Let us keep you informed via our e mail news update. Click here for more information. Check the latest news now at our headline page. Discuss MRSA using the comments link at foot of stories). Discover our MRSA Watch book of the month - Visit our bookstore. We have 2,800+ stories - see list below or categories in side columns.
Link: Keeping Your Fingers Clean: ProTouch PB or XT for Apple Keyboards.
Have you ever taken a minute and looked at the keyboards of your office mates. My Gosh! How can they even touch them you might ask yourself. Just like we tell our children to wash their hands before every meal and after using the bathroom, why don't we wash our keyboards before each use? Probably because running them under warm water with a little anti-bacterial soap would be a reason to void your warranty. Recently I read an article on engadget about Hospitals being sick of dirty keyboards and for good reasons. Unclean, contaminated keyboards can cause skin infections as well as trigger life-threatening bloodstream infections such as VRE and MRSA, not mention just pass icky common colds and flus. Who wants those? This is probably the number one reason for me to buy a ProTouch for all my Apple keyboard products. Not only does it help prolong its life, it also keeps me healthy (as long as I keep it clean). The ProTouch PB or XT installed by placing it over your keyboard. There is no tucking, no adhesive, no hair blow-dryer needed. All you have to do is line up the keys and start typing. Typing will allow the ProTouch to attach itself to the keys for a more airtight fit. The product will amazingly stay in place until you're ready to lift it off the keyboard and clean it. Cleaning it is just as easy as putting it on. Run some warm water from your kitchen faucet and squeeze it out like a sponge. Let it dry and then place it back on your keyboard; that's it.
Link: Nephrology Dialysis Transplantation.
Infection is a serious complication of tunnelled cuffed catheter (TCC) use and is associated with high complication and mortality rates. Although attempts at TCC salvage after bacteraemia have been associated with high rates of recurrent bacteraemia, there have been no large studies in which multivariate analysis has been performed to control for confounding factors such as infecting organisms, diabetes, etc.
Conclusions. We have shown, using multivariate analysis and adjusting for potential confounding factors, that the use of TCC salvage and S. aureus are independent risk factors for treatment failure after an episode of TCC bacteraemia, and that S. aureus is an independent risk factor for developing an infectious complication. An infected-appearing TCC exit site is associated with a higher mortality rate. Episodes of TCC bacteraemia treated using TCC salvage are associated with the highest treatment failure rates. TCC guidewire exchange can be an acceptable practice, unless severe exit site or tunnel infection is present.
Link: Privacy Curtains Proven Source Of MRSA Contamination.
A study from The Queen Elizabeth Hospital in Birmingham, UK, has highlighted a hitherto overlooked source of the killer super-bug MRSA. It has long been thought that environmental hygiene was the key to curbing the spread of the organism and infection-control staff across the country have been charged with ensuring that wards are kept clean, staff are meticulous over hand washing and wherever possible incidents of airborne infection are minimised. Until recently however one vital piece of the jigsaw has been missing, but at long last there is hard medical evidence to show that the privacy curtains surrounding patients' bed are an important but overlooked source of outbreaks. The Department of Microbiology at Birmingham's Queen Elizabeth hospital in collaboration with local partners has produced a report that conclusively proves a link between dirty curtains and MRSA. The results of this controlled study show that ‘The curtains surrounding the patients beds were the predominant source with comparatively high counts of organisms found'.
Link: Courier News Story.
THE POTENTIALLY deadly superbug MRSA could be spread by chairs used to move patients around Ninewells Hospital in Dundee, a Tayside ambulance officer has warned. The officer, who wishes to remain anonymous, said the chairs are not cleaned between patients—even when those patients are known to have MRSA. He claimed porters use the chairs not only to transport patients but also to move fluids and other objects around the hospital. He also claimed porters were approached by ambulance personnel concerned about the risk of spreading dangerous bugs but porters responded it was “not their responsibility” to clean the chairs between patients. “The infection control team at the hospital are really big on infection control,” said the ambulance officer. “If you go in to a ward you are told you are not allowed to sit on a patient’s bed or sit in a patient’s chair. “But if you go to level six at Ninewells, where the ambulances come in and out, porters’ chairs are constantly getting used and, between patients, they are not getting cleaned.
Link: Man Machine Inc..
Designed to promote patient safety, Simply Cool Keyboard can be sprayed or immersed in 10% bleach solution, alcohol, or other chemical disinfectant to deter spread of viruses, germs, and other MRSA pathogens. Unit is 100% latex-free as well as USB and PS/2 compatible. It feels and types like standard keyboard, but with no cracks or crevices where microbes can hide and grow. Keyboard is suited for nurses' stations, ORs, ICUs, clinical areas, and hospital carts.
Link: ClickPress
Medifix Limited announces the launch of U-Cannula™, designed to help doctors to cannulate with ease, reducing the number of attempts to cannulate successfully and prevent the spreading of hospital acquired infections like MRSA. Medifix has successfully re-designed, patented and produced the U-Cannula, optimised the technique and incorporated needle tip protection. The U-Cannula™ can help prevent accidental needle stick injuries and cannula fracture.
