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Link: Control of methicillin-resistant Staphylococcus aureus in Spanish hospitals
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the main nosocomial pathogens. The incidence of MRSA infections is increasing in Spain. The objective of this study was to investigate the measures used for surveillance and control of MRSA in a sample of Spanish hospitals. METHODS. A questionnaire survey was done, including data on the incidence of MRSA infection/colonization for 2002, the microbiological methods used to study S. aureus susceptibility, and the use of control measures based on published guidelines. RESULTS. Sixty-one hospitals with a catchment population of 16 million inhabitants participated. Automatic methods were most frequently used for routine susceptibility testing. The median incidence was 0.45 cases/100 admissions; this data could be obtained from only 70% of the centers. In 59%, the incidence was indicative of high transmission. Isolation precautions were indicated for all patients with MRSA in 95% of the hospitals; screening of carriers among patients was performed in 18% to 72%, depending on the circumstances. Health care workers from at least one unit had been screened in 52% of the hospitals during 2002. Mupirocin was used for the treatment of 90% of colonized persons. CONCLUSION. There is considerable variation in the application of control measures in the hospitals surveyed. National guidelines with recommendations for MRSA control are needed in Spain.
Link: News
Dr. van de Sande-Bruinsma presented the resistance trends from 1999 to 2004 for some of the main indicator pathogens -- MRSA, vancomycin-resistant E. faecium and fluoroquinolone-resistant E. coli. This EARSS antimicrobial susceptibility data is routinely generated from submissions by more than 800 laboratories serving 1300 hospitals in 31 European countries. For MRSA, the countries of central and northern Europe are still showing an increase in rates of resistance. This is even happening in Scandinavian countries, which have maintained low rates of MRSA infection (<1%) for many years. This trend must be taken seriously as a low threshold for losing control may exist, although it remains to be defined, Dr. van de Sande-Bruinsma said.
Link: Keck Futures Initiative announces grant recipients.
EXPLORING THE EMERGING ROLE OF PUBLIC HEALTH IN INTEGRATING GENOMICS INTO THE CONTROL AND PREVENTION OF INFECTIOUS DISEASES - $75,000 Blower, Breban, and Vardavas will collaborate with the Centers for Disease Control and Prevention to investigate the "superbug" methicillin-resistant STAPHYLOCOCCUS AUREUS (MRSA). These researchers will decide how genetic data can be used to characterize outbreaks, and predict the size and frequency; and design effective control strategies for MRSA at the state and the national level.
Link: News - National Danish
This is a very important story. For the model MRSA avoiding nation to be seeing a doubling of MRSA every year is very worrying. Click the link above for the whole story. It is vague as to the cause beyond citing foreign nationals. We believe that MRSA super carriers often have an indulgent sex or drugs lifestyle and that they infect many others leading more mundane lives until this infection touches the innocent. The next few years will tell whether there is evidence for this thesis.
The alarming increase of methicillin-resistant Staphylococcus aureus (MRSA) cases in Denmark is closely related to skin and soft tissue infections where there is a high prevalence of underlying skin disease and independent risk factors involved are foreign ethnicity and prior hospitalisation. Sidsel B�cher, MD, project manager and PhD student, Staphylococcus Laboratory, National Centre for Antimicrobials and Infection Control, Copenhagen, Denmark, reported on this multicentre, prospective, case-control study here April 3rd at the 16th European Congress of Clinical Microbiology and Infectious Diseases on behalf of the Danish CA-MRSA Study Group. Mr. B�cher conducted his research with Robert Skov, MD, head of the Staphylococcus Laboratory. Along with other Scandinavian countries, Denmark has remained a low prevalence area for MRSA, with <1% MRSA found in bacteremias up to 2005. However, the last 3 to 4 years have seen more or less a doubling of the number of MRSA cases each year, which appears to be driven by cases of community-acquired infection (CA-MRSA).
Link: News
In the isolates obtained from 541 people, the incidence of MRSA infection/colonisation showed a gradual increase from 1997, with an increasing rate apparent since 2003. When analyzed according to HCI/ non-HCI status, although the incidence in the HCI setting has generally been higher than that for non-HCI, the patterns of the increases seen in both group are such that for 2005 this difference has disappeared, mainly due to the continuous steady increase in the non-HCI setting. "The PVL isolates found in health care institutions do not differ in sequence type or SCCmec type from those discovered outside health care institutions, most likely meaning that the PVL isolates are a result of MRSA infection acquired in the community but discovered inside institutions." This potentially indicates a shift in the lineages of the CA-MRSA, from being dominated by ST80 to being dominated by ST8, Dr. Fossum said. Therefore, along with the worrying increases in MRSA incidence in Norway, this detailed MRSA type analysis also indicates both a shift in the lineages of CA-MRSA and a shift of CA-MRSA into the health care institution setting. The true levels and significance of these trends, however, remain to be seen, Dr. Fossum said.
Link: Today Tonight on Seven.
The only hospital in our study with a clean slate so to speak was Melbourne's Monash medical centre. Professor Peter Collignon is in charge of infectious diseases at Canberra hospital. He was also one of the few in the medical profession prepared to admit super bugs are a crisis for our health system. "I mean there are lots of people who die every year in Australia from infections a number of which are eminently preventable something like 6 to 8 per cent of people who come into hospital end up with an infection," he said. According to Dr Collignon the reasons for our high infection rates were simple. Medical staff only washed their hands about a tenth as often as they should, and many hospitals don't isolate their infected patients. "I mean we worry about HIV and how many people that kills per year and a lot of even cancers, but when you look at just one germ like staph aureus it probably kills at least 2 000 people per year in Australia just from getting in the blood stream," he said.
Link: Risk factors for specific methicillin-resistant Staphylococcus aureus clones in a Korean hospital..
OBJECTIVES: To analyse the risk factors for nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections caused by different clonal types. METHODS: A total of 134 non-duplicate nosocomial MRSA isolates were analysed for clonal types by molecular typing techniques. The medical records of 90 patients who had documented MRSA infection were evaluated retrospectively. RESULTS: Two predominant MRSA clones of sequence types (STs) ST239 (n = 75) and ST5 (n = 39) accounted for 85% of the isolates. Management of patients in the departments of orthopaedic surgery, neurosurgery and plastic surgery was identified as a risk factor for infection with MRSA of ST239, while the presence of intravascular catheters was a risk factor for infection with ST5. Pulmonary infection was significantly higher in the patients infected with ST239 strains than in the patients infected with ST5 strains (P < 0.05). The overall mean duration of antimicrobial therapy for the patients with ST239 infection was significantly more than that for the patients with ST5 infection (P < 0.05). CONCLUSIONS: ST239 and ST5 were the predominant MRSA clones in the study hospital. Risk factors were significantly different between ST239 and ST5 strains. The results of this study will be of use in designing larger prospective epidemiological studies for MRSA infection based on clonal types.
Link: Trinidad News
Recently, with the incidence of infection locally, the newspapers have been enquiring about the ability of our hospitals to contain the super bug known as MRSA. It has proven to be dangerous in hospitals in the developed world, where the standards and physical and human resources are superior to those in ours. It has caused the majority of the some 60-80,000 deaths per year in the US and 5,000 in the UK. It could be devastating if (when?) it were to take hold in any of our hospitals.
Link: Nephrology Dialysis Transplantation.
There has been a school of thought that says MRSA only leads to longer stays, not more deaths, than other infections such as MSSA. This study contradicts that.
Both methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) can cause potentially severe infections, such as bacteraemia, surgical site infections, complicated skin and soft tissue infections (SSTI), and ventilator-associated pneumonia. However, they are also involved in a large number of mainly minor SSTI and are often mere colonizers without leading to clinical infections. Severe MRSA infections are associated with increased length of stay, morbidity, cost (primarily driven by increased length of stay and not by the cost of antimicrobials) and mortality. In a large meta-analysis of 31 studies of S. aureus bacteraemia pooled between 1980 and 2000 [1], Cosgrove et al. [1] found a doubling of mortality with MRSA bacteraemia
Link: Epidemic
Recent reports indicate that community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) now has reached epidemic proportions in many areas and has become a worldwide problem.4-12 Kuehnert et al. (2006) estimate, based on samples obtained in the National Health and Nutrition Examination Survey, that 32.4 percent of the U.S. population are colonized with S. aureus.13 Circumcision long has been known to increase the risk of S. aureus infection in newborn boys. The advent of epidemic CA-MRSA dramatically worsens the risks associated with Staphylococcus infection because: * the presence of CA-MRSA in epidemic proportions increases the chance of an infant being infected with MRSA by caregivers. * the threat to health is escalated beyond that posed by methicillin-sensitive Staphylococcus aureus (MSSA) if an infant should be infected. * the risk of death is increased. This statement reviews the literature regarding MRSA with an emphasis on the risk to newborn circumcised boys. The Circumcision Wound as Portal-of-Entry for Staphylococcus aureus The circumcision wound is a known portal-of-entry for the pathogen and significantly increases circumcised boys' risk. Sauer (1943) reported fatal Staphylococcus broncho-pneumonia after ritual circumcision.14 Isbester (1959) identified circumcision as a factor in lowering resistance.15 Thompson et al. (1963,1965) reported that boys have about twice the infection rate of girls, and circumcised boys have twice as much SA disease as non-circumcised boys (26 percent compared to 13 percent).
Link: (TheyWorkForYou.com).
Keith Vaz (Leicester East, Lab) Hansard source
To ask the Secretary of State for Health what the infection rate was for patients receiving NHS dialysis treatment in the last period for which figures are available.
Jane Kennedy (Minister of State (Quality and Patient Safety), Department of Health) Hansard source National surveillance of healthcare associated infections, including methicillin resistant Staphylococcus aureus (MRSA) bacteraemia, is undertaken by the Health Protection Agency (HPA), based on data supplied by the national health service. Data specifically relating to the infection rate for patients receiving dialysis treatment is not available. However, data showing the MRSA bacteraemia rates per acute trust is available on the Department's website at www.dh.gov.uk/assetRoot/04/ll/40/15/04114015.pdf.
Link: Infection Control Today
But this was not the study’s only finding. Although women who had heart surgery were much more likely to have an infection than their male counterparts, women with an infection were less likely to die than men who had an infection. “This finding was a surprise since, overall, women had greater mortality,” says Rogers. “But when we looked closer, we found that there were two underlying relationships here: a greater prevalence of infection in women, and a higher mortality once infected for men.” This pattern of greater morbidity in women but greater mortality for men has been observed before in elderly populations, Rogers notes. “Women tend to live with their disease; men die of it,” she says. In this case, the overall mortality was higher in women because infections were so much more prevalent among them. In all, about 12 percent of patients in the study who had infections during their hospital stay died before leaving the hospital, compared with 4 percent of those without infections. And when the researchers looked at who had died in the first 30 and 100 days after their operation, those who had had an infection in the hospital were still far more likely to die.
Link: Epidemiology
Background. Most data on methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) isolates come from large tertiary care centers. Infection control personnel need to understand the epidemiology of MRSA and VRE across the continuum of care, including small rural hospitals, to develop effective control strategies.Objective. To describe the epidemiology of MRSA and VRE in Iowa.Setting. Fifteen hospitals in Iowa.Methods Between July 1998 and June 2001, a total of 1,968 S. aureus isolates and 1,845 Enterococcus isolates from patients infected with these pathogens were examined. Multivariate models were developed to evaluate patient and institutional risk factors for MRSA infection and VRE infection.Results. The proportion of S. aureus isolates resistant to methicillin was 31%, and the proportion of Enterococcus isolates resistant to vancomycin was 6%. Independent risk factors for MRSA infection included residence in a long-term care facility, age of more than 60 years, hospitalization in a hospital with less than 200 short-term care beds, and acquiring the infection in the hospital. Independent risk factors for VRE infection included use of a central venous catheter, residence in a long-term care facility, acquisition of infection in the hospital, and hospitalization in a hospital with more than 200 short-term care beds.Conclusions. In Iowa, the epidemiology of MRSA differ from those of VRE. MRSA has become established in small rural hospitals. Effective MRSA control strategies may require inclusion of all hospitals in a state or region.
Link: Infection Control Today
Many of the medical risks associated with smoking, such as cancer, emphysema and heart attacks, are well-known to physicians and the general public. However, there is new evidence that more children exposed to tobacco smoke carry Streptococcus pneumoniae than children without smoking exposure, according to an article in the April 1, 2006 issue of Clinical Infectious Diseases, now available online. S. pneumoniae often exists in the nose and throat, and children are more likely than adults to carry it. If the bacteria, also called pneumococci, grow out of control, infection can result in minor illnesses like ear infections or lead to more serious diseases like sinusitis, pneumonia and meningitis. Researchers in Israel conducted a surveillance study of more than 200 young children and their mothers. They swabbed the noses and throats of the subjects to determine bacterial carriage rates, and then analyzed the data based on the children's and mothers' exposure to smoking. Seventy-six percent of the children exposed to tobacco smoke carried pneumococci, compared to 60 percent of those not exposed.
Link: BREITBART.COM
North Carolina health officials are investigating the death of a woman who died last week of a flesh-eating bacteria three days after accidentally jamming her hand in a wheelchair while working at a nursing home. Nursing assistant Sharron Bishop, 44, died Feb. 27. A doctor said a rare flesh-eating bacteria may have entered her body through a thumb injury and she turned from healthy to fatally ill. The culprit was a rare invasive form of group A streptococcal bacteria, said Debbie Crane, a spokeswoman for the state Department of Health and Human Services. The noninvasive form is widespread and is commonly known for causing strep throat, she said. "It's kind of like getting bitten by a shark or struck by lightning," she said. "It's not something that spreads to the community." North Carolina gets about 125 reports of the invasive form of strep annually, and about 10 percent are fatal, she said. David Bishop said doctors at UNC Hospitals, where Sharron Bishop died, have told him it's impossible to know how his wife contracted the rare infection. "The UNC doctors said she could have picked it up at the gas station, at the grocery store, anywhere," he said. "We will never know." Sharon Bishop complained on Feb. 24 about a swollen thumb. She had jammed it at work and worried that she had dislocated it. David Bishop took her to Betsy Johnson Regional Hospital, where doctors gave her pain medication and sent her home. The swelling got worse. By the morning of Feb. 27, her arm was twice as large as normal and looked like it would burst, David Bishop said. Fluid leaked from her elbow and wrist. She complained of terrific pain.
