Acinetobacter Alert

Probe launched into Madrid hospital deaths

Link: Probe launched into Madrid hospital deaths - Yahoo! News UK.

Authorities in Spain launched Sunday an investigation into the deaths of at least 18 people in a reported bacteria epidemic at one of Madrid's main hospitals. (Advertisement)

Deputy Prime Minister Maria Teresa Fernandez de la Vega, who was on an official visit to Niger, announced a probe into what she described as "a very, very serious incident" at the 12th October University Hospital.

El Pais reported that at least 18 people had died in a bacteria epidemic that infected more than 250 patients over a period of 20 months at the hospital.

The deaths were caused by Acinetobacter baumannii, a highly virulent hospital-acquired infection that has strains that are resistant to most drugs, the daily reported.

The situation was so bad at the hospital that the intensive care unit had to be destroyed so that a new, non-contaminated structure could be built, the report said.

The hospital's director, Joaquin Martinez, denied at a press conference alongside his preventative medicine chief Jose Ramon de Juanes that 18 deaths were directly caused by the bacterial infection.

Patients in a critical state "die from their illness, accompanied exceptionally by an infection of multi-drug resistant Acinetobacter baumannii and other types of micro-organisms, because they are more vulnerable due to their health problems," said Juanes.

According to El Pais, the bacterium infected a total of 252 patients between February 2006 and its eradication 20 months later.

More than 100 of those patients died, although only 18 of them directly from this infection, the report said.

Killer Germ Comes Home With Troops

Link: ABC News: Killer Germ Comes Home With Troops.

Troops arriving home from Iraq and Afghanistan have been carrying a mysterious, deadly bacteria, according to a new magazine report.

Doctors have linked the bacterium acinetobacter baumannii to at least seven deaths, as well as to loss of limbs and other severe ailments, according to the report, which found the bacterium has spread quickly since the war in Afghanistan began in the fall of 2001

Acinetobacter baumannii has been found in military hospitals in Germany, the Washington, D.C., area and Texas -- the primary destinations of wounded service members from the two war zones. And it has now spread to civilians, according to the report.

"The outbreak began traveling with patients or nonpatients from Iraq all the way back to Walter Reed," said Dr. Rox Anderson at Harvard Medical School.

Insurgents in the Bloodstream

Link: Insurgents in the Bloodstream.

"It's why I lost my leg, so it sucks."

The assessment, from a 22-year-old Marine toughing out physical therapy on two prosthetic limbs, is laconic, matter-of-fact. Sgt. David Emery lost one leg in February 2007 when a suicide bomber assaulted the checkpoint near Haditha, Iraq, where he and fellow Marines stood guard. Military surgeons were forced to remove his remaining leg when it became infected with acinetobacter baumannii-a strain of highly resistant bacteria that since U.S. forces began fighting in Iraq and Afghanistan has threatened the lives, limbs, and organs of hundreds wounded in combat.

"They could have saved it," says Emery. "They had a rod in it, but then the bacteria was in too bad and my white blood cell count was up to 89,000-and they told my mom on a Friday that they had to take it."

Emery's mother recalls that the hazard was not confined to her son's limbs.

Acinetobactor concern over disinfectant impact

Link: Reduction of disinfectant bactericidal activities in clinically isolated Acinetobacter species in the presence of organic material -- Kawamura-Sato et al., 10.1093/jac/dkm498 -- Journal of Antimicrobial Chemotherapy.

Methods: The bactericidal activities of the four disinfectants against 283 strains of Acinetobacter species recovered from 97 Japanese hospitals in March 2002 were investigated by four different tests: MIC measurements, MBC measurements, time-killing assays and adaptation assays. Moreover, disinfectant efficacy was examined in the presence of BSA in two tests: MBC measurements and time-killing assays.

Results: No clinical isolates were able to withstand the in-use concentrations of the four disinfectants, although the MIC90 of ADH reached 100 mg/L. Strains for which MICs of at least two disinfectants were higher than MIC90 measured by the broth microdilution method were defined as isolates with ‘disinfectant reduced susceptibility (DRS)’. In the presence of 3.0% BSA, the MBCs of BZK, BZT and ADH for DRS isolates rose to 512 and 1024 mg/L, which were about half their in-use concentrations. Moreover, the times for bacterial complete killing were remarkably prolonged in DRS isolates even after a 10 min of exposure to 1000 mg/L of ADH, a half of its in-use concentration. The MICs of CHX for DRS isolates rose to 640 mg/L after repetitive passages in subinhibitory concentrations of CHX.