Link: Postgraduate Medical Journal.
Hospital acquired or nosocomial infections continue to be an important cause of morbidity and mortality. The critically ill patient is at particular risk of developing intensive care unit acquired infection, with the lungs being especially vulnerable. Nosocomial bacterial pneumonia occurring after two days of mechanical ventilation is referred to as ventilator associated pneumonia, and is the most common nosocomial infection seen in the intensive care unit. Intubation of the trachea and mechanical ventilation is associated with a 7-fold to 21-fold increase in the incidence of pneumonia and up to 28% of patients receiving mechanical ventilation will develop this complication. Its development is associated with an attributable increase in morbidity and mortality. The establishment of an accurate diagnosis of ventilator associated pneumonia remains problematic and as yet there is still no accepted "gold standard" for diagnosis. The responsible pathogens vary according to case mix, local resistance patterns, and methodology of sampling. However, there is general agreement that rapid initiation of appropriate antimicrobial therapy improves outcome.
Link: Washable Computer Mice Stop The Spread Of Infection.
A waterproof computer mouse that can be fully immersed in a sink or basin could be a major breakthrough in the spread of infection in hospitals, offices and homes. The ScrollSeal optical mouse is a fully-sealed, moulded unit with a unique scroll wheel that ‘clicks' out before washing and then just as easily, ‘clicks' back in. Its UK inventors, Unotron Ltd, are predicting that their little mouse will become one of the most significant preventative measures since the introduction of hand washing. The ScrollSeal mouse is the latest in a line of washable computer technology that started with the SpillSeal washable keyboard. Using now patented technology the SpillSeal washable keyboards can be fully immersed in sterilising fluid for just 30 seconds* to completely rid them of bacteria such as Staphyloccocus aureus.
Link: Volamp
Could this touch keyboard help keyboard related infection control issues?
The MOSKEY (Patent applied for) is a combined keyboard and absolute mouse. It consists of a durable, easy to clean touch sensitve panel, has no mechanical moving parts and is resistant to a wide variety of substances, including most common liquids. This qualifies its use in environments otherwise alien to keyboards, mice and trackerballs.. The MOSKEY employs the touch panel, under which is a graphic keyboard layout, as a keyboard, or an absolute mouse that utilises the whole area of the panel. The MOSKEY is supplied with USB interfaces. No extra software is required. Functionality A touch button selects keyboard or mouse mode, LED's indicating the active mode. The MOSKEY can be toggled between the two modes, with an audible indication at change over.
Link: Chest
We reviewed the epidemiology, clinical manifestations, and outcomes of 3 cases of chest tube-related empyema due to methicillin-resistant Staphylococcus aureus (MRSA). Antiseptic-impregnated chest tubes were inserted in cultures containing MRSA isolates from these 3 patients, and zone of inhibition were measured. Chest tube-related MRSA empyema might complicate tube thoracostomy, and coating the chest tube with antiseptic agents could prevent this complication.
Link: Infection Control Today
Rigorous attention to patient safety and monitoring for unexpected spikes in bloodstream infection rates at the Johns Hopkins Hospital led a team of Hopkins specialists to uncover an unintended, surprising safety problem with a new device that was supposed to make patients safer and easier to treat.
“No one could have anticipated this outcome,” says senior hospital epidemiologist Trish Perl, MD, an associate professor of medicine and pathology at The Johns Hopkins University School of Medicine. “But, our experience underscores how advances in technology designed to improve healthcare may also have hidden risks to patients that can only be identified by paying close attention to what happens after the technology is put into practice.”
In a case study reported in the latest edition of the journal Infection Control and Hospital Epidemiology online Jan. 6, 2006, a team of Hopkins patient safety experts describe how the introduction of a catheter valve newly marketed to the hospital in April 2004 coincided with a spike in potentially deadly bloodstream infections picked up by patients in the hospital’s pediatric intensive care unit (PICU) and other intensive care units.
Once the increased rate was confirmed, Hopkins experts launched an investigation that identified an intravenous catheter valve as the likely source of infection. No one at Hopkins died from the infections. Hopkins stopped using the valve and alerted the Food and Drug Administration (FDA), which approves use of medical devices, and the Centers for Disease Control and Prevention (CDC), which monitors infections in hospitals, the report noted.
Link: HighWire Press -- Medline Abstract.