Link: Beacon Journal
When Mary Pashley, a 75-year-old resident of Coventry Township, went into The Cleveland Clinic for open heart surgery in September, she thought she knew the risks. But doctors had never brought up one of the biggest dangers -- infection acquired during hospital stays. And less than three months after surgery to repair a deteriorating heart, Pashley was dead. The culprit was a bloodstream infection from a bacterium called methicillin-resistant Staphylococcus aureus (MRSA). It's one of the most problematic infections to fight because the bacterium is resistant to many drugs. Pashley, a former real estate agent and performer for water-ski shows, underwent surgery at The Cleveland Clinic on Sept. 27. She had been anticipating a 10-day hospital stay. Eight days later, she went into septic shock from MRSA. For the rest of her life, in the Clinic and in rehab facilities, she battled the infection. When she died on Dec. 14, after suffering several strokes, her death certificate listed sepsis as the cause. That day, as she took her last labored breaths after life support was removed, her husband Dick was there, stroking her hair. ``Carelessness got her infected,'' Dick Pashley says. ``What can be done to stop this kind of thing?'' Infections widespread Each year, about 2 million patients -- one in every 20 -- gets infected during a hospital stay, and, according to the U.S. Centers for Disease Control and Prevention, 90,000 of those patients die from the infections.
Link: Trinidad News
The dreaded Methicilline Resistant Stsph Aerus (MRSA) virus was diagnosed in a patient who was admitted to the San Fernando General Hospital two weeks ago. Medical Chief of Staff Dr Austin Trinidade disclosed on Wednesday that the MRSA was found in a patient who was admitted for treatment to burns. He said that the patient was treated and sent to an infectious ward. Trinidade was responding to a question from Senator Mary King, Chairperson of the Joint Select Committee of Parliament who was meeting with the South West Regional Health Authority to discuss the operations of the authority. Trinidad said the deadly infection is resistant to antibiotics and " from time to time we have found this in the hospital and have treated it". He said it can be spread by contact and persons who can be easily infected are those suffering with diabetes. Trinidade had high praise for the Infection Control Staff of the hospital who found the bug and immediately reported it to him. MRSA is a germ that can cause staphylococcal infection and is usually found in hospitals and other health care institutions.
Link: Columbus cases of staph infection rising - Science.
An aggressive strain of the common staph infection - also known as MRSA - is popping up around Columbus. The infectious critter is a strain of staphylococcus aureus bacteria that is resistant to most antibiotics, drugs used to kill bacteria or slow their growth. MRSA infections are most commonly seen in health care facilities, such as hospitals and nursing homes. Recently, however, cases have been reported in Columbus residents who have not had recent exposure to these health -care facilities. MRSA is considered a class C infection and is not on the Ohio Department of Health's list of reportable diseases. This is because class C infections are "innocent until proven guilty": The ill are screened and asked to have limited contact with others until the test results come back. If positive, more intense treatment and quarantine measures are taken while results negative for a disease, provide patients more lenient control. The disease is, however, on Ohio Department of Health's list of diseases of public health concern needing timely response, because outbreaks of MRSA have been reported to Ohio Department of Health and an epidemic spread has been established, according to documents from the Ohio Department of Health's public affairs office. Kristopher Weiss, spokesman for the Ohio Department of Health, said that in instances which more than two people who can be associated with each other contract the infection, the Ohio Department of Health considers this a community outbreak.
Link: HighWire Press -- Medline Abstract.
To obtain data on peritonitis and exit-site and/or tunnel infections (ESI/TI) in Japanese children undergoing peritoneal dialysis (PD) from January 1999 through June 2003, we surveyed 22 members of the Japanese Study Group of Pediatric Peritoneal Dialysis (JSPPD) by questionnaire. One hundred and thirty patients were eligible. Seventy episodes of bacterial peritonitis occurred in 45 patients (0.17 episodes/patient-year), and 123 ESI/TI occurred in 60 patients (0.29 episodes/patient-year). S. aureus and MRSA were found to be the causative organisms in 39% and 13% of the peritonitis episodes, and in 59% and 20% of the ESI/TI, respectively. Tunnel infection was found in 55% of the MRSA peritonitis episodes. Eleven percent of the peritonitis episodes relapsed, and 19% needed hemodialysis. One patient died due to MRSA peritonitis. The PD catheter was removed in all fungal and 78% of MRSA peritonitis. However, the type of organism did not influence the need for catheter-related surgery for ESI/TI. Neither peritonitis nor ESI/TI was prevented by the use of a swan-neck catheter, a downward-pointing exit site, povidone iodine exit-site care, bathing instruments, or nasal mupirocin. In conclusion, MRSA peritonitis was not uncommon in children in Japan, was frequently associated with tunnel infections, and had a poor outcome. No association was found between the occurrence of infection and preventive measures previously reported as effective. Alternative approaches are needed in children, especially for MRSA.
Link: ScienceDaily:
The MRSA ‘superbug’ evades many of the measures introduced to combat its spread by infecting a common single-celled organism found almost everywhere in hospital wards, according to new research published in the journal Environmental Microbiology. Microscope image of an amoeba with epidemic MRSA stained green. (Image courtesy of University of Bath) Scientists from the University of Bath have shown that MRSA infects and replicates in a species of amoeba, called Acanthamoeba polyphaga, which is ubiquitous in the environment and can be found on inanimate objects such as vases, sinks and walls. As amoeba produce cysts to help them spread, this could mean that MRSA maybe able to be ‘blown in the wind’ between different locations. Further evidence from research on other pathogens suggests that by infecting amoeba first, MRSA may emerge more virulent and more resistant to antibiotics when it infects humans. “Infection control policies for hospitals should recognise the role played by amoeba in the survival of MRSA, and evaluate control procedures accordingly,” said Professor Mike Brown from the Department of Pharmacy and Pharmacology at the University of Bath. “Until now this source of MRSA has been totally unrecognised. This is a non-patient source of replication and given that amoeba and other protozoa are ubiquitous, including in hospitals, they are likely to contribute to the persistence of MRSA in the hospital environment”. “Adding to the concern is that amoebal cysts have been shown to trap pathogens and could potentially be dispersed widely by air currents, especially when they are dry.
Link: National hospital
National hospital infection surveillances on methicillin-resistant Staphylococcus aureus (MRSA) had been carried out in 1995 and 1996. Recently, in the UK and the USA, the prevalence of MRSA has increased and strict precautions against MRSA are recommended. In Japan, hospital infection rates of MRSA have appeared to be stable in recent years, but a reevaluation is required to confirm this assumption. In a nationwide surveillance, the incidences of MRSA hospital infections per 100 admissions remained stable at between 0.7 and 0.8 from 1999 to 2003, with a tendency towards a slight decline being observed. This study shows that the precautions against MRSA infection in Japan may prove to be an effective preventive measure.
Link: Annals of Internal Medicine.
Results: The prevalence of colonization with S. aureus and with MRSA was 31.6% and 0.84%, respectively, in the noninstitutionalized U.S. population. People younger than 65 years of age, men, persons with less education, and persons with asthma were more likely to acquire S. aureus. Persons of black race and those of Mexican birth had lower risk for S. aureus colonization. Persons 65 years of age or older, women, persons with diabetes, and those who were in long-term care in the past year were more likely to have MRSA colonization. Hispanic persons had statistically significantly less risk than white persons. Isolates of MRSA with staphylococcal chromosomal cassette mec type IV (which is often associated with community-associated MRSA) were statistically significantly more likely to be sensitive to erythromycin, clindamycin, and ciprofloxacin. Limitations: Colonizing isolates may be different from isolates associated with infection. Risk factors identified may differ from those associated with invasive disease. The 2001–2002 NHANES data are several years old and may not reflect the most recent changes in epidemiology, but they are the only national data available. Conclusions: Characteristics of persons with MSSA and MRSA seem to differ. These findings may be useful for differentiating those who may be at risk for MRSA.
Link: Journal of Clinical Microbiology.
Recurrence of osteomyelitis by the same bacterial strain is well known. We report three patients with a second episode of osteomyelitis at the same site caused by different strains of bacteria from the original. Formerly infected and altered bone surface might present a region of diminished resistance for a new infection.
Link: Disaster News Network
MRSA is a growing problem that's not limited to disaster-stricken areas. But post-hurricane conditions have increased the risk of contracting MRSA, said Boe. "I think there ought to be a national tracking of this in the wake of Katrina," he said, but acknowledged that such a program would have to be well-publicized in order to work well. "These people scatter to the four winds when they leave and get seen by local physicians," he said. "Unless they get a heads up, they're not going to report these things." There is a precedent for post-disaster health monitoring. In the wake of the Sept. 11 terrorist attacks, the World Trade Center Medical Monitoring Program was created with support from the United Church of Christ (UCC) and other partners. The program continues to provide free, confidential medical exams to workers and volunteers who responded to the terrorist attacks in New York City.
Link: MRSA In Sweden
There are 2 ways to read this story. Blame the foreigners or blame the holidaymakers. I'm leaning towards the holidaymakers who bring it back. It would be interesting to know more about sources of infections - is the Thai sex industry a major MRSA amplification engine?
A quarter of all people with MRSA in Sweden between 2000 and 2003 were infected abroad. A study published today in the open access journal BMC Infectious Diseases reveals that the number of methicillin-resistant Staphylococcus aureus (MRSA) infections in Sweden nearly doubled between 2000 and 2003. The study also shows that 25% of all cases came from abroad. This highlights the threat posed by international transmission of MRSA to countries in which incidence of MRSA infection is still relatively low.
Link: ABC News
David Jackson still can't believe his ex-wife, Kimberly, is gone — the victim of a deadly infection she contracted from an unsanitary pedicure. "Something so stupid like a pedicure took her life," Jackson said. "She couldn't get it healed. No matter what she was doing, and the antibiotics just wasn't, wouldn't stop it." Kimberly Jackson had contracted a staph infection — a bacterial infection that can strike anywhere in the body, from the blood to the skin. Many of these bacteria are becoming resistant to antibiotics, and that has many doctors worried. The Infectious Diseases Society of America today released a "hit list" of six drug-resistant "superbugs." No. 1 on that list is a potentially deadly strain of staph called MRSA (methicillin-resistant Staphylococcus aureus).
Link: Belfast Telegraph.
The top Ulster infection control doctor who found MRSA-causing bacteria on mobile phones used by doctors and nurses in hospital has been appointed one of the World Health Organisation's key international expert advisers, it can be revealed today. Dr Nizam Damani, Consultant Microbiologist and Head of Infection Control at Craigavon Area Hospital, has become specialist adviser to the WHO's 'Global Patient Safety Challenge'. In his role he will be probing hospital-acquired infection and ways of tackling it worldwide. "There are about 10 or 11 international experts in the team," he said. "Hopefully I can bring back ideas that will help Northern Ireland's hospitals tackle infection.
Link: ICEID 2006 March 19-22, 2006 Atlanta, GA.
The International Conference on Emerging Infectious Diseases was first convened in 1998; ICEID 2006 marks its fifth occurence. The conference brings together public health professional to encourage the exchange of scientific and public health information on global emerging infectious disease issues. The program will include plenary and panel sessions with invited speakers as well as oral and poster presentations on emerging infections. Major topics include current work on surveillance, epidemiology, research, communication and training, bioterrorism, and preventions and control of emerging infectious diseases, both in the United States and abroad.
Link: Daily Mail.
Up to one in 10 patients catches an infection in hospital, alarming figures have revealed. The chances of developing a potentially fatal illness simply by checking into a British ward are among the highest in the world, says a report from the British Medical Association. Such illnesses, including the superbug MRSA and infection clostridium difficile, contribute to the deaths of at least 5,000 patients a year. Other estimates claim the real figure may be twice as high. In England alone, 300,000 patients every year pick up an infection in hospital. The results range from pain and severe chronic illness to permanent disability and, in some cases, death. The report from the BMA's influential Board of Science says government NHS targets have played a part in rising infection rates. A reduction in beds and pressure to treat and discharge a greater number of patients has led to higher bed occupancy rates.
Link: HighWire Press -- Medline Abstract
OBJECTIVE: Methicillin-resistant Staphylococcus aureus (MRSA) infection appears to be increasing, the UK has one of the worst MRSA rates in Europe. As urological patients are at high risk, the aim of this study was to determine the number of newly diagnosed cases of MRSA detected in a urology ward. PATIENTS AND METHODS: The urology department serves an annual local population of greater than 500,000 with 30 inpatient beds and a tertiary population of 1 million. Over a five year period, we retrospectively recorded all patients with a new diagnosis of MRSA. We also determined colonization site and if the diagnosis of MRSA was made in an elective surgical patient or a patient admitted as an emergency. RESULTS: The mean number of newly diagnosed cases of MRSA was 20.6 per year. The percentage of patients with a new diagnosis of MRSA was less than or equal to 1% per year with no significant difference of new cases of MRSA over five years. Emergency patients had a trend towards a mean higher rate of MRSA. The commonest site of MRSA colonization was from catheters (32%) and open wounds (18%). DISCUSSION: MRSA is of concern, as compared to methicillin-sensitive staphylococcus aureus, because it is associated with high rates of clinically relevant infection, increased hospital stay and cost, greater mortality and high vancomycin usage. Mandatory reporting has shown a steady increase in the number of cases of MRSA infection over the past four years. We found that the number of newly diagnosed cases of MRSA was low, at less than or equal to 1% of patients per year. Furthermore, the number of new cases of MRSA remained constant over five years suggesting low acquisition rates in a busy UK urology ward. PMID: 16426726
Link: Fatal Pneumonia
Severe infections are the most dangerous complications in liver transplantation and their prevention is one of the major goals. A 60-year-old Saudi-Arabian female with decompensated hepatitis C liver cirrhosis received a right-lobe liver graft from her healthy daughter. After 9 days, the patient developed a rapidly progressive necrotizing pneumonia that was fatal in spite of extracorporal lung assist. The pneumonia was due to a Panton-Valentine Leucocidine-positive (PVL) methicillin-resistant Staphylococcus aureus (MRSA), or "community-acquired" MRSA, that had not been detectable in the patient preoperatively. The same strain of PVL-MRSA could be demonstrated in the nares of the asymptomatic donor, but not of other relatives, patients, or medical staff. These findings strongly suggest transmission of PVL-MRSA from the donor to the recipient. This case demonstrates a previously unknown, and potentially fatal, risk in living-donor liver transplantation: transmission of a severe infection from a healthy donor to the recipient.