Conclusions: Given that the bactericidal effects of the four major disinfectants were considerably reduced in the presence of organic material (BSA) and DRS isolates tended to adapt to CHX, continuous surveys of the profiles of susceptibility to disinfectants among clinically isolated Acinetobacter species are very necessary from the standpoint of nosocomial infection control.

Copper, Silver better than steel when it comes to hygiene

Link: The Associated Press: Copper, Silver Tested As Germ Wards.

In a British study published last year, drug-resistant staph germs survived for three days on stainless steel plates kept at room temperature, but the researchers found no sign of the germs on pure copper after 90 minutes.

The new study, funded by a government grant to the Copper Development Association, is putting that finding to a real-world test involving three drug-resistant bugs — staph, enterococci and acinetobacter.

First, researchers are swabbing down a handful of ICU rooms at New York's Memorial Sloan-Kettering Cancer Center, the Medical University of South Carolina and Charleston's Veterans Affairs Medical Center. They must learn where the germs lurk, explains Sloan-Kettering lead researcher Dr. Kent Sepkowitz.

Then the hospitals will substitute copper for some germ-prone surfaces in those rooms, and track if the change makes a difference.

Copper is expensive, but so are hospital-caused infections, Sepkowitz says.

"The question is will it save more money than it costs," he says.

Fears over superbug from Iraq, Afghanistan

Link: Fears over superbug from Iraq, Afghanistan - Telegraph.

Last year, the Department of Health admitted that wounded soldiers returning from Iraq may have spread the superbug to NHS wards and hospitals were urged to step up preventative measures.

The Ministry of Defence insists that the risk of being infected by A.baumannii is low and there has not been a case since November 2004.

Armed forces 'superbug' causing intense alarm

Link: Armed forces 'superbug' menaces UK | Special Reports | Guardian Unlimited Politics.

Although different types of acinetobacter have been known for decades in hospitals, the new 'T' strain identified in the injured troops is particularly virulent and has been observed to appear in US servicemen within two hours of being admitted to a field hospital. It affects the spinal fluid, bones and lungs, causing pneumonia, respiratory failure and other complications. Equally worrying is its resilience. Extremely difficult to eliminate from medical facilities once established, the bug can survive for up to 176 days in a human host. US officials concede that, once established in the medical evacuation chain, the germ is almost impossible to stamp out.

Although the Ministry of Defence tried to play down fears of the infection when the first suspected British cases were reported last year in the Lancet, its increasingly rampant progress through America's military hospital system has been causing intense alarm elsewhere.

TROOPS BRING BUG TO CANADA

Link: TROOPS BRING BUG TO CANADA.

Federal authorities are warning hospitals across the country to beware a highly drug-resistant bacterium that wounded troops are bringing back from Afghanistan -- and which could inadvertently be spread to civilian patients.

The threat posed by the resistant strain of acinetobacter underlines the health care system's general lack of readiness for such emerging infections as they arrive in the country, said a senior Public Health Agency of Canada official.

Several soldiers being treated in civilian hospitals here have already developed pneumonia from the drug-resistant strain of the bacterium, which scientists say likely originated in the Canadian-led trauma centre at Kandahar Air Field.

Acinetobactor Part Of Growing "Superbug" Problem

Link: Kansas City infoZine News - Infectious Diseases Experts Issue New Strategies Report to Address Growing "Superbug" Problem - USA.

But the problem goes well beyond MRSA. IDSA is concerned about other drug-resistant superbugs looming on the horizon, including E. coli and tuberculosis, as well as less-familiar names such as Clostridium difficile, Klebsiella, Pseudomonas aeruginosa, and Acinetobacter.

IDSA's report was issued during a major federal meeting called by the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Food and Drug Administration (FDA) to update the federal Action Plan to Combat Antimicrobial Resistance, first issued in 2001. For the meeting, the federal government has brought together a panel of more than 60 medical, veterinary and infectious diseases consultants, including IDSA physician leaders, to reshape and strengthen existing action items relating to antimicrobial resistance surveillance, prevention and control, research, and product development.

The Society's report is intended to help guide the revision of the federal Action Plan, influence congressional action on the three IDSA-endorsed bills and, finally, to press for a significant increase in appropriations to support federal efforts.