In this study a total of 219 patients who developed nosocomial infections and were treated in Sisli Etfal Training and Research Hospital between January 2001 and March 2003 were evaluated retrospectively. In all, 337 bacterial strains were isolated in these patients. The aim of our study was to assess the causative agents of catheter-related nosocomial infections, the distribution rate of causative agents due to hospital units, infection sites and catheter types, and determine the risk factors which facilitate such nosocomial infections. The most frequently isolated causative agents in catheter infections were Pseudomonas spp. (17%), Klebsiella spp. (16%), E. coli (13%), Acinetobacter spp. (12%), Coagulase Negative Staphylococci (CNS) (11%) and Methicillin-Resistant S. aureus (MRSA) (9%). In 136 (59%) patients infections were due to urinary catheterization and in 52 patients (23%) due to tracheal aspiration catheters. Of the 229 catheters applied, the polymicrobial infection rate was found to be 24% (55 patients). Multiple drug resistant strains were more frequently isolated in Intensive Care Units (ICU). It was emphasized that as ICUs are important risk factors for the development of catheter infections, the resistance patterns of the isolated microorganisms from the unit should be taken into consideration for the selection of appropriate antibiotics. We also conclude that it is important to avoid unnecessary catheterization and that preventive measures should be properly applied.
Link: Waterproof Mouse
IKEY, makers of the popular SlimKey-MD(TM) line of medical keyboards, announces the UK release of its latest infection control solution, the AquaPoint(TM) waterproof, optical mouse. Designed for use in healthcare settings, the AquaPoint(TM) is completely sealed from fluid ingress, while being compatible with any hospital cleaning agent. It is ideal for use in patient rooms, OR's, nursing stations, or anywhere cross-contamination is a concern. It features a comfortable, ergonomic design, as well as smooth-surface buttons that are easily wiped clean. Its optical technology allows the AquaPoint(TM) to function on nearly any surface, while its rugged, silicone overlay, polycarbonate frame and solid-state engineering, all ensure the AquaPoint(TM) a long operating life.
The AquaPoint(TM) waterproof mouse is now available in the UK exclusively through FB Peripherals Ltd.
Link: European Respiratory Journal.
Inappropriate therapy (IT) and delayed initiation of appropriate therapy (DIAT) result in inadequate therapy in patients with ventilator-associated pneumonia (VAP). The aim of the current study was to assess the impact of DIAT in VAP. A total of 76 mechanically ventilated patients with bacteriologically confirmed VAP were prospectively evaluated in the intensive care unit of six hospitals in Buenos Aires, Argentina.
Appropriate therapy was defined as coverage of all the identified pathogens by the antimicrobial therapy administered at the time of VAP clinical diagnosis. The clinical pulmonary infection score was measured during the 3 days before, at the onset and during the days which followed the onset of VAP. A total of 24 patients received adequate therapy; mortality was 29.2%. The remaining 52 patients received either IT (n = 16) or DIAT (n = 36); the mortality was 63.5% combined, and 75.0 and 58.3% for IT and DIAT, respectively (statistically significant compared with adequate therapy).
Inappropriate therapy and delayed initiation of appropriate therapy increased the mortality of ventilator-associated pneumonia. Patients with inappropriate therapy and/or delayed initiation of appropriate therapy had a more gradual increase in clinical pulmonary infection score than those receiving adequate therapy, and this increase was found to occur prior to the time of the clinical diagnosis.
In conclusion, these findings might provide the rationale for a trial of earlier initiation of therapy, based on clinical grounds in an effort to improve the outcome of patients with ventilator-associated pneumonia.
Link: New Nanotechnology
AcryMed Inc today announced clearance from the Food And Drug Administration (FDA) for the first use of SilvaGard™, the company's breakthrough silver nanotechnology that can render existing medical devices impervious to infection-causing bacteria. Unlike any other infection control technology available today, SilvaGard can be used to treat virtually any medical device and its use does not alter the device's original properties. Due to these and other unique attributes, SilvaGard is expected to have a significant impact on the battle against hospital-related infections.
The Centers for Disease Control (CDC) estimates that 2 million U.S. patients a year acquire hospital-related infections. These infections cost an average of $47,000 per patient to treat and cause 90,000 deaths each year. The added cost to hospitals is $4.8 billion annually in extended care and treatment.
The initial FDA clearance was given to I-Flow Corporation for marketing the company's ON-Q� SilverSoaker™ regional anesthesia delivery catheters. ON-Q SilverSoaker catheters are treated with AcryMed's SilvaGard, a silver nanoparticle antimicrobial coating that protects against the formation of infection-causing biofilm.
Link: Student's solution to kill MRSA wins award - Evening Times.
A GLASGOW-BASED graduate has won an award for his idea to halt the spread of the MRSA bug. Belfast-born Alan Boyd, a Strathclyde University graduate, scooped the prestigious Glasgow 1999 Design Medal for his solution to combat the spread of the hospital-acquired infection. Alan's design - a portable hand-washing device aimed at increasing the effectiveness of hospital hygiene - was the unanimous choice of judges for the annual design award set up by The Lighthouse. The design can be used by anyone in a ward - from doctors to patients - and incorporates a self-cleaning rotating basin as well as touch-free taps and soap dispenser. Alan worked with two medical teams in Belfast - at the Royal Victoria and the Ulster Independent Clinic. He is now collaborating with another hospital to develop the idea into a fully operational system to be used on wards. Stuart MacDonald, director of The Lighthouse, said: "Alan's design could make a major contribution to addressing a vital health issue." Publication date 01/12/05
Link: Infection Control Today: Needleless Connectors.