Link: Incidence
The distribution of 3497 Staphylococcus aureus strains according to methicillin resistance, specimens, departmental profession and antibiotic resistance patterns was analysed. The strains were cultured from the patients of the Clinical Center of Skopje, Macedonia, between 1 January 2002 and 31 December 2004. The majority of the isolates was obtained from suppurated wounds (28.5%), nares (21%), intratracheal tubes (13%) and blood cultures (11.8%). Overall 1100 (31.4%) of the isolates was methicillin-resistant with 1 microg oxacillin disc. Of these 35.5%, 30.5% and 10.4% were cultured from wounds, intratracheal tubes and blood samples, respectively. The prevalence of MRSA strains was 78.6%, 75%, 44.2% and 37.3% in specimens of ICU, Coma Center, General Surgery and Haematology patients. There were extremely big differences in the frequency of MRSA between departments with particular specialisation. The 2397 MSSA isolates belonged to practically one antibiotic resistance pattern characterised with penicillin resistance and susceptibility to other antistaphylococcal drugs. The 1100 MRSA isolates distributed to four antibiotic resistance patterns on the basis of their resistance to oxacillin, penicillin, amoxicillin clavulanic acid, azithromycin, clindamycin, amikacin, gentamicin, ciprofloxacin, trimethoprim sulphamethoxasole, vancomycin and teicoplanin. All the MRSA isolates were multidrug resistant but sensitive to glycopeptides.
Link: Changes
Medical proffesionals can find the full report above
The proportion of Staphylococcus aureus isolates that were methicillin resistant (MRSA) increased from 35.9% in 1992 to 64.4% in 2003 for hospitals in the National Nosocomial Infections Surveillance system. During the same period, there was a decrease in resistance rates for several non- beta -lactam drugs among the MRSA isolates.
Link: Journal of Clinical Microbiology.
The data support the origin of the Cordobes clone as a member of a lineage that includes the pediatric and New York/Japan international clones and that is genetically related to the British EMRSA-3 strain. Interestingly, the pediatric clone, isolated from most community-acquired infections in Cordoba, was characterized by ST100, a single-locus variant of ST5 and a new variant of SCCmec type related to SCCmec type IVc.
Link: Journal of Clinical Microbiology.
Pulsed-field gel electrophoretic analysis of 2,144 methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from patients in Spanish hospitals over a 7-year period revealed 17 predominant profiles. Typing showed the replacement of Iberian clone E1 (ST247-MRSA-I) by two prevalent clones, E7 and E8, that are closely related to each other and have the same genetic background as ST125-MRSA-IV.
Link: Journal of Clinical Microbiology.
Staphylococcal interspersed repeat unit typing has previously been shown to have the ability to discriminate between epidemic methicillin-resistant Staphylococcus aureus strains in the United Kingdom. The current study illustrates its ability to distinguish between strains within an endemic setting thereby providing a rapid transportable typing method for the identification of transmission events.
Link: Journal of Medical Microbiology.
The aim of this study was to identify a set of genetic polymorphisms that efficiently divides methicillin-resistant Staphylococcus aureus (MRSA) strains into groups consistent with the population structure. The rationale was that such polymorphisms could underpin rapid real-time PCR or low-density array-based methods for monitoring MRSA dissemination in a cost-effective manner. Previously, the authors devised a computerized method for identifying sets of single nucleotide polymorphisms (SNPs) with high resolving power that are defined by multilocus sequence typing (MLST) databases, and also developed a real-time PCR method for interrogating a seven-member SNP set for genotyping S. aureus. Here, it is shown that these seven SNPs efficiently resolve the major MRSA lineages and define 27 genotypes. The SNP-based genotypes are consistent with the MRSA population structure as defined by eBURST analysis. The capacity of binary markers to improve resolution was tested using 107 diverse MRSA isolates of Australian origin that encompass nine SNP-based genotypes. The addition of the virulence-associated genes cna, pvl and bbp/sdrE, and the integrated plasmids pT181, pI258 and pUB110, resolved the nine SNP-based genotypes into 21 combinatorial genotypes. Subtyping of the SCCmec locus revealed new SCCmec types and increased the number of combinatorial genotypes to 24. It was concluded that these polymorphisms provide a facile means of assigning MRSA isolates into well-recognized lineages.
Link: News
New research estimates that about 2 million people carry a strain of drug-resistant bacteria in their noses. The research, conducted by the Centers for Disease Control and Prevention (CDC), is the first reliable nationwide estimate of colonization with Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). It is published in the Jan. 15 issue of The Journal of Infectious Diseases, now available online.
Those colonized with normal strains of staph are at higher risk of infection with the bacterium, which can lead to conditions ranging from mild skin infections to fatal toxic shock syndrome. MRSA causes more difficult-to-treat and, sometimes, more virulent illnesses. MRSA was once primarily a problem in hospitals, but is now a growing problem in communities around the country.
Matthew J. Kuehnert, MD, and colleagues collected samples from nearly 10,000 participants in the 2001-2002 National Health and Nutritional Examination Survey, a representative sample of the U.S. population.
Nearly one-third were found to be colonized with staph.
Link: HighWire Press -- Medline Abstract.
Objective: To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strains among clinical isolates collected from the 4 tertiary hospitals in Makkah, Saudi Arabia, and to test the antimicrobial susceptibility patterns of S. aureus isolates against 9 antimicrobial agents. Materials and Methods: A total of 512 S. aureus clinical isolates were collected during a period of 1 year starting in April 2003 in Al-Noor, King Abdul-Aziz, Hera and King Faisal Hospitals, Makkah, Saudi Arabia. The sensitivity patterns of these isolates were determined using the Kirby-Bauer disk diffusion method. Results: The prevalence of MRSA among S. aureus isolates was 38.9% (199/512). Among 199 MRSA isolates, 78.8% showed multidrug resistance to erythromycin, gentamicin and oxytetracycline. Conclusion: The rate of MRSA resistance in this study was much higher than what had been reported in other areas of Saudi Arabia emphasizing the need for local or country-based surveillance to characterize and monitor MRSA and to develop strategies that will improve MRSA treatment and control. Copyright (c) 2006 S. Karger AG, Basel.
Link: A quarter of Britons know a MRSA victim | the Daily Mail.
This does not auger well if CA MRSA takes hold - nor would it be good if Bird Flu attacks vulnerable MRSA carriers.
A quarter of the population know someone whose family or friends have contracted MRSA, and one in eight has a direct friend of family member who has the deadly bug according to new research.
Government figures show around 5,000 people a year die from hospital-acquired infections.
However the poll funded by Talley Environmental Care found one in four of people were just one-step away from a sufferer.
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Join the debate �Tip of the iceberg
TEC manager Neil Manser believes the problem could be bigger than first understood.
He said: "The well quoted Government figures of 5,000 deaths a year attributed to HAIs, while appalling, may only be the tip of the iceberg as this information is based on assumptions in a very limited report published in 2000 from data gathered over five years ago.
"Our new survey confirms the problem is far bigger than anyone had thought and highlights the need for us to invest in our trained infection control professionals and give them the tools to do their job."
Link: HighWire Press -- Medline Abstract.
Nosocomial infections due to methicillin-resistant Staphylococcus aureus (MRSA) is an important health problem worldwide. This microorganism causes a variety of clinical infections, including osteomyelitis, invasive endocarditis, septic arthritis and septicemia. Antimicrobial resistance is a factor that influences the persistence of MRSA in the hospital environment. The introduction of molecular typing techniques in epidemiological investigations has provided new tools for identifying the microorganism's origin and routes of dissemination. One of the most important conclusions that have resulted from these types of studies is that a small number of clones are responsible for most of the staphylococcal infections throughout the world.
Link: Chest.
Context: Traditionally, pneumonia developing in patients outside the hospital is categorized as community acquired, even if these patients have been receiving health care in an outpatient facility. Accumulating evidence suggests that health-care–associated infections are distinct from those that are truly community acquired.
Objective: To characterize the microbiology and outcomes among patients with culture-positive community-acquired pneumonia (CAP), health-care–associated pneumonia (HCAP), hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP).
Design and setting: A retrospective cohort study based on a large US inpatient database.Patients: A total of 4,543 patients with culture-positive pneumonia admitted into 59 US hospitals between January 1, 2002, and December 31, 2003, and recorded in a large, multi-institutional database of US acute-care hospitals (Cardinal Health-Atlas Research Database; Cardinal Health Clinical Knowledge Services; Marlborough, MA).
Main measures: Culture data (respiratory and blood), in-hospital mortality, length of hospital stay (LOS), and billed hospital charges.
Results: Approximately one half of hospitalized patients with pneumonia had CAP, and > 20% had HCAP. Staphylococcus aureus was a major pathogen in all pneumonia types, with its occurrence markedly higher in the non-CAP groups than in the CAP group. Mortality rates associated with HCAP (19.8%) and HAP (18.8%) were comparable (p > 0.05), and both were significantly higher than that for CAP (10%, all p < 0.0001) and lower than that for VAP (29.3%, all p < 0.0001). Mean LOS varied significantly with pneumonia category (in order of ascending values: CAP, HCAP, HAP, and VAP; all p < 0.0001). Similarly, mean hospital charge varied significantly with pneumonia category (in order of ascending value: CAP, HCAP, HAP, and VAP; all p < 0.0001).Conclusions: The present analysis justified HCAP as a new category of pneumonia. S aureus was a major pathogen of all pneumonias with higher rates in non-CAP pneumonias. Compared with CAP, non-CAP was associated with more severe disease, higher mortality rate, greater LOS, and increased cost.
Link: HighWire Press -- Medline Abstract.
Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a notable cause of hospital-acquired infections. A statewide screening and control policy was implemented in Western Australia (WA) after an outbreak of epidemic MRSA in a Perth hospital in 1982. We report on statutory notifications from1998 to 2002 and review the 20-year period from 1983 to 2002. The rate of reporting of community-associated Western Australia MRSA (WAMRSA) escalated from 1998 to 2002 but may have peaked in 2001. Several outbreaks were halted, but they resulted in an increase in reports as a result of screening. A notable increase in ciprofloxacin resistance during the study period was observed as a result of more United Kingdom epidemic MRSA (EMRSA) -15 and -16. WA has seen a persistently low incidence of multidrug-resistant MRSA because of the screening and decolonization program. Non-multidrug-resistant, community-associated WAMRSA strains have not established in WA hospitals.
Link: RangelMD.com.
This'll make you think! Basic premise is that SA is the problem and that the MRSA version makes you sicker for longer but is no more deadly. Comments welcome
Hospital acquired MRSA is known to be able to spread directly to the community when infected hospital patients or those who become carriers are discharged but an increasing number of MRSA infections are being seen in patients who have no known risk factors (recent hospitalization, health care worker, nursing home exposure, recent antibiotic use). This "community acquired" MRSA as caused quite a stir in the medical community and in the media who (as per par for the course) are giving it amusingly hysterical names like "super bug", "killer Staph", "flesh eating bacteria", and "Mersa" (a bizarre attempt to create a name out of the abbreviation for MRSA). But the reality is that there is nothing "super" about MRSA the superbug. Such lay media hyping implies that MRSA is more virulent (i.e. more harmful) than it's more common cousin Methicillin sensitive Staphylococcus Areus (MSSA). However, MSSA is perfectly capable of killing and eating flesh just as well as MRSA and in fact does so with vigor killing and harming thousands each year despite being totally susceptible to antibiotics. The wrinkle with MRSA is almost exclusively in its antibiotic resistance patterns. It is not at all clear whether MRSA is actually more virulent or more lethal than MSSA. While there is some evidence for worse outcomes with hospital acquired MRSA, other studies have found no differences and others have suggested that the increased risk of death from hospital acquired MRSA infection is related more to factors like the severity of illness and lengths of stay.
Link: EducationGuardian.co.uk
Thames Valley University (TVU) is to lead research into hospital superbugs under a healthcare research contract from the Department of Health. The university's Richard Wells centre is to establish and direct a new national healthcare-associated infection (HCAI) research network, managing work on prevention and control of these infections in the National Health Service on a three year contract. The prevalence of superbugs, such as methicillin-resistant staphylococcus aureus (MRSA), has hardly declined in hospitals in England over the last decade. Although not all of these infections can be avoided, it is estimated that up to one third can be prevented.
Robert Pratt, the director of the Richard Wells research centre, said: "Almost one in every 10 patients develops a new infection when they are cared for in hospital. These new infections, which are often difficult to treat, frequently worsen the patient's original complaint and can cause serious disability and death. What's more, these infections are expensive, costing the NHS �1bn each year.
Link: [Resistant microorganisms in patients transferred from foreign hospitals].
To determine the prevalence of carriers of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and gentamicin-resistant Gram-negative bacilli (GGNB) in patients repatriated from foreign hospitals to The Netherlands. DESIGN: Determination of prevalence. METHOD: In the period May 1998-August 2001, 1167 patients were repatriated. Swab specimens, demographic data and clinical data were obtained during the transfer. RESULTS: The prevalence of carriers of resistant microorganisms was 18.2%. MRSA was carried by 2.7% of the total repatriated group and by 4.7% of patients transferred to a Dutch hospital. Risk factors were antimicrobial treatment (odds ratio (OR): 3.4; 95% CI: 1.2-9.7), length of stay in a foreign hospital > or = 14 days (OR: 5.4; 95% CI: 2.3-12) and artificial ventilation (OR: 8.5; 95% CI: 1.8-41). VRE and GGNB were isolated from 2.7% and 14.1% of patients, respectively. Transfer from Asia or southern, south-eastern and eastern Europe were risk factors for carrying GGNB. CONCLUSION: Carriership of resistant microorganisms was high among repatriated patients. The highest risk of GGNB was more closely associated with the country from which the patient was transferred than the antimicrobial treatment received in the foreign hospital.
