MRSA (Mersa, Staph) Questions

A Milestone In The Fight Against MRSA Is Reached With Antibiotic Impregnated Catheters

Link: A Milestone In The Fight Against MRSA Is Reached With Antibiotic Impregnated Catheters.

Data presented at a conference in America shows that catheters impregnated with the antibiotics minocycline and rifampin not only reduce the risk of bacteraemia (the presence of bacteria in the blood), but also the likelihood of bacteria developing antibiotic resistance. This research has very positive implications for those fighting the spread of healthcare associated infections (HCAIs) - which affect at least 100,000 people a year in the UK and cost the NHS in the region of £1,000 million.[1] Dr Duncan Wyncoll, a Consultant Intensivist in London believes that the findings will be of significant interest to doctors in the UK. He said: "It is very reassuring that resistance doesn't increase with long term use of the antibiotic impregnated catheters. It is also great to see such a long term and sustained decrease in catheter related bloodstream infection (CRBSI) rates with use of these catheters.

Catheter solution leads to major decrease in infections

Link: Trisodium citrate (TSC) 46.7% selectively and safely reduces staphylococcal catheter-related bacteraemia (CRB) -- Winnett et al., 10.1093/ndt/gfn299 -- Nephrology Dialysis Transplantation.

Background. Trisodium citrate (TSC) 30% has been shown in a randomized control trial to be an effective antimicrobial catheter locking solution, able to significantly reduce catheter-related bacteraemia (CRB) in haemodialysis patients. Since that report, the formulation in Europe has been changed to 46.7% TSC without confirmatory data on efficacy. We report a 55 915 patient-day at risk experience in tunnelled lines of 46.7% TSC, emphasizing efficacy and changes in microbiology seen. Methods. On 1 July 2006, inter-dialytic catheter locking solution was changed from 5000 IU/ml heparin to Citra-lockTM (46.7% TSC) in all haemodialysis patients at Barts and the London Renal Unit dialysing through an incident or prevalent tunnelled catheter. Prospectively collected blood culture data for the 6 months prior to the switch and 3 months at the end of the first year of TSC use were analysed. TSC tolerability was excellent with only a single withdrawal for intolerance of the agent. No major adverse events were reported. Results. A major fall in CRB rates was noticed with a change from heparin (2.13/1000 catheter-days) in 2006 to TSC (0.81/1000 catheter-days) in 2007. This was due to significant reductions in staphylococcal CRB, true for sensitive, methicillin-resistant and coagulase-negative staphylococci. No increase in catheter malfunction was observed. Conclusions. We found that 46.7% TSC is a safe, convenient and highly effective catheter locking solution, leading to significant reduction in CRB largely by preventing staphylococcal bloodstream infections. Given that Staphylococcus aureus in particular is associated with serious and often disseminated infection, TSC seems to be a powerful tool for dialysis units.

Curtis and Xerox launch antibacterial paper to help combat superbugs

Link: Curtis and Xerox launch antibacterial paper to help combat superbugs | printweek.com | Latest Print Industry News, Jobs, Features, Product Reviews, Used Printing and Packaging Machinery.

An antimicrobial document paper said to kill 99.9% of bacteria is set to be launched by Scottish speciality papermaker Curtis Fine Papers and Xerox. The pair has teamed up to develop the paper, which can be printed without affecting its antibacterial capabilities. It will be targeted at hospitals, private healthcare organisations and GP surgeries. Andrew Broad, custom solutions business manager for Xerox Office Supplies, said: "If by developing a range of antimicrobial papers, we can play a part in preventing the spread of hospital-acquired infections such as MRSA, then we are achieving our objective in a critically important situation." As well as MRSA and E.coli, the paper has been shown to be effective against Salmonella, Listeria, Pseudomonas and C.difficile. It has been tested according to the Japanese Standard Test (JISZ2801).

Catheter technology fights MRSA

Link: HEALTH AWARENESS.

Now there is a technology that helps to prevent contamination and growth of certain bacteria within the needleless IV access device commonly used with IV catheters. Baxter Healthcare Corporation recently introduced the V-Link Luer-activated device (LAD) with VitalShield protective coating, making it available for hospitals around the country. V-Link with VitalShield is the first needleless IV connector to contain an antimicrobial coating and has been shown to kill on average 99.9 percent of specific common pathogens known to cause catheter-related bloodstream infections, including MRSA. Silver has been used for centuries as an antimicrobial agent, and the specially designed silver formulation that coats this device has been shown to be effective against a broad spectrum of infection-causing agents. The silver antimicrobial coating helps prevent the contamination and growth of specific pathogens within the device. Reduction in colonization or microbial growth on the device has not yet been studied to substantiate a reduction in infections.

Silver-Coated Endotracheal Tube Dramatically Reduces Resistant Infections

Link: Silver-Coated Endotracheal Tube Dramatically Reduces Resistant Infections.