Needleless connectors, used today as integral components of an infusion system, evolved in response to demands for enhanced healthcare worker safety and as part of the continuing development of infusion technology. At this time, there are three design categories among needleless connectors: split septum connectors, luer activated valves, and luer valves with positive displacement. Numerous branded products are available within each category. Although needleless connectors offer enhanced safety features, there have been recurrent concerns about an increased risk of bacteremia associated with their use. This article reviews the development of these devices, examines the available evidence base, identifies unresolved issues, and suggests strategies to facilitate optimum use of needleless connectors within infusion systems. Introduction During the past two years there has been increasing concern expressed by infection control practitioners, infusion specialists, and epidemiologists that the use of needleless connectors, either generally or specifically according to design category or brand, is directly responsible for increased bacteremia inpatients receiving intravenous therapy.
Link: Brandon Medical
Brandon Medical have become the first company to produce anti-microbial operating theatre lighting. All Galaxy Ultra lighting now comes treated with Polygiene – the latest anti-microbial compound from chemicals giant Perstorp. Polygiene uses a combination of specially treated silver ions and chemical agents to break down and destroy harmful virus / bacteria / yeast cell walls. This action is effective against both SARS and MRSA. Because Polygiene is non-toxic, non-allergic and environmentally friendly Brandon Medical have been able to mould it directly into both their Galaxy Ultra and Astralite lamp heads quickly and safely. This process never needs to be repeated, as Polygiene will remain active for the entire lifetime of the light with no wearing off or diminishing effect.
Link: Hospital's TV earphones could transmit superbug.
Patients at Banbury's Horton Hospital could catch the MRSA superbug by sharing their bedside television headsets, it has been claimed. Headsets and earphones used by patients to listen to TV and radio have been passed from bed to bed without being cleaned or sterilised because of a shortage, a hospital volunteer has said. She has written a letter to Slough-based Patientline, the company which runs the service and charges patients �3.50 a day to watch TV and 49p a minute for phone calls. The volunteer, who does not want to be identified, wrote: "There are insufficient headsets to go round and certainly not enough to ensure each headset is sterilised between patients. At the very least, new foam ear-pieces should be fitted for each new patient. "Many headsets are faulty, and replacements are simply brought from other beds without being cleaned." She added with MRSA being a worry for all hospitals that this was a potential source of contamination. A spokesman for Patientline said: "There are sufficient headsets to go round, even though patients sometimes take them home.
Link: Infection Control Today
A new study shows that antiseptic-coated catheters and better safety measures in hospitals could significantly reduce the number of infection-related hospital deaths, which account for nearly 100,000 lives lost each year. The study, led by University of Nebraska Medical Center physician-scientists, is published in the Oct. 18 issue of the Annals of Internal Medicine. “Our study clearly indicates the importance of using various precautions in insertion and care of central venous catheters,” said Mark Rupp, MD, professor of internal medicine at UNMC and the lead author of the study. “Infections of these devices result in approximately 250,000 cases of bloodstream infection per year. Patient safety is a big concern.” Each year more than 2 million people in the United States develop an infection during their hospital stay. These nosocomial infections are a leading cause of death in the United States and cost nearly $5 billion annually to treat. The nine-center study evaluated a new kind of central venous catheter designed to help reduce nosocomial infections. Central venous catheters (CVC’s) are placed in a major vein to draw blood and provide nutrition and medication to patients. The CDC estimates about 53 percent of adult patients in intensive care units have a CVC on any given day. This study compared an antiseptic-coated CVC to an uncoated CVC in 780 intensive care unit patients. The results showed a substantial decrease in bacterial colonization, the first step to an infection, in patients receiving the coated catheters. But the study revealed something with even broader implications, Rupp said. It suggested that meticulous infection-control measures used by hospital personnel may have played an even greater role in reducing microbial infections than the catheter itself.
Link: online.ie: news.
Traces of MRSA have reportedly been discovered at the Coombe Women's Hospital in Dublin. Reports this morning said the so-called 'superbug' had been detected on medical equipment in the hospital's emergency room. Yesterday, it emerged that the bacterium had also been detected on the skin of five newborn babies at Dublin's National Maternity Hospital.
Link: Courier News Story.
THE DRIVE to stop patients picking up dangerous bugs in Ninewells Hospital, Dundee, is to step up a gear, writes Marjory Inglis, health reporter. Ninewells is to develop three “model” wards aimed at slashing the number of patients testing positive for MRSA and other healthcare -acquired infections. Everything from the design of furniture to the cleaning of equipment and simple hand washing is to be looked at in a bid to halt the spread of infection. Specialist advice from one of the region’s top micro-biologists will inform bosses about the measures they have to put in place.
Link: BBC NEWS | Health | Cards 'next anti-superbug weapon'.