Link: Mirror.co.uk
SUPERBUGS: Birmingham THE second city is the worst place in the country for the killer hospital superbug MRSA. The government's latest performance tables showed the University Hospital Birmingham NHS Foundation Trust came bottom with 152 cases of MRSA between October 2004 and March 2005. The bug kills an estimated 5,000 people a year in the UK.
Link: Health Business - A quarter of Britons.
A quarter of Britons are just one step away from MRSA, a nationwide study has said. The research, from Talley Environmental Care, set out to probe how close the infection is to any individual, and its impact on millions of families. The findings were unveiled at the Infection Control Nurses Association annual conference in Torquay and presented to the Prime Minister at the Labour Party conference. A total of 1,003 people interviewed by market research company BMRB were asked if they had a friend or family member who had contracted MRSA, or knew of someone whose immediate circle had been similarly affected. The results revealed that 14 per cent of those in the poll had family or close friends who had contracted MRSA. Twenty-six per cent of respondents knew of someone whose immediate circle had been affected by MRSA. Talley manager Neil Manser said: “The well-quoted Government figures of 5,000 deaths a year attributed to HAIs, while appalling, may only be the tip of the iceberg, as this information is based on assumptions in a very limited report published in 2000 from data gathered over five years ago. “Our new survey confirms the problem is far bigger than anyone had thought and highlights the need for us to invest in our trained infection control professionals and give them the tools to do their job.”
Link: Torbay Hospital
Torbay Hospital is turning up the heat in its fight against the MRSA super-bug, as staff are being observed this week to ensure they are minimising the risk of infection. The monitoring is part of Infection Control Week and follows on from news of a �700,000 cash injection to increase the number of cleaners at the hospital. Forty specially trained experts will be watching their colleagues perform septic procedures and advising on any improvements. Torbay Hospital recorded 35 cases last year, which will have to be cut to 12 by 2008 if targets are to be met. Of those infected by MRSA at the hospital, 72 per cent are males compared to 28 per cent of females, a trend which is seen throughout the country.
Link: Pathogen
The frequency of Staphylococcus aureus increased over time, corresponding to an increase in the occurrence of methicillin-resistant S. aureus (MRSA). In addition, the rate of isolation of Serratia marcescens also increased over time, especially among patients with urinary tract catheters. Our results demonstrate that the uropathogens isolated at a single institution have shown a trend of increasing resistance to various classes of antimicrobial agents. In addition, serious problems should be anticipated in the treatment of multidrug-resistant P. aeruginosa, fluoroquinolone-resistant E. coli, and arbekacin-resistant MRSA.
Link: BMJ.
About a quarter of UK hospital patients with methicillin resistant Staphylococcus aureus (MRSA) bacteraemia are infected before coming to hospital, and nine out of 10 of these patients had been hospitalised before. Wyllie and colleagues (p 992) analysed MRSA infection rates in two hospitals in Oxfordshire over seven years. Half of the patients who came into the hospital infected had no record of previous isolation of MRSA; about a third were admitted to renal, oncology, or haematology wards for intensive day case therapy, and most of the rest were admitted to emergency services.
Link: Lancaster Eagle-Gazette
MMMM ............... With 10% of the population maybe carrying MRSA any way the story below seems a little ridiculous
Law enforcement and court officials are pledging to communicate more after revelations of a sick prisoner forced the closure of a courtroom. A man told Fairfield County Common Pleas Court Judge Chris Martin during a preliminary hearing Thursday he had MRSA, which is a type of staph that is resistant to antibiotics. ADVERTISEMENT Martin's courtroom was closed for about 5 and a half hours - 10:30 a.m. to 4 p.m. Hearings were moved to the magistrate's courtroom. Before the day was over, the courtroom was sprayed with a disinfectant. But the incident had many employees concerned about contracting the infection. "We were not aware of it before the hearing," Martin said. "After we did become aware of it, I closed the courtroom until we could get more information about it."
This is an extremely topical publication, in an area of Intensive Care that has come to the fore as of immense importance to microbiologist and intensivist alike. It is an impressive book of over 600 pages packed with useful information. It is worth having for the first section alone, which starts with a glossary of terms and then moves onto a superb r�sum� of basic, essential microbiology
Link: HighWire Press -- Medline Abstract.
Thirty-one patients with nosocomial MRSA infective endocarditis between October 1996 and May 2003. DESIGN: A retrospective chart review was conducted. Data were compared with those from a control group of patients with nosocomial MRSA bacteremia. Logistic regression was used to identify independent risk factors for nosocomial infective endocarditis. RESULTS: Compared with patients who had nosocomial MRSA bacteremia and no infective endocarditis, patients who had infective endocarditis had a higher incidence of chronic liver disease and a lower incidence of immunodeficiency. The risk of developing infective endocarditis was approximately 10% for patients with nosocomial MRSA bacteremia. CONCLUSION: Patients with MRSA bacteremia and underlying chronic liver disease were prone to infective endocarditis.
Link: ballarat.yourguide.
BALLARAT'S two largest health-care providers have dismissed fears of a superbug epidemic, saying infection rates in the city's hospitals are extremely low. Spokespeople from the Ballarat Health Services Base Hospital and St John of God Hospital said cases of MRSA, a strain of golden staph, were extremely rare. Their comments came after it was revealed 123 deaths had been linked to the superbug in Victorian hospitals and 1600 people had been infected. MRSA - methicillin resistant staphylococcus aureus - which typically affects the critically ill, is becoming drug resistant and can cause lethal septicemia. Ballarat Health Services executive director of medical services John Ferguson said there were less than five cases of the superbug at the Base Hospital each year. "It's very rare, remembering we treat 25,000 in-patients a year," he said.
Link: Superbug crisis 'mishandled'
HOSPITAL patients are dying from superbugs because Australian health authorities are mishandling the crisis, Australia's peak body for surgeons said today. Superbugs were endemic to every hospital in Australia and would spread further unless authorities changed their approach to infection control, the Royal Australasian College of Surgeons said. The common superbug MRSA (methicillin-resistant Staphylococcus aureus), a strain of golden staph, is resistant to most prescribed antibiotics. Australians should be very concerned about the death rate from hospital superbugs, as the nation was lagging behind international best practice in combating infection, the college's infection control committee head Professor Richard West said. His comments come after the Victori
Link: theage.com.au.
The potentially deadly superbug MRSA was found in 123 people who died in Victorian public hospitals in the last financial year. It is not known, however, whether the patients died because of the penicillin-resistant form of golden staph or from another condition and were simply carrying the bug when they died. Figures obtained by The Age, under freedom of information, show MRSA (methicillin-resistant staphylococcus aureus) was present in 1589 people admitted to hospitals from July 2004 to May 2005. Doctors believe most patients contract it in hospitals, but about 23 per cent of cases are acquired outside. The numbers could be higher, because hospitals record the information differently and not all patients undergo swab tests to detect the superbug.
In laymens terms this seems to infer that just over 50% get it from sources within the ward. 40% from a non isolated patient and 10% from an isolated patient. What about infection bought in and via staff members? Food for thought anyway
OBJECTIVE: To consider statistical methods for estimating transmission rates for colonization of patients with methicillin-resistant Staphylococcus aureus (MRSA) in an intensive care unit (ICU) from three different sources: background contamination, non-isolated patients, and isolated patients. METHODS: We developed statistical methods that allowed for the analysis of interval-censored, routine surveillance data and extended the general epidemic model for the flow of patients through the ICU. RESULTS: Within this ICU, the rate of transmission to susceptible patients from a background source of MRSA (0.0092 case per day; 95% confidence interval [CI95], 0.0062-0.0126) is approximately double the rate of transmission from a non-isolated patient (0.0052 case per day; CI95, 0.0013-0.0096) and six times the rate of transmission from an isolated patient (0.0015 case per day; CI95, 0.0001-0.0043). We used the methodology to investigate whether transmission rates vary with workload. CONCLUSION: Our methodology has general application to infection by and transmission of pathogens in a hospital setting and is appropriate for quantifying the effect of infection control interventions.
Link: Hospital staph infections 'staggering'.
A new study is documenting what researchers call the "staggering" burden of such Staphylococcus aureus infections. In the Archives of Internal Medicine, researchers estimate staph infections cause nearly 12,000 deaths per year in the United States and increase hospital bills by $9.5 billion. About 1 percent of all patients -- nearly 300,000 per year -- suffer staph infections. Eleven percent die, compared with 2 percent of other patients. Patients with staph infections spend an average of 14 days in the hospital, three times longer than other patients. Patients most vulnerable to staph infections include the elderly and those who are on dialysis or have lung disease or diabetes, the study found.
Link: Journal of Bone and Joint Surgery - British Volume.
We wished to estimate the incidence of surgical-site infection (SSI) after total hip replacement (THR) and hemiarthroplasty and its strength of association with major risk factors. The SSI surveillance service prospectively gathered clinical, operative and infection data on inpatients from 102 hospitals in England during a four-year period. The overall incidence of SSI was 2.23% for 16 291 THRs, 4.97% for 5769 hemiarthroplasty procedures, 3.68% for 2550 revision THRs and 7.6% for 198 revision hemiarthroplasties. Staphylococcus aureus was identified in 50% of SSIs; 59% of these isolates were methicillin-resistant (MRSA). In the single variable analysis of THRs, age, female gender, American Society of Anesthesiologists (ASA) score, body mass index, trauma, duration of operation and pre-operative stay were significantly associated with the risk of SSI (p < 0.05).
Link: Guardian Unlimited
Both MRSA and MSSA infections are most likely to take hold of weak patients. The attributed death rate for MSSA is 8%, compared with 21% for MRSA.
Link: BBC NEWS
Bradford Teaching Hospitals Trust has seen the biggest rise in the number of MRSA superbug cases among England's general hospitals, new figures show. The trust, which runs Bradford Royal Infirmary and St Luke's, saw 31 more cases of MRSA last year, said the Health Protection Agency. The research showed that 68 of the country's 173 trusts - almost 40% - saw MRSA rates rise in 2004/5 from 2003/4.
Link: Hospitals across Europe
Hospitals across Europe will soon battle the MRSA superbug by following a £500,000 master plan developed in the north-east. Research by doctors at NHS Grampian forms the basis of a brochure to be circulated throughout the continent. The most sophisticated investigation into the clinical infection began on January 1, 2002 and ran until December 31 last year. It measured antibiotic resistance over the last four years in 300 hospitals, with the aim of producing a co-ordinated approach to fighting clinically acquired infections. The Aberdeen team held a consensus conference in Amsterdam last November and is on the verge of publishing its findings.
More at the link above
Link: HighWire Press -- Medline Abstract.
To know nosocomial infections (NI) rates among newborns and hospitalised children according to age and units of hospitalisation, METHODS: In 2001, the Comit� technique des infections nosocomiales (CTIN) initiated a one-day prevalence survey on an arranged date. It was conducted by the 5 centres de coordination de lutte contre les infections nosocomiales (C.CLIN). Paediatric data only were analysed dividing them into 2 groups: newborns (NB) up to 28 days old, whether in maternity, neonatology or intensive care units, and children (CH) from 29 days to 18 years old with separate analysis for surgery, cancer units and intermediate care and rehabilitation centres (ICRC).
Link: Journal of Clinical Microbiology.
Analysis of hospital-acquired methicillin-resistant Staphylococcus aureus strains isolated from a tertiary public hospital in Singapore revealed that multisusceptible strains had gradually started to replace the endemic multiresistant strain (ST239-MRSA-III) since 2002. Molecular typing showed that this was a predominantly clonal outbreak of a UK-EMRSA-15 strain (ST22-MRSA-IV).
Link: Infection Control Today - Study Reports HAIs are on the Rise.
“Research shows that there is a wide disparity in the number of HAIs identified using administrative codes and those identified through validated infection surveillance systems,” states Sebazco. An abstract presented during the April 2005 Society for Healthcare Epidemiology in America (SHEA) annual conference reported that data abstracted from hospital billing records identified 943 patients with presumed HAI from administrative codes versus 239 cases using validated HAI surveillance. Another 131 infections identified by validated infection surveillance were not captured from billing records. The abstract authors concluded that further investigation of the use of administrative/billing databases for HAI surveillance is needed.
Link: National hospital infection surveillance on methicillin-resistant Staphylococcus aureus..
Surveillance of methicillin-resistant Staphylococcus aureus (MRSA) infections in Japan was performed in 1995 and 1996. Hospital infection rates of MRSA appear to have remained stable in recent years, and this study was undertaken to test this hypothesis. In national surveillance, the incidence of MRSA hospital infections per 100 admissions remained stable at between 0.7 and 0.8 from 1999 to 2003, with a tendency towards a slight decline. This study shows that precautions against MRSA infection in Japan may prove to be an effective preventive measure.
Link: As science gets wiser, so do the bugs.
Researchers at the Baylor College of Medicine and Texas Children's Hospital conducted a three-year study of S. aureus infections in children. They found that among S. aureus isolates acquired in the community, the proportion of isolates that were MRSA had reached 76 percent in 2003. Over the preceding three years, the number of MRSA infections acquired in the community had more than doubled. The MRSA isolates caused skin and soft tissue infections in most cases, and more than 60 percent of these children were admitted to the hospital. The rapid rise in pediatric community-acquired MRSA infections in Texas should raise red flags for health care workers everywhere. "There have been deaths related to this organism, although the vast number are skin and soft tissue infections," said Sheldon Kaplan, MD, lead author of the Texas study. He added that because of this "very dramatic increase" in MRSA infections, physicians should learn what percentage of staphylococcal isolates are drug-resistant in their own communities so they can monitor for increases and adjust treatment accordingly. And if regular drug-resistant bacteria weren't bad enough, some bacteria have become multidrug resistant (MDR). Researchers at the Beth Israel Deaconess Medical Center and Harvard Medical School studied the prevalence of bacteria resistant to three or more drugs over a six-year period. From 1998 to 2003, there was a significant increase in the incidence of patients carrying MDR bacteria when they were admitted to the hospital. Of the four species of MDR bacteria that the researchers examined, three of them--including Escherichia coli, a familiar bug that can cause urinary tract infections--were involved in the upswing.
Link: STUFF.