A silver-coated endotracheal tube may reduce infections with highly resistant bacteria over traditional tubes by nearly half, according to the results of a large randomized trial to be presented at the American Thoracic Society’s 2008 International Conference in Toronto on May 19. Patients who are on ventilators are often at risk for developing ventilator-associated pneumonia (VAP) because of resistant bacteria. “VAP is a serious disease with significant mortality,” said lead investigator Andrew Shorr, MD, MPH, of Washington Hospital Center in Washington, D.C. “Crude mortality rates from VAP approach 25 percent to 30 percent and VAP rates are now thought to reflect hospital quality. These infections include highly resistant pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA), which are the most troubling ones and often the hardest to treat. The average costs associated with treatment of VAP exceed $40,000 because of the impact on length of stay in the ICU.” To test the efficacy of the silver-coated tube in preventing infections, the study included a modified intention-to-treat population of 1,509 subjects, balanced between traditional endotracheal tubes and the silver-coated ones. The researchers used brochoavelolar lavage fluid cultures to ascertain the presence of pathogenic organisms and classified as “highly resistant” organisms MRSA, Pseudomonas aeruginosa (PA) and Acinetobacter bumanii (AB).

Cannula care to cut MRSA by one third

Link: Channel 4 - News - NHS trust claims MRSA elimination.

This means that doctors use the tube only when absolutely necessary and are able to monitor them closely for signs of infection. The cannulae are prescribed only by specialists trained in their insertion and they are signed off by a doctor. Once in, the cannula is flushed with a saline solution and inspected on a daily basis. A scorecard is then used to regularly rate its appearance and spot any irregularities or signs of infection. In 2007/08, the Trust had 11 MRSA bloodstream infections - one under the maximum level of 12 the Government says is acceptable for it. Four of these cases were believed to have been cannula-related. But since the introduction of the new system in November, there have been no new cases of MRSA at the Trust, which runs the Royal Hampshire County Hospital in Winchester and the Andover War Memorial Hospital. The Trust believes that if the same practice was adopted nationwide by the NHS, MRSA levels would drop dramatically.

Hospital Winning Mrsa Fight by attention to cannula hygiene

Link: Hospital Winning Mrsa Fight (from Hampshire Chronicle).

WINCHESTER'S Royal Hampshire County Hospital claims it has discovered a new way to help fight the spread of hospital infections. A doctor and nursing sister at the Romsey Road hospital have found a "simple" way to cut MRSA rates, which could have national implications. Since a change in policy was introduced at the hospital six months ago, there have been no new cases of the deadly superbug. advertisement Now Dr Chris Gordon, consultant physician and divisional director of medicine at Winchester and Eastleigh Healthcare NHS Trust, believes it could slash infection rates and save lives in hospitals across the UK. It involves better management of what is called a cannula, a thin tube inserted by needle under the skin to administer intravenous fluids.

New keyboards to be 70% less infective

Link: NHS cleans up keyboard act - Public Sector - Breaking Business and Technology News at silicon.com.

The NHS is introducing 7,500 infection-resistant keyboards in hospitals across England as part of efforts to make hospitals cleaner and safer. The keyboards have been developed by University College London Hospital in a pilot supported by the Department of Health tech agency, Connecting for Health. The devices are completely flat to avoid collecting debris that often harbour infections and are covered with a hypoallergenic material which is resistant to bug growth. The keyboards also have a warning light to alert users when they haven't been cleaned for a certain time. This period is adjustable depending on the environment. This light only goes out once sensors on the device are satisfied it has been sufficiently cleaned. UCLH microbiologists have found the new tech can lead to a 70 per cent fall in bacteria levels on keyboards if they are properly cleaned every 12 hours.

Developing hygenic hardware for hospitals

Link: Developing hygenic hardware | Technology | The Guardian.

Five years in to the world's largest civil computerisation programme, the NHS in England is waking up to the danger of computers creating fast lanes for hospital infections. The IT agency NHS Connecting for Health has just spent £1m on custom-designed PC keyboards that are not only cleanable, but encourages users to clean them. The snag is that the deal covers only 1% of the NHS's keyboards. A quick inspection of any keyboard shows how they collect muck. In an office, it's disgusting; in hospitals, it's potentially lethal. Dr Peter Wilson, a consultant microbiologist at University College Hospital, London, says that studies have found up to a quarter of keyboards in wards are contaminated with MRSA and other pathogens. Vital signs The danger arises from the way the NHS shares computers, he says. A nurse taking blood pressure and other vital signs will enter them on the keyboard directly after touching the patient. "She doesn't wash her hands between patient and keyboard, because she's not touching any other patients." However a doctor making a ward rounds will later touch the keyboard to check data - and then move on to the next patient. "That's how an infection can go round the entire ward," Wilson says.

Hospitals will have to pay for preventable infections

Link: CMS Regulations To Be Addressed At APIC Conference.

Beginning October 1, 2008, CMS will no longer reimburse hospitals for costs related to eight preventable conditions, including three HAIs: catheter-associated urinary tract infections (UTIs), catheter-associated blood stream infections, and mediastinitis (a deep infection following coronary artery bypass surgery). The APIC conference will present information on how leading institutions are managing the clinical and economic impact of the new HAI regulations and practical strategies to assist facilities with compliance. "We see this as an important opportunity to help clinical and administrative leaders work together to reduce infection, improve outcomes and preserve healthcare resources," said APIC Chief Executive Officer Kathy L. Warye. "The conference will offer the most current information from CMS, as well as best practices and ways of approaching quality improvement to achieve reductions in HAIs."