Nurses are to be given checklist cards for routine tasks to help prevent the spread of hospital-acquired infections, it has been revealed. Nursing Standard magazine says there will be step-by-step guides for procedures such as inserting catheters, where there is a risk of infection. They are part of an infection control package for NHS trusts in England. The Royal College of Nursing welcomed the cards as "reminders" of what staff should be doing.
Link: News Of the World - Online Edition.
Another tabloid story with the fingerprints of Chemsol all over it. There are doubts about the tests they use. The other question is - so what? If you look at all the stories this man generates it seems that MRSA is on surfaces everywhere. Given that up to 30% of the population may carry it this is hardly surprising. Short of cleaning everything several times a day how would one eradicate it? For the whole story click the link above.
THE DEADLY MRSA superbug is being dispatched to hospitals by the lorry-load every day. The News of the World secretly entered an NHS storehouse where EVERY container of vital equipment we tested was contaminated. The bug was lurking on almost every surface at an NHS Logistics Authority warehouse supplying northern England. Shocking Nappies, syringes and surgical gowns—wrapped in their infected packaging—are loaded on to trucks daily at the warehouse and taken straight to hospitals. Last night a top consultant described our findings as "shocking" and said the levels of MRSA were potentially deadly.
Link: University of Manchester.
Scientists at The University of Manchester, along with healthcare product manufacturer Brimaid, have unveiled a new product which aims to aid hospitals in the fight against MRSA. The BioKab is a bedside cabinet which has been specifically designed to reduce the spread and infection of harmful bacteria in hospital wards. The cabinet is made from a polyethylene plastic impregnated with an antibacterial agent proven to kill the MRSA bug. The cabinet's unique soft-edge radiused-corner design and its light weight also means it is easy for hospital staff to keep clean and move, thus further preventing the harbouring of bacteria.
Link: The Register.
Scientists in the US have linked the spread of the hospital super bug MRSA to a sharp increase in the use of technology in hospitals. Researchers working in hospitals have found that the deadly bacteria clings to the keys of the computer keyboards used to update patient records and therefore can re-infect the hands of staff even after they had washed their hands. The US findings, which were presented to the Society for Healthcare Epidemiology of America earlier this month, found that just touching a keyboard is enough to pick up the bacteria and pass it onto a patient. Computers quickly become magnets for airborne dust and bacteria-harbouring dirt, which builds up on their internal cooling fans. The fans represent a further health hazard because of their potential to blow that same dust around a ward. "Anything that can put bacteria into the air is a risk," said Norskin. "If you bang into a computer and disturb that dust you can effectively create a dust cloud." A spokesman for the UK’s National Health Service confirmed that the department's computer specialists were looking into the concerns and that the agency responsible, NHS Connecting for Health, was conducting a study into the issue at University College London to find the risks. Dr Paul Grime, the British Medical Association's spokesman on MRSA commented: "If computers and keyboards are going to be next to people's beds then this is something that we have to be aware of because this equipment is no different from any other hard surface in a hospital but the key to this is hand hygiene and staff have to get used to washing their hands before and after touching a patient.”
Peritonitis and exit-site infections (ESI) are major causes of technique failure and morbidity in peritoneal dialysis (PD) patients. Topical mupirocin on the exit-site has been shown to reduce such complications and prolong life in PD. Since the year 2000, such an approach has been adopted for our new incident PD population. We now report the results of this new protocol. We also studied the effect of co-morbidity on peritonitis occurrence. Methods. A total of 740 incident PD patients were studied. Patients were divided into two groups based on year of entry into PD (Group 1 from January 1998-December 1999 without topical mupirocin and Group 2 from January 2000-March 2004 with topical mupirocin). Variables studied included gender, age, diabetic status, ischaemic heart disease, peripheral vascular disease, cerebrovascular disease and serum albumin. Results. Topical mupirocin at the exit-site has led to a significant reduction in peritonitis rate (0.443 vs 0.339 episodes/patient-year; P<0.0005) and ESI (0.168 vs 0.156 episodes/patient-year; P<0.005) attributed primarily to the significant reduction in Staphylococcus aureus infections.
Link: Finance - canada.com network.
Covalon Technologies Ltd. (TSX VENTURE:COV) is extremely pleased to announce that it has received a U.S.A. patent and a European Patent Certificate for its method of making silver ion-releasing anti-microbial coatings for implantable medical devices for reducing hospital acquired infections in patients. Covalon has received U.S.A. and European patent protection for its technology in applying an anti-microbial, sustained silver ion-releasing coating/complex to wound dressings, skin surface coverings and implantable medical devices for deterring the onset of hospital acquired infections (HAI) in patients. The use of skin coverings and implanted medical devices are a vital component of clinical practice, however, complications may arise from their use. Complications include the potential of the device to become the focus of microbial contamination that may lead to an HAI in the patient.
Increasing demand for ambulances has made it more difficult to ensure high hygiene standards in the battle against MRSA, a senior NHS official says. There has been a 120% rise in 999 calls, Ambulance Service Association chief executive Richard Diment said. While extra training and cleaning standards had been introduced, he said staff still had limited time to clean. There have been reports of MRSA infections from ambulances, but a lack of official research, Mr Diment said. Speaking at the Patient Association's Clean Hospitals Summit in London, Mr Diment said: "We hear of stories in the media about people getting infections from ambulances. "But what we need is more research to establish exactly what the risk is."