While rates of antibiotic resistant bacteria are lower in New Zealand than in Australia, the United States and Britain, the incidence of superbugs has increased dramatically here since reporting began in 1990. One of the most common is methicillin-resistant staphylococcus aureus or MRSA. Environmental Science and Research figures show that last year, 1688 patients and 100 healthcare workers around the country were recorded as having multi-resistant MRSA, resistant to two or more classes of antibiotics. Almost three-quarters of those were hospital patients. While the number of MRSA cases increased from 2003 to 2004, the rate of multi-resistant cases decreased. In 2004, Wellington's multi-resistant MRSA rate was about two thirds the national average. There were eight cases at Wellington Hospital up till April 15 this year. It is widely acknowledged that over prescribing of antibiotics is responsible for the rising incidence, and the Health Ministry has campaigned for appropriate use to prevent the development of resistant bacteria.
Link: Superbug cases are down.
Last week the Gazette reported cases of the "hospital superbug" found in Frenchay and Southmead Hospitals have dramatically fallen over a three year period. North Bristol NHS Trust which runs the two hospitals confirmed a study by the Department of Health's surveillance system revealed between April 2001 and March 2004 the number of MRSA cases had dropped from 144 to 88. Spokesperson for North Bristol NHS Trust, Juliet Armstrong, said the strict cleanliness at both hospitals and hygiene policies have been praised by the Clean Hospitals Initiative, which awarded a score of 95 percent - just one percent off an excellent rating. She said: "In particular, the trust has been spotlighted by the National Audit Office for its effective use of modern matrons in establishing infection control audits for wards and departments.
Link: American Journal of Respiratory and Critical Care Medicine.
This article is relevant because it highlights the possibility that vulnerable people may be infected with hospital infections in the out patient context
Link: Staphylococcus aureus Bacteremia, Australia - Hubmed..
Staphylococcus aureus bacteremia (SAB) is common and increasing worldwide. A retrospective review was undertaken to quantify the number of cases, their place of acquisition, and the proportions caused by methicillin-resistant S. aureus (MRSA) in 17 hospitals in Australia. Of 3,192 episodes, 1,571 (49%) were community onset. MRSA caused 40% of hospital-onset episodes and 12% of community-onset episodes. The median rate of SAB was 1.48/1,000 admissions (range 0.61-3.24; median rate for hospital-onset SAB was 0.7/1,000 and for community onset 0.8/1,000 admissions). Using these rates, we estimate that approximate, equals6,900 episodes of SAB occur annually in Australia (35/100,000 population). SAB is common, and a substantial proportion of cases may be preventable. The epidemiology is evolving, with >10% of community-onset SAB now caused by MRSA. This is an emerging infectious disease concern and is likely to impact on empiric antimicrobial drug prescribing in suspected cases of SAB.
Link: Scotsman.com
He said MRSA rates were not decreasing, adding: “We are probably in a steady state now.” Dr Enright said he believed targets should be set for cutting the rate of MRSA infections, but added: “I just don’t think we have the technologies in place. We don’t know enough about MRSA and about how it is spread. The only short-term method is to trace and destroy. “If half the hospital infections are MRSA it is very difficult to isolate all the people who have got those infections. If we had started this policy between 1990 and 1995 it would have been viable, but we can’t really have a search and destroy policy now because we don’t have the isolation facilities.”
Link: Hubmed Poland
As part of the Polish external quality assurance scheme, clinical laboratories were asked to send five consecutive isolates of Staphylococcus aureus and the corresponding susceptibility results to the national Centre of Quality Control in Microbiology. Of 1376 isolates submitted as S. aureus from 276 medical centres, 13 (< 1%) had been misidentified by local laboratories. Of 181 (13.5%) methicillin-resistant S. aureus (MRSA) isolates, most were identified correctly (c. 98% of laboratories). Although all MRSA isolates were fully susceptible to vancomycin, teicoplanin and linezolid, they were usually multiresistant; almost 23% were resistant to seven antimicrobial agents. Most (> 90%) MSSA isolates were susceptible to the tested antibiotics, except penicillin (21% susceptible) and tetracycline (62.4% susceptible). In addition to evaluating the proficiency of testing by local laboratories, the study yielded valuable information regarding the susceptibility patterns of S. aureus isolates in Poland.
Link: Hubmed.
Our objective was to evaluate the accuracy of a methicillin-resistant Staphylococcus aureus (MRSA) rate using the imported MRSA reservoir identified at the time of hospital admission. Two indicators were used: the number of imported MRSA patient-days/total number of patient-days [representing colonization pressure (CP) at the time of admission] and the incidence of hospital-acquired MRSA isolated from clinical samples expressed as density/100 patient-days for carriers identified at the time of admission [representing the incidence taking CP into account (ICP)]. The variations of these indicators were analysed and compared with two more common indicators: percentage of MRSA acquired in our hospital and the incidence of hospital-acquired MRSA isolated from clinical samples expressed as density/1000 patient-days within three four-month periods during 2002. Common indicators varied similarly, with marked decline during the third period; first-period CP was twice that of other periods (P<10(-6)) and the highest (>two-fold) ICP was seen in the summer (second) period (P<0.001) when the personnel/patient ratio was the lowest. Thus, comparison of different indicators within four-month periods underlines important differences between common and novel indicators. Despite several limitations, ICP should be helpful in the interpretation of MRSA surveillance data, particularly for estimating the extent of MRSA transmission.
Link: Journal of Clinical Microbiology.
A nationwide surveillance program has collected and stored all MRSA isolates since 1988 and, since 1999, clinical information has been also recorded. We used this information and isolates in a detailed epidemiological and molecular analysis of the 81 MRSA infections identified in Denmark in 2001. MRSA isolates were characterized by pulsed-field gel electrophoresis (PFGE), spa typing, multilocus sequence typing, and SCCmec typing. Comparison of the 45 community-onset MRSA (CO-MRSA) infections with the 36 hospital-acquired MRSA (HA-MRSA) infections showed several striking contrasts. Most CO-MRSA were recovered from skin and soft tissue infections caused by isolates carrying the Panton-Valentine leucocidin toxin genes, and the majority (84%) of isolates belonged to a single clonal type, ST80-IV, which has been found in the community in other European countries. Clone ST80-IV could be traced in Denmark back to 1993. ST80-IV was rarely found in HA-MRSA infections, which belonged to a large number of clonal types, including some pandemic MRSA clones. The low number of HA-MRSA infections and the diversity of MRSA clones in Danish hospitals may be the result of successful infection control measures that prevent spread of clones in hospitals. The mechanism of spread of the ST80-IV clone in the Danish community is not known, and new control measures are needed to control further spread of this and other CA-MRSA clones.
Link: MRSA surveillance system - results.
PLEASE NOTE - WE RECEIVE MANY REQUESTS FOR HOSPITAL SPECIFIC FIGURES. THESE WOULD TAKE FROM 10-15 MINUTES EACH TO PROCESS IF WE SEARCH AND RESPOND. DUE TO THE SHEER PRESSURE OF WORK WE CAN'T RESPOND THEREFORE. PLEASE SEE INSTRUCTIONS BELOW
These tables give data on numbers and rates of MRSA bacteraemias per 1000 bed days in NHS acute Trusts: Mandatory surveillance – April 2001-September 2004. The data was produced by the Health Protection Agency Communicable Disease Surveillance Centre for the Department of Health.
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For private health facilities click here and search for your facility using the alphabetical index. There will be an inspection report that you can download.
Link: Michigan.
Here is a chilling line. Dentists, doctors, opticians, hairdressers and sex workers spring to mind.
Others who routinely have skin-to-skin contact with strangers are at greatest of developing an MRSA infection, health officials said.
Link: Quebec
Quebec Health Minster Philippe Couillard says that the province’s hospitals are doing their best to control MRSA, an infection that is resistant to most antibiotics, and can be deadly to people with damaged immune systems. Five thousand cases were reported in 2004, resulting in an unspecified number of deaths. Couillard told reporters that improved infection-control procedures had kept the “superbug” from getting out of control, and that studies to improve the system would continue.
Link: News.
This is helpful - it clears up the confusion re the death certificate. It also reveals that the mother worked in an environment usually linked to high levels of MRSA. The plea for cleaner wards is understandable but if the source was a hospital one as suggested by the test it could have come from a variety of sources other than a dirty floor or worktop.
The hospital denied a cover-up and insisted it was the result of a misunderstanding. A spokeswoman for the Norfolk, Suffolk and Cambridgeshire Strategic Health Authority said: "The cause of death was initially given as septicaemia. It takes time for MRSA to incubate in the laboratory. As soon as the results were known the parents were informed and a new certificate issued." Luke was born naturally on 2 February, weighing 7lb 7oz. The hospital said it was a "complicated" birth, but he showed no signs of ill health. His mother, Glynis Day, 17, a kitchen assistant at a home for the elderly, blamed poor standards of cleaning for their loss. She said: "They told us they had no understanding of what had happened. He had no symptoms or anything. As far as they were concerned Luke was just a normal, healthy baby. "I just can't believe how MRSA can kill a tiny little baby. I want people to know that things like this can happen. Something needs to be done to sort hospitals out, like more money for cleaners instead of people sitting in offices."
Link: HighWire Press -- Medline Abstract.
Methicillin-resistant Staphylococcus aureus (MRSA) is an increasing problem for patients with cystic fibrosis (CF). It has been associated with clinical deterioration in some patients with CF, creates additional infection control problems, and may affect acceptance onto transplant waiting lists. Recent attempts to eradicate the organism have met with only moderate success. An understanding of those factors which increase the risk of acquisition of MRSA by CF patients will aid the development of effective preventative strategies. We conducted a retrospective case-control study comparing a variety of risk factors for 15 MRSA-positive patients and 30 age-sex-matched MRSA-negative controls who attended the Regional Paediatric or Regional Adult Cystic Fibrosis Units in Leeds. During the year prior to initial isolation, MRSA-positive CF patients spent more days in hospital (mean 19.8 days versus 5.5 days, p=0.0003), received more treatment days of oral ciprofloxacin (43.5 days versus 13.9 days, p=0.03) more treatment days of oral/intravenous cephalosporins (42.7 days versus 15.4 days, p=0.04) and were more likely to be chronically infected with Aspergillus fumigatus (40% versus 10%, p=0.04) than the age-sex-matched MRSA-negative controls. There were no significant differences in observed clinical parameters (clinical and X-ray scores) with between the two groups. Minimising the number and length of hospital admissions and judicious use of antibiotics, particularly ciprofloxacin, should be the key components of any strategies designed to reduce the risk of MRSA acquisition by patients with CF.
Link: Superbug cases are down.
A COLLECTIVE sigh of relief was breathed this week as Health Secretary Dr John Reid announced hospitals were winning the battle against the potentially fatal disease MRSA. Reporter Hannah Swingler investigated whether these national statistics ring true with local hospitals. "We are beginning to see results in the battle against MRSA in our hospitals." announced Dr John Reid this week. According to the Health Secretary, figures showed a 6.3 percent reduction in new cases of methicillian resistant Staphylococcus aureus compared to the same period last year. However, while the debate rages over this contentious issue it seems evidence taken from local research backs this claim up. Last week the Gazette reported cases of the "hospital superbug" found in Frenchay and Southmead Hospitals have dramatically fallen over a three year period.
Interesting feature - click link above for full story
Link: HighWire Press -- Medline Abstract.
This report presents the prevalence of Palestinian isolates of methicillin-resistant Staphylococcus aureus (MRSA) in nosocomial infections and their antibiotic resistant pattern. A total of 321 clinical isolates of S. aureus were identified from different patients. The prevalence of methicillin resistance among S. aureus isolates was 8.7% (28 isolates). Resistance rates of MRSA to other antibiotics were as follows: 82.1% resistant to erythromycin, 67.9% to clindamycin, 64.3% to gentamicin, and 32.1% to ciprofloxacin. No co-trimoxazole- and vancomycin-resistant isolates were identified in this study. The proportion of methicillin resistance was highest among S. aureus isolates associated with upper respiratory specimens (42.8%); the proportion of methicillin resistance was 39.3% among skin ulcer isolates, 10.7% among urinary tract infection isolates, and lowest among isolates associated with blood and prostate discharge (3.6% each).
Link: HighWire Press -- Medline Abstract.
To describe the relative proportions of nosocomial and community-onset Staphylococcus aureus bacteremia at our institution and the epidemiologic characteristics and clonal diversity of S. aureus isolates, as determined by pulsed-field gel electrophoresis (PFGE) and antimicrobial resistance patterns. DESIGN: Retrospective cohort study of all cases of S. aureus bacteremia between October 2001 and October 2002. SETTING: A 1300-bed, tertiary-care hospital. RESULTS: One hundred sixty-two unique episodes of S. aureus bacteremia were identified. Forty-three cases (26.5%) were caused by methicillin-resistant S. aureus (MRSA). Most cases of S. aureus bacteremia, whether MRSA or methicillin susceptible (MSSA), were nosocomial in origin (77.2%) or were otherwise associated with the healthcare system (16%). Only 11 (6.8%) of the cases (all MSSA) were strictly community acquired. Thirty-five unique macrorestriction patterns were identified among the 154 isolates that were typed by PFGE. Four major genotypes were defined among the isolates of MRSA, with 36 (85.7%) represented by a single PFGE type. Of the isolates within this major clone, all (100%) were ciprofloxacin resistant and 77.8% were erythromycin resistant. In contrast, the 112 isolates of MSSA comprised 31 different PFGE types, 3 of which represented 42.9% of all MSSA isolates and were associated with both nosocomial and community-onset bacteremia. CONCLUSIONS: Most cases of S. aureus bacteremia in our healthcare region are nosocomial in origin or are acquired through contact with the healthcare system and are thus potentially preventable. To preclude dissemination of pathogenic clones, it is therefore necessary to redouble preventive measures in both the hospital and the community.
Link: CBC Montreal - Deadly superbug poses new threat in Quebec hospitals.
Quebec hospitals are fighting a new battle against an antibiotic-resistant bacterium. Radio-Canada is reporting that methicillin-resistant staphylococcus (MRSA) infected at least 5,000 people last year. Of those 5,000 cases, 800 led to serious infections, and somewhere between 25 and 50 per cent of patients died from direct or indirect causes of those infections. Quebec hospitals are trying to find ways to combat this highly infectious bacterium. Five years ago, only a handful of hospitals were fighting MRSA, Radio-Canada reports. Now, according to government documents acquired under the access to information laws, almost every hospital in the province is fighting the superbug. MRSA usually strikes the elderly and the extremely sick. Infectious disease specialist Marie Gourdeau says the situation with the superbug is very troubling, and that if it is not contained, hospitals will be fighting superbugs resistant to all antibiotics.
