HIV/AIDS, Parkinson's disease, emphysema, or homicide!

PD helps fight MRSA

The Robert Wood Johnson Foundation (RWJF) and the Plexus Institute (Plexus) today announce results from an analysis of a multifaceted methicillin-resistant Staphylococcus aureus (MRSA) prevention program that employed positive deviance (PD), a novel approach to social and behavioral change, to trigger significant reductions in MRSA incidence ranging from 26 to 62 percent at participating hospitals.

In addition, as MRSA rates dropped, the hospitals saw a decline in the proportion of Staphylococcus aureus infections caused by methicillin-resistant bacteria, signifying that hospitals can make headway in the fight against drug-resistant superbugs.

“Reports of successful multicenter interventions to reduce endemic antimicrobial resistance problems among U.S. hospitals are extremely rare,” says John A. Jernigan, MD, MS, an epidemiologist at the national Centers for Disease Control and Prevention (CDC) and part of the CDC team that conducted the analysis. “These extremely encouraging findings add to a growing body of evidence that hospitals can make a difference in their endemic MRSA rates, and further might be able to improve the chances that infected patients have the best possible treatment options available. It shows that hospitals can make an important difference in antimicrobial resistance even at a time when the availability of new antibiotics has stagnated.”

Read more at plexusinstitute.org.

MRSA on CBS Evening News

Jasper Palmer, an escort servicve worker at Albert Einstein Medical Center demonstrates how to safely and efficiently remove the gowns and gloves worn while caring for patients in isolation because of contageous infections. His method also reduces trash volume. Doctors and nurses tell how they used Positive Deviance working together to protect patients from MRSA infections.

Read the complete story at cbs.com