Link: HighWire Press -- Medline Abstract.
Modern lubricants fulfil these recommendations; in addition, they provide therapeutic opportunities for local therapy, for instance, of non-gonococcal urethritis. The latest results show that there are a few lubricants with antimicrobiotic influence on MRSA (methicillin-resistant Staphylococcus aureus), which is of great importance because of the steady increase in MRSA-dependent infections.
Link: Scotsman.com
Claire Rayner, president of the Patients Association who will chair the event, said action had to be taken to save the lives of around 5,000 people who die needlessly each year. “Clearly, something has to be done, with a problem which kills at least 5,000 people per annum – the equivalent of a fully-laden 747 crashing once a month – and in which the young and old are most vulnerable,” she said. Ahead of the conference, the Patients Association revealed evidence that equipment used in hospitals for internal examination is not always cleaned between patients. The organisation condemned “haphazard” standards following the poll of 180 infection control staff, consultant microbiologists, nurses and other hospital workers on the sterilisation of endoscopes, a long tube usually used to view the stomach and bowels. “If this is happening in a number of UK hospitals, it is inevitable that infections are spreading widely,” said Ms Rayner.
Link: Sky News
The conference is being staged in the wake of a survey by the Patients Association which revealed that hospital equipment used to examine inside the body is not always cleaned between patients and sterilising fluid was often re-used.
Link: London Free Press.
The electronic circuitry contained in keyboards, Blackberries, PDAs (personal data assistants) and other types of information technology make them particularly difficult to clean. The recent proliferation of these devices in hospitals poses a serious challenge for infection control. "The difficulty with keyboards is you can't pour bleach on them. They don't work so well when you do that," Allison McGeer, an infection control specialist at Toronto's Mount Sinai Hospital, said when asked to comment on the study. McGeer noted another Toronto-area hospital eventually had to ditch keyboards a few years ago when it was battling an outbreak of vancomycin-resistant Enterococcus (VRE). "We could not get the keyboards clean."
Link: Computer equipment could help MRSA spread.
Keyboards and computer equipment installed in hospitals may aid the spread of 'superbug' bacteria such as MRSA, a study in a Chicago hospital has revealed. Just touching a keyboard is enough to pick up the bacteria and potentially pass it on to a patient, according to the results of the study. Furthermore, cleaning the equipment with soap and water, according to the manufacturer's instructions, may not remove the infection. Dr Gary Noskin, medical director of healthcare epidemiology at the Northwestern Memorial Hospital in Chicago, who carried out the study, told Reuters that the only solution was frequent hand-washing. "Hands are washed before treating a patient, but hand washing prior to computer use is superfluous. Most hospitals are not aware of this." Dr Noskin's team contaminated three computer keyboards with common bacteria found in hospitals, namely vancomycin-resistant Enterococcus faecium (VRE) and methicillin-resistant Staphylococcus aureus (MRSA), as well as non-drug resistant Pseudomonas aeruginosa. While the bacteria that were not resistant to any drugs dissipated after an hour, the two drug-resistant bugs, VRE and MRSA, remained on the keyboard for twenty-four hours.
Investigations into the bacteria that infest urinary catheters could relieve millions of patients each year from the discomfort of recurrent infection, according to an article in the February 2005 issue of Microbiology Today, the quarterly magazine of the Society for General Microbiology. Around 100 million catheters are used each year to provide a convenient way to drain urine from the bladder of many elderly or disabled patients. Unfortunately, they provide an ideal surface for a community of different bacteria to grow in the form of a biofilm. The problem seems to be one bacterium in particular, Proteus mirabilis, which causes salt crystals to form in the urine and the biofilm. The crystals quickly build up, encrusting the catheter and blocking the flow of urine. Researchers at the Cardiff School of Biosciences are trying to understand how these biofilms are formed in order to design better catheters. "The microbes in catheter biofilms are mixed communities containing many species and our research is looking for factors produced by other bacteria that can inhibit crystalline biofilm formation by Proteus mirabilis", explains Dr David Stickler. Even with meticulous nursing care, all patients undergoing catheterisation for longer than a month will develop urinary infections. "Preventing P. mirabilis from forming crystalline biofilms is essential, if we are to improve the health and quality of life of so many individuals", says Dr Stickler.
Link: SocietyGuardian.co.uk
Almost a quarter (24%) of hospital staff frequently encounter dirty medical equipment, according to a new survey. The Patients Association poll found "on-going fears" among frontline healthcare staff in England and Wales about the "overall cleanliness of medical devices", with a tenth reporting that dirty instruments slip through decontamination procedures. The association called on the NHS to introduce an electronic database to track every item of medical equipment in hospitals and cleaning plants to ensure they are all decontaminated. Simon Williams, the director of policy at the association, said individual items were not tracked under the current system, which meant that some dirty equipment evaded decontamination. Mr Williams said: "This survey overwhelmingly shows that there is a strong need to track individual surgical instruments to protect patients safety using modern IT systems. "With the technology now available to individually code most medical devices, the reasons for resisting this significant patient safety step must be few."