Link: SocietyGuardian.co.uk | Society | Praise for hospital staff after MRSA fall.
But opposition critics claimed the figures - published for six months rather than 12 as has been the norm - gave a misleading impression, and it is clear that good progress on fighting hospital acquired infection in London is not matched in all parts of the country. League tables, published on the government website, revealed widely varying rates of infections at different hospitals.
Link: Scarborough Today
SUPERBUG infections of MRSA in Scarborough's NHS trust area more than halved in 2004 compared to the previous year. Figures published by the Department of Health show that from April to September 2003 Scarborough and North East Yorkshire NHS Trust had 19 cases of the killer bug compared to nine in the same period of 2004. During the same six-month period of 2001, the Scarborough trust reported 16 cases of MRSA and in 2002 there were eight. Hospital spokesman Chris Coombes said that the trust was encouraged by the latest figures but was working to reduce them further. He said: "They only cover a six-month period and can fluctuate a lot throughout the year. We are working very hard to bring figures down through education of staff and increased washing of hands. "But it is hard to control because in most cases the bacteria comes in from outside and is brought in by patients and visitors."
Link: SUPERBUG STRIKES HARD.
KILLER hospital superbug MRSA has struck a Dorset hospital so hard it is one of the worst affected in the country. There were 28 cases of the superbug reported by Poole Hospital NHS Trust between April and September last year. Only six general hospitals in England had a worse percentage of MRSA outbreaks over the same six months, according to a government league table released this week. Royal Bournemouth and Christchurch Hospitals had 14 cases of the bacteraemia and is listed in the best one-third of trusts in the country. And the private Bournemouth Nuffield Hospital, which is not covered by the government league table, revealed it has no MRSA infection spread.
Link: Luton Today.
Bedford Hospital seems to be coming out on top when it comes to MRSA infection rates. A list was published by the Department of Health this week, showing which hospitals around the country have the highest infection rates. It assessed the progress of 110 hospital trusts across the UK and Bedford was ranked second for its control and prevention of the 'superbug'. The survey showed that between April and September 2004, Bedford Hospital had only two cases of MRSA.
Link: Herts24.
MRSA has almost halved at our hospitals, official figures claim. Twenty-five superbug cases were reported at WGC's QE2 and the Lister in Stevenage in six months last year. This is almost half compared to the 47 cases reported in the same period in 2002. Bosses of the trust which runs both hospitals said they welcomed the downward trend. Noel Scanlon, director of nursing at the East and North Hertfordshire NHS Trust, said: "The figures are a testament to the hard work of our staff, including our highly dedicated infection control team."
Link: icCheshireOnline .
PATIENTS being treated at Leighton Hospital in Crewe are still at risk of catching the superbug MRSA, according to new Government figures. Statistics out this week show the number of reported cases in the Mid Cheshire Hospitals Trust, which runs Leighton, have risen from 14 in the six months from April to September 2003 to 20 cases in the same period last year. The increase comes despite a nationwide fall to a four-year low. Trust director of service development Mandy Donald said it is committed to ridding the hospital of the bug and will continue to implement new ideas and schemes to ensure patients can be treated with out fear.
Link: icNewcastle
Hospitals across the North-East are losing ground in the fight against superbug MRSA. The number of infections has increased by 14pc in four years. And as health ministers yesterday hailed a national reduction in the number of cases, the region went against the trend with 22 more incidents recorded in the six months to September 2004 than in the same period three years ago. The fall was in stark contrast to the success seen nationally: Health Secretary John Reid announced a 6.3pc fall in the number of infections over the past four years - a figure mainly helped by action in London. Although some individual hospitals in the region are among the better performing NHS trusts in England, the regional breakdown has caused concern among health unions.
Link: barrow in furness
SUPERBUG cases at Furness General Hospital rose over the past year. An Evening Mail request under the Freedom of Information Act revealed a 15 per cent overall increase in cases of MRSA between 2003 and 2004. The bacteria, which has been associated with poor hygiene on hospital wards, has caused a nationwide controversy over the number of patients who acquire illnesses while already in hospital. Up to 5,000 people die from such diseases in hospitals across the country every year, according to the National Audit Office. Among FGH inpatients a total of 226 cases were diagnosed with MRSA in 2004, compared with 167 in 2003 and 174 in 2002.
Link: East Anglian Daily Times news.
AN MP claimed last night that the hospital superbug MRSA was still a “massive problem” in Suffolk's hospitals despite the Government insisting the rising tide of cases had been stemmed. Health Protection Agency figures issued yesterday showed the number of MRSA bloodstream infections stabilised between April and September last year. But a comparison with the same period in 2003 showed every hospital trust in the region, except Addenbrooke's Hospital in Cambridge, had experienced a rise in serious MRSA cases. The figures also revealed that two hospital trusts in the region were ranked among the worst in the country over the period April-September last year. James Paget Healthcare Trust in Gorleston was ranked second from the bottom out of the country's general acute NHS trusts, with an MRSA bloodstream infection rate of 0.32 per 1,000 bed days. Addenbrooke's Trust in Cambridge was fourth from the bottom on the national list of “specialist” trusts with an infection rate of 0.36 per 1,000 bed days. Richard Spring, West Suffolk MP, said: “This is dreadful and the measurement of the statistics leaves something to be desired. It is very, very worrying and people write to me all the time about it.
Link: EDP24 News.
The Government's claim that it is winning the fight against the hospital superbug MRSA looked questionable last night as new figures showed the Queen Elizabeth Hospital at King's Lynn was among the worst performers in the country. Nationally, cases of the superbug have reached their lowest level since mandatory records began in 2001. But the King's Lynn and Wisbech Hospitals NHS Trust, which runs the QEH, saw a rise in cases - putting it fourth in the national table of the worst-performing trusts.
Link: Mirror.co.uk
PATIENTS face an MRSA postcode lottery as some hospitals struggle to contain the superbug while others are slashing the number of cases. Figures out yesterday showed a 6.3 per cent reduction in new cases compared to the same period last year. But new statistics revealed a mixed fortune for individual trusts trying the beat the bug. While hospitals in Mid-Yorks had the biggest drop in MRSA, followed by Birmingham and Solihull Trust, Norfolk and Suffolk's James Paget Trust had the largest rise in cases. Hull and East Yorkshire Hospitals and Brighton and Sussex University Hospitals also fared badly. Health minister Lord Warner said: "There are exceptions where the numbers have gone the wrong way, but the figures speak for themselves, 6.3 per cent is 6.3 per cent. "We need to sit down with people and find out what they are not doing."
Link: this is plymouth.
Rates of infection from the MRSA superbug at Derriford Hospital have improved over the last recorded six months, but are still worse than for the same period a year before. According to figures published by the Health Protection Agency, Plymouth Hospitals NHS Trust's rate for MRSA in the six months from April to September 2004 is 0.24 per 1,000 bed days. This is an improvement on the last recorded year (April 2003 to March 2004), when the figure was 0.26 per 1,000 bed days.
Link: icCheshireOnline - MRSA on the rise in region's hospitals.
INFECTIONS of the MRSA 'superbug' are still on the rise in Merseyside and Cheshire hospitals, despite a nationwide fall to a four-year low. The number of cases rose by 6.6% last year, from 151 to 161, with seven out of 13 local hospitals reporting an increase compared to the same period in 2003. The biggest rise was at Aintree Hospitals, which had 33 antibiotic-resistant superbug infections over the six months between April and September 2004 - up from just 19. It meant Aintree had just three fewer cases than the giant Royal Liverpool and Broadgreen Hospitals Trust, which reported the biggest fall, from 49 cases to 36. Mid Cheshire Hospitals (up from 14 to 20 cases), North Cheshire Hospitals (up from nine to 13) and St Helens and Knowsley Hospitals (up from nine to 15) also showed big increases.
Link: Sheffield Today
SUPERBUG infections are failing to drop in Sheffield's adult hospitals, new figures have revealed. Government tables show that overall the number of MRSA infections have declined in NHS hospitals over the last six months - including most in South Yorkshire. But numbers of infections have remained static at Sheffield Teaching Hospitals Foundation Trust. Between last April and September there were 51 cases at the Trust, the same number as the previous six months. And it was only one case less than the 52 recorded a year earlier. Health managers for the Trust, which runs the Royal Hallamshire Hospital, Northern General Hospital, Charles Clifford Dental Hospital, Weston Park Hospital, have defended their record on tackling superbugs. A spokesman said: "We're pleased that MRSA detection rates have not risen in this period at the hospitals. For a major teaching hospital treating so many patients each year we do have a good record of controlling MRSA infections and have retained a good comparative position when compared to other hospitals of a similar size." .
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Link: Infection Control Nurses Asociation.
The ICNA is aware of the continuing strenuous efforts that all its members have been making to reduce levels of MRSA and other Healthcare Associated Infections (HCAI). It is anticipated that their commitment and hard work within hospitals in England, together with local and national initiatives will be lead to a reduction in MRSA rates to be announced by John Reid on Monday 7th March. However, any improvement must be viewed with caution as we do not as yet have full figures that include the autumn and winter, a period when MRSA levels can increase due to the seasonal rise in hospital admissions and disease patterns. Any reduction in MRSA in our hospitals must be welcomed, but there is no room for complacency as the threat of MRSA and other resistance bacteria spreading outside of hospitals into the wider community is very real and there are already reports of this happening. MRSA dominates news headlines to the exclusion of other HCAI such as Clostridium difficile, Norovirus and other highly resistant Gram negative bacteria which are already prevalent in the healthcare system and are of equal concern to healthcare professionals.
Link: Guardian Unlimited Politics
Hospitals delivering specialist care have the highest superbug rates in the country, according to figures published today. Specialist hospital Queen Victoria hospital NHS trust gained the unenviable accolade of having the worst prevalence rate in the country for MRSA infections. The second and third worst ranking were two fellow specialist trusts, Brighton and Sussex University hospitals NHS trust and University Hospital Birmingham NHS trust. This partly reflects the prevalence of vulnerable patients undertaking more invasive and high risk specialist care in these hospitals. The greater the number of patients seen in specialist units, the greater their vulnerability to infection, and the higher resulting MRSA rates are likely to be.
Link: barrow in furness
SUPERBUG cases at Furness General Hospital rose over the past year. An Evening Mail request under the Freedom of Information Act revealed a 15 per cent overall increase in cases of MRSA between 2003 and 2004. The bacteria, which has been associated with poor hygiene on hospital wards, has caused a nationwide controversy over the number of patients who acquire illnesses while already in hospital. Up to 5,000 people die from such diseases in hospitals across the country every year, according to the National Audit Office. Among FGH inpatients a total of 226 cases were diagnosed with MRSA in 2004, compared with 167 in 2003 and 174 in 2002. Cases discovered among out-patients or by GPs actually fell overall between 2002 and 2004. In June 2004 Second World War veteran Fred Hill became the first patient at the hospital to die solely as a result of MRSA, which he contracted after a routine bladder operation.
Link: this is bath
"We have installed new alcohol gel dispensers at patients' bedsides and in other treatment areas, and have run a major awareness campaign to encourage good hand hygiene among patients, staff and visitors." One of the hospital's key objectives is to reduce the incidence of MRSA rates by 20 per cent this year. The number of incidents has nearly halved from 42 cases from April to December 2003/04 to 24 in the same period 2004/05.
Link: Peterborough Today
THE number of MRSA cases in Peterborough hos- pitals has gone up by one third in a year, new statistics have revealed. The rise in the number of cases from 12 to 16 follows a revelation from the Office of National Statistics that MRSA deaths across the country have doubled in the past four years. However, Peterborough NHS Trust has claimed it is doing everything it can to try to control the superbug and prevent it from spreading further under its existing infection control measures. A spokesperson for the trust also claimed none of the 16 MRSA-related cases in 2004 in Peterborough's hospitals – Peterborough District Hospital, Edith Cavell and Stamford Hospital – were serious.
Link: Latest News.
The Department of Health wishes to encourage a range of research in the area of the control of infection, with a particular emphasis at this time on the control of MRSA. Up to £1 million has been earmarked for research in this area, as part of a package of research being developed in response to the report 'Winning Ways'. The present evidence-base for infection control is poor and questions about the relative importance and cost-effectiveness of interventions for control of infection remain unanswered.
We have identified a number of example areas where further evidence is required (see attached research specification). This is not exhaustive and proposals in other areas are welcome. We are seeking to fund a programme of research within a coordinated framework of activity and are now calling for expressions of interest from any group who wish to contribute to this programme.
Link: Guardian Unlimited
If MRSA is not the pending cataclysm that Michael Howard suggests - currently one death in every 1,000 according to the ONS - it nevertheless needs calm, serious attention. Distinguished scientists have expressed their concern. Professor Barry Cookson, director of the Laboratory of Hospital Infection at the Public Health Laboratory, warns that there could be an epidemic. The UK is suffering from two virulent strains of the bug that have not yet reached most other countries. Britain has the second-highest rate of MRSA infection in Europe, although higher rates have been reported in Japanese and American hospitals.
Link: Clean blitz amid rise in MRSA cases.
The family of 54-year-old Allan Grange, who lived in Cooper Lane, insist MRSA killed the dad-of-two as he was recovering from an operation to remove a cancerous tumour from his lung in Bradford Royal Infirmary. Today his former wife Janet Hamilton, 53, said: "We had to pay £50 for all Allan's medical notes and it says in there he had MRSA but his death certificate says he died of multi-organ failure. I am not surprised by the latest figures and I'm sure the real figures are much higher. But how can it be checked if it's not being recorded on the death certificate? "I will push for this to be recorded on the death certificate. MRSA was Allan's biggest fear before he went into hospital. The state he ended up in was tragic."
Link: Times Online - Britain.
Peter Goldblatt, the ONS chief medical statistician, said the 955 deaths were probably an underestimate because MRSA may not have been fully reported in the past. The ONS and the Health Protection Agency are now carrying out a study at the request of the Chief Medical Officer to establish better methods of monitoring MRSA. Christine Beasley, the Chief Nursing Officer, said: “By improving reporting of MRSA like this, it will help us identify avoidable factors and learn useful lessons. There is no one simple solution to preventing infection, but we are taking a whole range of actions in fighting the superbug and it’s a top priority for this Government and the NHS.”
Link: The Sun Newspaper Online - UK's biggest selling newspaper.
AN explosion in deaths linked to superbug MRSA is being covered up, a disease expert said last night. Scientist Dr Mark Enright warned new official figures vastly underestimate the scale of the plague across Britain. He says many doctors do not give MRSA as a cause of death on certificates — and claims the annual toll could be close to 5,000 victims. "It does not often find its way on to death certificates. “You’re talking about really sick people — you can always find something else they’ve died of. But it’s not really in the interests of hospitals or NHS trusts to report MRSA properly.” Dr Enright, a senior research fellow in the Department of Biology and Biochemistry, stressed many victims had serious underlying diseases — making it hard to know if MRSA is the main cause of death. Currently, doctors are not forced to state the cause of death as MRSA — only the immediate cause, like heart failure. They then make a clinical judgment about the patient’s medical history which may or may not include mention of MRSA. This allows doctors to leave out all mention of the superbug to avoid damaging the hospital’s reputation.
The Department of Health said hospitals must report MRSA cases. But it is not compulsory to record the superbug on death certificates.
Link: News.
Mr Howard whose mother-in-law died of the disease, thought the true extent of MRSA in the health service could be higher than the official figure. "We know that people die and the cause of death is often vague and ambiguous," he said. "I think the figures may not be reflecting the true extent of MRSA." Mr Howard, quoting earlier figures by the National Audit Office, said 5,000 died each year from MRSA and other infections picked up in hospitals.
He added: "No other country has seen the superbug infection take over its hospitals in the same way we have in Britain." He accused Tony Blair of being personally responsible by imposing health targets that prevented matrons from closing infected wards. "Mr Blair's obsession with targets has created a culture in which the superbug thrives," he said. "It is a fact that doctors and nurses are prevented from closing wards they know to be infected with the superbug because of Mr Blair's targets."
Tony Field, chairman of the patient group MRSA Support, said the health authorities "still haven't got to grips with it". He added: "I would expect the true figure to be much more than 955." Karen Jennings of the NHS union, Unison, said: "It cannot be a coincidence that, just as the number of cases of MRSA have gone up, so the number of cleaners employed in the NHS has gone down." The Liberal Democrat health spokesman Paul Burstow said the figures were "only the tip of the iceberg". Chief Nursing Officer Chris Beasley said "Improving reporting of MRSA will help us identify avoidable factors and learn useful lessons."
Last night, Mr Howard's allegations were rejected by allies of Mr Reid, who said the Royal College of Nursing had said closing a ward and dispersing the patients could spread the disease. "Matrons do have the power they need," said a source close to Mr Reid. "This is a good sound bite for the Tories, but it is a lousy policy."
Link: MRSA deaths double.
The news comes after Greater Manchester Strategic Health Authority revealed patients have spent around 5,000 bed days in its hospitals because of MRSA - methicillin-resistant staphylococcus aureus. The latest figures for 2003-4 showed that seven out of 10 hospital trusts in Greater Manchester had seen an increase in infection rates- with one hospital seeing the number of cases double in the last two years. In the north west the level of MRSA cases has risen 11 per cent and in Greater Manchester the number has gone up by 8.5 per cent. Previously experts have been unable to state the numbers killed by the bug - it is often difficult to work out whether a patient died from the illness they were in hospital for, or whether MRSA was the most important factor in their death.
In the latest report, Stepping Hill Hospital in Stockport saw the biggest increase in MRSA - from 13 cases in 2001/2 to 18 cases 2002/3 and 30 cases in 2003/4. Central Manchester and Manchester Children's University Hospitals NHS Trust - which runs Manchester Royal Infirmary, Booth Hall, Manchester Royal Eye Hospital, the Royal Manchester Children's Hospital and St Mary's Hospital - also fared badly with MRSA infection rates up by a third to 59 cases compared to 38 cases last year. Pennine Hospitals Acute NHS Trust, which runs North Manchester General, the Royal Oldham, Fairfield General and the Rochdale Infirmary still has the worst record for the super bug in Greater Manchester - 95 cases this year.
Link: Sky News
New figures show that 955 people died in 2003 as a result of being infected by the bug. That's up 155 on the previous year - a rise of almost 20% Experts say more needs to be done to keep hospitals clean. MRSA - or methicillin-resistant Staphylococcus aureus - is the bug hospital patients fear the most, and with good reason. The infection kills some patients, but many more are maimed.
Link: Telegraph
Between 2002 and 2003, mentions of MRSA on death certificates increased by 19 per cent while laboratory reports of MRSA only increased by 7 per cent, indicating that some of the increase in mentions of MRSA on certificates may have been due to improved levels of reporting. Christine Beasley, chief nursing officer, said: "There is no one simple solution to preventing infection, but we are taking a whole range of actions in fighting the superbug and it's a top priority for this Government and the NHS."
Link: Scotsman.com News
The number of deaths in which the superbug MRSA was a factor doubled over four years, statistics released today reveal. The Office for National Statistics issued the first in a series of annual reports on deaths in England and Wales where the superbug was mentioned on death certificates. The number of certificates mentioning MRSA rose from 487 in 1999 to 955 in 2003. Mortality rates were highest among older people with more men than women dying, the statistics show.
Link: Belfast Telegraph.
One of Ulster's highest profile doctors called today for all frontline medics to be "routinely tested" for MRSA - in a bid to stop the rising spread of superbugs in hospitals here. Dr Peter Maguire, a consultant anaesthetist at Daisy Hill Hospital, in Newry, and a leading BMA official, said swab tests should be given to every doctor dealing with the sickest patients.
Link: ShropshireStar.com
A new strain of the highly contagious MRSA superbug has hit Shropshire hospitals, it was revealed today. Medical bosses have reported a four-fold increase of the MRSA 16 clone across the Royal Shrewsbury and Princess Royal sites. Until recently only about five cases a month were being reported in the hospitals. Now 20 new cases are appearing each month. It appears the new clone is more resistant to traditional antibiotics - which doctors rely on to beat the superbug - than previous strains. Some scientists believe Britain's current MRSA problem may be due to the emergence of this particular version along with another nasty strain, MRSA 15. It is unclear how the latest strain developed. Their emergence - first documented in the mid-1990s - has coincided with increasing infection rates, it is claimed. They are believed to be more transmissible than other strains of the bug, allowing them to spread from patient to patient, or via hospital staff or equipment, easily.
Link: EDP24 - Hospital superbug cases rise.
The James Paget Hospital in Gorleston reports a 50pc increase in superbug MRSA. The number of cases at the JPH is expected to reach 45 for the year ending in March, compared to 30 over the previous 12 months. However, JPH spokeswoman Elayne Guest said hygiene measures put in place to combat the bug as soon as the rising trend was detected, were already working. Until the latest rise, the JPH had reported a 25pc drop in MRSA over four years, from 39 cases in 1999-2000 to 30 during 2003-2004. Tony Hegarty, director of infection control at the JPH, said: "Last summer . . . numbers started to rise again. "However, we recognised there was a problem and started looking in depth at every case." The hospital's domestic services had been runners-up in the recent national awards for the cleanest hospital.
Link: HighWire Press -- Medline Abstract.
OBJECTIVES:
Multiresistant pathogens cause major clinical problems and considerably increase treatment costs. Since 2001 the Protection Against Infection Act (PIA) obligates hospitals in Germany to the documentation of multiresistant bacteria. We analyzed the use of these data for routine internal surveillance.METHODS: We used standard data collected for the mandatory documentation and studied consecutive diagnoses of Methicillin-resistant Staphylococcus aureus (MRSA) in a 893-bed tertiary level hospital in North Rhine-Westphalia in Germany. Based on the Poisson distribution for the cumulative yearly incidence of MRSA, we defined a threshold level for an outbreak.
RESULTS: During a 12-month time period 80 patients were diagnosed with MRSA. The time structure and spatial distribution of different MRSA phenotypes (defined through specific antibiotic resistance patterns) were consistent with the within-hospital transmission. In the two preceding time periods of 12 months each, 15 respectively 8 patients with MRSA were found. The defined alert threshold level for cumulative yearly incidence was crossed in the beginnings of the outbreak.
CONCLUSION: Monitoring the mandatory data collected on multiresistant bacteria allows the early detection of accumulations suspect for the within-hospital transmission. This knowledge can be used for a fast reaction and breaking off the transmission chains.
Link: HighWire Press -- Medline Abstract.
Objective
Transmission between human and environmental contamination from colonized methicillin-resistant Staphylococcus aureus (MRSA) remains a controversial issue. We, therefore, investigated the differences between MRSA types which colonize in humans and in the environment.Methods A 4-week prospective culture survey for MRSA was performed for 12 patients as well as for the environment of the room of MRSA carriers in quarantine in the geriatric long-term care ward of a 270-bed hospital.Results A total of 97 S. aureus strains (80 MRSA and 17 methicillin-sensitive Staphylococcus aureus [MSSA]) was isolated during the periods of September 8 to 10, 23 to 25 and October 5 to 7, 1998; 25 strains were from the respiratory tract, 4 strains from feces and 11 strains from decubitus ulcers. Fifty-seven strains were from the patients' environment. Molecular typing by pulsed-field gel electrophoresis (PFGE) with the Sma I restriction enzyme demonstrated that the predominant type of MRSA isolated from the environment changed by the minute. The patterns of 42 MRSA strains isolated from the environment were identical in 26 (61.9%), closely related in 15 (35.7%) and possibly related in 1 (2.4%) of the cases of those isolated from patients simultaneously. There was no correlation between patients and the environment with the 17 MSSA isolates
Conclusion Our results demonstrated that MRSA from patients can contaminate the environment, whereas MRSA from the environment might be potentially transmitted to patients via health care workers under unsatisfactory infection control.
Link: HighWire Press -- Medline Abstract.
Background. - The risk associated with methicillin-resistant Staphylococcus aureus (MRSA) has been decreasing for several years in intensive care departments, but is now increasing in rehabilitation and chronic-care-facilities (R-CCF). The aim of this study was to use published data and our own experience to discuss the roles of screening for MRSA carriers, the type of isolation to be implemented and the efficiency of chemical decontamination.
Discussion. - Screening identifies over 90% of patients colonized with MRSA upon admission to R-CCF versus only 50% for intensive care units. Only totally dependent patients acquire MRSA. Thus, strict geographical isolation, as opposed to "social reinsertion", is clearly of no value. However, this should not lead to the abandoning of isolation, which remains essential during the administration of care. The use of chemicals to decolonize the nose and healthy skin appeared to be of some value and the application of this procedure could make technical isolation unnecessary in a non-negligible proportion of cases.
Summary. - Given the increase in morbidity associated with MRSA observed in numerous hospitals, the emergence of a community-acquired disease associated with these strains and the evolution of glycopeptide-resistant strains, the voluntary application of a strategy combining screening, technical isolation and chemical decolonization in R-CCF appears to be an urgent matter of priority.
Link: HighWire Press -- Medline Abstract.
Our results clearly distinguish a high-virulence high-survival group of variola (smallpox) virus, Mycobacterium tuberculosis, Cornynebacterium diphtheriae, Bordetella pertussis, Streptococcus pneumoniae, and influenza virus (where all pathogens have a mean percent mortality > or = 0.01% and mean survival time >10 days) from a low-virulence low-survival group containing ten other pathogens. The correlation between virulence and durability explains three to four times of magnitude of difference in mean percent mortality and mean survival time, using both across-species and phylogenetically controlled analyses. Our findings bear on several areas of active research and public health policy: (1) many pathogens used in the biological control of insects are potential sit-and-wait pathogens as they combine three attributes that are advantageous for pest control: high virulence, long durability after application, and host specificity; (2) emerging pathogens such as the 'hospital superbug' methicillin-resistant Staphylococcus aureus (MRSA) and potential bioweapons pathogens such as smallpox virus and anthrax that are particularly dangerous can be discerned by quantifying their durability; (3) hospital settings and the AIDS pandemic may provide footholds for emerging sit-and-wait pathogens; and (4) studies on food-borne and insect pathogens point to future research considering the potential evolutionary trade-offs and genetic linkages between virulence and durability. Publication Type:
Link: BBC NEWS
They were more transmissible than other 15 strains of the bug that have been isolated, allowing them to spread from patient to patient, or via hospital staff or equipment, easily. "You might only need to isolate one in 10 MRSA cases to stop these outbreaks starting," he said. But he acknowledged that this would require "a politically unacceptable level of resource and lengthen hospital waiting lists" in the Society for General Microbiology's publication Microbiology Today. He also said there had been "an unacceptably low" amount of government spending on research into the causes of the MRSA epidemic started.
Link: ThisisLondon.
Highly contagious clones of the superbug MRSA may be responsible for the UK's hospital epidemic, a scientist claims today. Research says two versions of the bacteria emerged at the same time hospital infection rates began to soar. Dr Mark Enright, of Bath University, says instead of focusing on cleaning, the Government should increase screening for patients with these strains, which are more infectious.
Link: HighWire Press -- Medline Abstract.
A total of 9 patients (15%) became colonized. In multiple logistic regression analyses, the use of a urinary catheter for >/=5 days (P = .006), postoperative bleeding at the surgical site (P = .009), and preoperative use of fluoroquinolones (P = .08) were associated with a higher risk of colonization. Patients without any of these risk factors did not become colonized. In conclusion, nasal carriage of MRSA is frequently acquired after OLT. Periodic postoperative screening for MRSA carriage should be an integral component in programs designed to reduce nosocomial MRSA transmission in these patients. Further studies are needed to set up and validate a predictive model that could allow targeting postoperative screening to high-risk OLT recipients.
Link: Journal of Clinical Microbiology.
Overall, a total of 16 genotypes based on sequence type and SCCmec types were identified among MRSA strains from Asian countries. Data revealed two major genotypes of MRSA strains in Asia, with unique geographic distributions. By MLST analysis, all strains from Korea and Japan except one belonged to clonal complex 5 (CC5) while most MRSA isolates from other Asian countries belonged to CC239. SCCmec typing showed that most isolates from Korea and Japan were SSmec type II whereas SCCmec type III (or IIIA) was the most common type in strains from other Asian countries. Our data documented a unique geographic distribution and evolutionary pattern of MRSA clones in Asia.