Link: MRSA bug.
Brimaid has spent two years developing a bedside cabinet, the BioKab, which is moulded from high-grade polyethylene impregnated with a continually active anti-microbial bactericide called Irgaguard. As well as destroying most germs with which it comes into contact, the furniture features a soft, rounded design which is easy to clean and eliminates the nooks and crannies where germs normally gather. Brimaid director Trevor Iles revealed that the BioKab's design had been inspired by a hospital ward sister's firm conviction that traditional bedside cabinets were a breeding ground for infectious germs. "Traditional cabinets are square and the sister was particularly concerned about the inability to fully clean and disinfect internal corners and joints between the tops and sides of the cabinets," said Mr Iles.
Link: Mrsa: 22 Feb 2005: Written answers (TheyWorkForYou.com).
Advice on appropriate precautions to reduce the spread of infection has been published by the Department in the health service circular 2000–02 and in Winning Ways—Working together to reduce hospital acquired infection in England (December 2003). All healthcare organisations, including ambulance trusts, should have systems in place to minimise the risk to patients from healthcare associated infections as required by Standards for Better Health (July 2004). Infection control policies and any particular precautions for reducing the spread of methicillin resistant Staphylococcus aureus (MRSA" >MRSA) are a matter for individual trusts. The Ambulance Service Association published guidelines on infection prevention and control in June 2004. Additionally, the training and common core syllabus for ambulance personnel covers infection control, including reference to MRSA.
Link: HighWire Press -- Medline Abstract.
In recent years, general and urinary tract infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have became an increasing problem worldwide. Catheterization of the urinary bladder is one of the most significant risk factors for MRSA contamination of the urine.In vitro tests have documented the antimicrobial activity of the catheter lubricants Instillagel and Endosgel against MRSA specimens within 5 min. These findings support recommending the use of these lubricants in high-risk patients in hospitals and old people's homes for prophylaxis of MRSA bacteriuria.
Link: Tameside Advertiser - News.
A TEENAGER fighting a crippling lung disease suffered a second blow after catching MRSA in hospital. Rachael Wakefield, 17, has to be hooked up to oxygen 24-hours-a-day and is a virtual prisoner in her own home. But now she faces a new battle after being struck down by the deadly superbug in Tameside Hospital. It is believed she contracted the blood-borne infection through a Hickman line inserted under the skin to administer antibiotics. Mum Lynnette and stepdad Phil Mottershead, 34, are furious and may take further action.
Link: HighWire Press -- Medline Abstract.
Background and objective:
In recent years, meningitis caused by methicillin-resistant S. aureus has increased. This study was undertaken to compare the clinical characteristics and prognosis of methicillin-resistant S. aureus (MRSA) postneurosurgical meningitis and methicillin-sensible S. aureus (MSSA) postneurosurgical meningitis.Patients and methods: Twenty-five episodes of postneurosurgical meningitis due to S. aureus (13 methicillin-resistant strains) seen during a ten-year period were retrospectively reviewed.
Results: Most common underlying diseases were: intracerebral hemorrhage (50% of MRSA patients and 46% of MSSA patients) and neoplasm (53% of MRSA patients and 33% of MSSA patients). Eleven patients (6 of them with MRSA infection) had received antibiotic treatment previously. Thirteen patients were carriers of intraventricular catheters (8 with MRSA infection), 5 wore a ventriculoperitoneal shunt (4 with infections by MSSA), 5 cases had a CSF leakage (4 with infections by MRSA), and one patient with infection by MSSA wore an epidural catheter. Fiftteen patients were cured (7 with MRSA infection), and 8 died due to the infection (27% with MSSA infection and 38% with MRSA infection).
Conclusions: The prognosis of postneurosurgical meningitis by S. aureus does not depend on the presence of resistance to methicillin. Nowadays, the intravenous administration of vancomycin is the treatment of choice in MRSA meningitis.
Link: HighWire Press -- Medline Abstract.
Transducers are medical products that are categorized as uncritical, semicritical and critical, depending on their applications and perceived risks . Uncritical medical products are transducers that solely come in contact with the intact skin, such as transducers used for sonography of the abdomen or breast. Semicritical medical products are transducers that come in contact with mucosal membranes or diseased skin, comprising transducers used for transesophageal, transvesical, transvaginal, transrectal and perineal sonography. Critical medical products are transducers that come in contact with blood, internal tissues or organs, such as transducers used for intraoperative sonography. Under the most unfavorable circumstances, sonographic transducers can become contaminated with pathogenic agents (e. g., MRSA, HBV, HCV, HIV, Herpes viruses) and turn into a not to be underrated source of infection. For this reason, correct handling as well as cleaning and disinfection of the transducers are indispensable. Depending on the application, the recommended handling of the transducers differs
Click the link above for more
Link: HighWire Press -- Medline Abstract.
BACKGROUND: Catheter-related bloodstream infections (CR-BSIs) are associated with substantial mortality, prolongation of hospital stay, and increased cost of care. Dalbavancin, a new glycopeptide antibiotic with unique pharmacokinetic properties that have allowed clinical development of a weekly dosing regimen, possesses excellent activity against clinically important gram-positive bacteria, suggesting utility in the treatment of patients with CR-BSIs. METHODS: A phase 2, open-label, randomized, controlled, multicenter study of 75 adult patients with CR-BSIs compared treatment with intravenous dalbavancin, administered as a single 1000-mg dose followed by a 500-mg dose 1 week later, with intravenous vancomycin, administered twice daily for 14 days. Gram-positive bacteria isolated in this study included coagulase-negative staphylococci (CoNS) and Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). RESULTS: Infected patients who received weekly dalbavancin (n=33) had an overall success rate (87.0%; 95% confidence interval [CI], 73.2%-100.0%) that was significantly higher than that of those who received vancomycin (n=34) (50.0%; 95% CI, 31.5%-68.5%). Adverse events and laboratory abnormalities were generally mild and were comparable for the 2 drugs. CONCLUSIONS: Dalbavancin thus appears to be an effective and well-tolerated treatment option for adult patients with CR-BSIs caused by CoNS and S. aureus, including MRSA.
Link: Journal of Diagnostic Medical Sonography.
An investigation was conducted to determine how well sonographers clean transducers and other sonography-related equipment. Previous studies have shown that cross-contamination is possible between patients during a sonogram and may lead to nosocomial infections. The potential for infecting patients is now common knowledge, so research was conducted to establish how well sonographers are sterilizing the equipment. The equipment from the sonography departments of six hospitals and clinics was tested for the presence of bacteria and fungi. Growth was present at every facility. Although only normal skin flora, including yeast, were isolated, sonographers must be more diligent in the prevention of cross-contamination in patients.
Link: Journal of Antimicrobial Chemotherapy.
Objectives: To test the efficacy of gendine, a novel antiseptic, containing Gentian Violet and chlorhexidine, in coating different medical devices, including endotracheal tubes (ETT) and urinary catheters (UC). Gendine-coated UC significantly reduced the amount of viable MRSA, E. coli or C. parapsilosis organisms adhering to their surfaces when compared with silver/hydrogel-coated urinary catheters or control uncoated catheters (P < 0.01). Similarly GND-ETT significantly reduced the adherence of the same organisms as well as P. aeruginosa when compared with control (P ≤ 0.02). Conclusions: GND-ETT and GND-UC impregnated using an instantaneous dip method, were shown to have broad-spectrum activity, prolonged antimicrobial durability and high efficacy in inhibiting adherence of organisms commonly causing nosocomial pneumonia and urinary tract infection. Furthermore, these coated devices were shown to be non-cytotoxic.
Link: HighWire Press -- Medline Abstract.
Using the modified Kirby-Bauer method, gendine-coated devices showed zones of inhibition of >/=15 mm against methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Escherichia coli and Candida parapsilosis. RESULTS: Gendine-coated endotracheal tubes (GND-ETT) soaked in bronchoalveolar fluid (BAL) and incubated at 37 degrees C maintained a zone of inhibition of >/=15 mm against MRSA and P. aeruginosa for at least 3 weeks.
Link: - Journal of Antimicrobial Chemotherapy.
To test the efficacy of gendine, a novel antiseptic, containing Gentian Violet and chlorhexidine, in coating different medical devices, including endotracheal tubes (ETT) and urinary catheters (UC). Using the modified Kirby-Bauer method, gendine-coated devices showed zones of inhibition of ≥15 mm against methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Escherichia coli and Candida parapsilosis. Results: Gendine-coated endotracheal tubes (GND-ETT) soaked in bronchoalveolar fluid (BAL) and incubated at 37�C maintained a zone of inhibition of ≥15 mm against MRSA and P. aeruginosa for at least 3 weeks. Gendine-coated UC significantly reduced the amount of viable MRSA, E. coli or C. parapsilosis organisms adhering to their surfaces when compared with silver/hydrogel-coated urinary catheters or control uncoated catheters (P < 0.01). Similarly GND-ETT significantly reduced the adherence of the same organisms as well as P. aeruginosa when compared with control (P ≤ 0.02).
HighWire -- Medline Abstract
This paper examines hygiene and medication procceses that helped prevent MRSA in people having special feeding devices inserted because they couldn't swallow.
this is derbyshire
This quite detailed report of the situation surrounding the death of a lady in Derbyshire highlights several of the key issues surrounding MRSA including the nature of the drugs used and the risk surrounding the use of ventilators. Click the link above for the full story.
A short introduction from Dave Roberts
This 12 minute introduction will help you grasp the key facts and the key issues surrounding drug resistant staph aureus (mersa, mursa)