Link: Journal of Clinical Microbiology.
A total of 1,838 subjects from the community and 393 subjects from health care-related facilities in Taiwan were evaluated for the prevalence of nasal Staphylococcus aureus colonization and to identify risk factors associated with S. aureus and methicillin-resistant S. aureus (MRSA) colonization. In conclusion, a high prevalence of MRSA colonization was observed among people with no relationship to the hospital setting. The high level of multiple-drug resistance among community MRSA strains in association with the previously reported excessive use of antibiotics in Taiwan highlights the importance of the problem of antibiotic selective pressure. Our results indicate that both the clonal spread of MRSA and the transmission of hospital isolates contribute to the high MRSA burden in the community.
Link: HighWire Press -- Medline Abstract.
OBJECTIVES: To describe clinical features, microbiologic characteristics and outcome of bacteremia in the elderly patients hospitalized in a geriatric hospital. 68% of S. aureus strains were resistant to methicillin. Portals of entry were urinary tract (44%), respiratory tract (14%), digestive tract (11%), and soft tissue (8%). The same bacterial strain as in bacteremia was isolated from a peripheric site in 30 cases (47%), most of them being urines. For 15% cases, portal of entry cannot be determined. Mortality associated to nosocomial bacteremia was 25%, and death was significantly associated to MRSA, urinary or intravascular devices, chronic wounds and inappropriate antibiotic prescription. CONCLUSION: In geriatric hospitals, bacteremia are mainly nosocomial cases. Prevention should focus on indwelling devices and antibiotic resistance.
Link: HighWire Press -- Medline Abstract.
OBJECTIVES: The objective of this study was to evaluate the epidemiology of antibiotic-resistant bacteria among motor impaired patients admitted to an acute rehabilitation unit.
It seems to infer that many patients were MRSA infected before arrival
Link: HighWire Press -- Medline Abstract.
In the past 20 to 30 years, methicillin-resistant Staphylococcus aureus (MRSA) strains have been present in hospitals and have become a major cause of hospital-acquired infection. Methicillin resistance rates of S. aureus vary considerably between countries, with a high prevalence in the United States, and southern Europe (>20%) and a low prevalence in northern Europe (< or =5%). Community-acquired MRSA emerged worldwide in the late 1990s. There has been great confusion in the literature between healthcare-associated MRSA infections occurring in the community in patients who are at risk of acquiring hospital MRSA (such as those with past history of hospital admission, immunocompromised status, etc.), and true CA-MRSA infections due to strains that are present in the community only.
You can order the paper at the link above
Link: Aftenposten Norway, Norwegian news in English.
Eleven patients at the lung ward at Oslo's Ullevl Hospital have been isolated after an outbreak of Multi-resistant Staphylococcus aureus. The bacteria, which is highly contagious and can spread quickly, causes thousands of deaths around the world each year. It thrives in hospitals environments and often attacks patients with weakened immune systems after operations. Norway has been relatively spared by outbreaks, and there was special concern in Oslo since the infection source is unknown and originated outside of the hospital. "This is extremely worrying. The situation in Oslo is out of control. We have warned about this repeatedly, and now it has happened," said Professor Bjorg Marit Andersen at Ullevol Hospital
Link: icBirmingham
MRSA cases could be going unreported in Birmingham because hospitals are reluctant to declare it as a possible cause of death, a top level investigation ruled today. Hospitals are now being ordered to routinely report the presence of MRSA at death or as a contributory factor so the public can know the extent of the problem. An extensive MRSA review by Birmingham City Council found many cases of the flesh-eating bug were not recorded on death certificates and this meant the level of cases remained unknown. The inquiry also call for hospitals to take over the washing of nurses uniforms to make sure they are properly cleaned.
Link: HighWire Press -- Medline Abstract.
In conclusion, a high prevalence of MRSA colonization was observed among people with no relationship to the hospital setting. The high level of multiple-drug resistance among community MRSA strains in association with the previously reported excessive use of antibiotics in Taiwan highlights the importance of the problem of antibiotic selective pressure. Our results indicate that both the clonal spread of MRSA and the transmission of hospital isolates contribute to the high MRSA burden in the community.
Link: icNewcastle - Doctor hit by superbug.
A hospital doctor has tested positive for MRSA. Consultant anaesthetist Stuart Hargrave, who works at Newcastle's Royal Victoria Infirmary, has the superbug but has been cleared to continue working by bosses. He is receiving treatment for the bug, which is resistant to antibiotics. The infection was identified last week when staff in the hospital's Leazes Wing were screened. Hospital bosses said there is no risk to patients, infection control measures have been taken and Dr Hargrave, of Gosforth, can continue to work during his treatment. But Kay Parsons, 33, of Ashington, Northumberland who lost her father-in-law Tony Miller to the superbug last year, said: "It's hard enough to get rid of MRSA without risking spreading it more by having doctors with it as well.
Link: HighWire Press -- Medline Abstract.
Significantly higher persistent MSSA and MRSA nasal carriage rates among ESRD patients >75 years of age are suggestive of an elevated risk of potentially serious S. aureus- related complications among the very elderly during long-term HD. These findings might be helpful in the identification of elderly HD patients as a high-risk group for S. aureus-linked vascular access-related septicemia (VRS) and to evolve appropriate preventive strategies. Publication Type:
Link: HighWire Press -- Medline Abstract.
One out of three patients came from an institution (nursing, residential home or hospital). Nearly one in four of these patients were MRSA carriers, compared with a carrier rate of less than 1 in 20 in patients admitted from home. Of the 11 cases presenting as MRSA carriers, two developed a MRSA deep wound infection, compared with 2 out of the 94 patients not colonised with MRSA (X2 p < 0.01).
Link: Journal of Clinical Microbiology.
We investigated the emergence and spread of community-associated strains of methicillin-resistant Staphylococcus aureus (CA-MRSA) in central and northern Wisconsin by determining the temporal and clonal relationships and geographic expansion among 581 of 956 clinical isolates of MRSA collected between 1989 and 1999. MCG-2 isolates were multidrug sensitive, harbored type IVa staphylococcal cassette chromosome mec, and were very closely related by PFGE to the Midwestern CA-MRSA strain MW2. MCG-2 strains were mostly obtained from skin infections and affected patients with a mean age of 24 (�18.0) years. MCG-2 strains spread to four additional Native American communities and 20 other communities. Our findings suggest that CA-MRSA in Wisconsin likely originated in Native American communities in the early 1990s and since has become widespread throughout the state. Two early CA-MRSA strains (WI-33 and WI-34) in Wisconsin represent progenitors of the MW2 strain, based on their almost indistinguishable genotypic characteristics.
Link: HighWire Press -- Medline Abstract.
In November 2001 a one-day prevalence survey of nosocomial infections (NI) was conducted in surgical and intensive care units at two hospitals in Rome. The main goal was to quantify the occurrence of NI and of some patient-care practices, such as antibiotic use.
Link: MedicalPost.com
This is a very important article - click the link above for the whole story
In particular, researchers in San Francisco have documented an "alarming" prevalence of community-acquired MRSA in hospitalized patients. Since 2000, there has been an "exploding prevalence" of MRSA, largely fuelled by the epidemic spread of a single clone (known as ST8:USA300) in the community."The early consequences of an escalating epidemic of community-acquired MRSA infections involved the spread of the epidemic clone into the hospital environment and the development of multidrug resistance," Diep said. The researchers found that result when they first screened laboratory reports from January 2000 to June 2004, and came up with more than 2,500 cases of MRSA. They then performed a detailed analysis of a random sample of 389 patient isolates. The sample was stratified according to hospital- or community-onset of infection, as defined by the time of each patient's first MRSA culture.During that period, community-acquired MRSA accounted for more than 81% of unique infections, and 42% of the community patients required hospitalization.
Link: ic Birmingham
A Birmingham hospital trust is tackling the superbug MRSA by teaching staff, visitors and patients how to wash their hands properly. During a one-day conference at the Queen Elizabeth Hospital in Edgbaston, delegates were given the opportunity to see how well they washed. The event, which was held as part of healthcare scientists awareness week, highlighted the work being done to detect MRSA and protect patients.
Organised by University Hospital Birmingham NHS Foundation Trust (UHB), it is thought to be the first forum dedicated to MRSA in the country. Stewart Messer, UHB's associate director of health-care sciences, believes more awareness is needed about the antibiotic-resistant bug and how to guard against it. He said: "There is a lot of misinformation about MRSA, particularly over whether patients are screened for it. "The problem is this bug is not just in hospitals, it can be picked up anywhere because it's airborne.
"MRSA takes 48 hours to grow and therefore is often not picked up until after a patient has been in hospital for a few days and, unknowingly, brought the bug in with them." Mr Messer added: "The simplest and most effective way to tackle this problem is by thorough handwashing, but that's not as easy as it sounds. "You may get your hands in a lather but most people miss the fingertips, the webbing in between fingers and their wrists.
Link: Times Online - Health.
From carnivorous bed mites in London to a new strain of salmonella in Taiwan, an army of unbeatable nasties is on the march and we're losing the battle. Once it was the stuff of horror stories, a notion as reassuringly far-fetched as the apocalyptic writings of John Wyndham or Stephen King.But the idea of an army of indestructible bugs swarming through communities to kill and contaminate at ease is fast leaving the realms of science fiction; increasingly, it is becoming a pronouncement of scientific fact. Earlier this week, pest experts gave warning of a carnivorous “super” bed bug that was claiming mattresses across London. Species of rat, grasshopper, head louse, housefly and cockroach have also evolved a similar resistance to the chemicals used to control
Link: ABC News
Staph is a common bacterium, and the Centers for Disease Control and Prevention estimates that about 25 percent to 30 percent of the population are carrying staph bacteria in their nose at any given time. Left untreated, staph can cause skin and bone infections, pneumonia, bloodstream infections and other illnesses.
Link: The Kentucky New Era.
According to a report from the Christian County Health Department, he is suffering from a Methicillin-Resistant Staphylococcus aureus infection, or MRSA. Health officials believe the infection originated at the Trigg County Primary Care clinic.
Etheridge and another patient, Creta Fay Cooper Mitchell, 60, received cortisone shots at the clinic in late October. Mitchell died Sunday at Jennie Stuart. Etheridge is a carpenter. He went to the clinic for treatment after he hurt his back while working.
Link: Journal of Clinical Microbiology.
Epidemic methicillin-resistant Staphylococcus aureus 16 (EMRSA-16) and EMRSA-15 are the two most important and prevalent EMRSA strains found in the United Kingdom and have also been found in a number of European countries and the United States. We describe for the first time the spread of an EMRSA strain (EMRSA-16) from its point of origin in one hospital to the surrounding hospitals and regions over the following 2 years. In the first 18 months after its original appearance, 136 hospitals referred EMRSA-16 isolates for typing, and interhospital and intraregional spread were reported: it was more prevalent in males between 60 and 80 years old and was isolated from sputum and throat more often than EMRSA-15.
HighWire
MRSA prevalence varied almost 100-fold, from <1% in northern Europe to >40% in southern and western Europe. MRSA proportions significantly increased in Belgium, Germany, Ireland, the Netherlands, and the United Kingdom, and decreased in Slovenia. Within countries, MRSA proportions varied between hospitals with highest variance in countries with a prevalence of 5% to 20%. The observed trends should stimulate initiatives to control MRSA at national, regional, and hospital levels. The large differences between hospitals indicate that efforts may be most effective at regional and hospital levels.
HighWire
To define methicillin-resistant Staphylococcus aureus (MRSA) reservoirs in the community and their population dynamics, we studied the molecular epidemiology of a random sample (n=490) from a collection of 2154 inpatient and outpatient MRSA isolates during a 7-year period in San Francisco. The longitudinal results linked the dramatic increase in MRSA infections to an expanding community reservoir of MRSA genotypes with intrinsic community survival advantage.
RSM
Methicillin-resistant Staphylococcus aureus (MRSA) has presented special problems in intensive care units (ICUs) because of the difficulties in implementing infection control measures. The prevalence and rate of acquisition of MRSA were studied over thirty months in a nine-bed ICU. Nasal and groin swabs were taken on admission and then weekly, and other cultures as clinically indicated.
Of 1361 admissions 119 were MRSA-positive on arrival. 21 cases had been identified before admission and the remainder were detected by screening; in 57 the positive result was known only after discharge. Of the 1242 admissions initially negative 68 acquired MRSA while in the ICU. The ICU had no known MRSA-positive patients on 185 (20.3%) of 914 days, the longest sequence being 17 days. Positive patients occupied 1387 (16.9%) of the 8226 available bed days. Length of stay predicted the risk of acquiring MRSA. Estimated from patients who completed each weekly screening cycle, the risk was 7.5% per week in the first week and 20.3% per week thereafter. The risk was not influenced by initial APACHE II score, the use of haemofiltration, or the number of MRSA-positive patients in the unit.
(So what is the key risk factor? MRSA Watch)
Medical News
Johns Hopkins researchers report potentially life-threatening hospital infections with bacteria resistant to the antibiotic methicillin can occur even if patients havent been treated with that drug. But, they add, these infections can be stopped with one of medicines oldest and most powerful antibacterial treatments: hand washing. We know there is more to MRSA infection than just exposure to antibiotics, says infection control and antibiotic management expert Xiaoyan Song, M.D., M.S., a research associate at Hopkins. So the best way to avoid these infections is for doctors and nurses to wash their hands before they touch you, and for patients to tell their caregivers to wash their hands before they touch you.
Song led a look-back study of 2,279 patients admitted to Hopkins between 2000 and 2002. None of the patients had a history of methicillin-resistant Staphylococcus aureus (MRSA) infection, after hospital stays averaging 19 days, but 3.4 percent (77) patients acquired the infection anyway. Compared to patients who remained MRSA-free at discharge, MRSA patients tended to have additional medical problems, such as chronic respiratory illness and/or liver or kidney disease. In addition, patients infected with MRSA were also more likely to be admitted to an intensive care unit or a medical ward, or to have been transferred from other health care facilities.
Yahoo! News
Breast milk has been identified as the source of the 'superbug' known as methicillin resistant Staphylococcus aureus (MRSA) In two outbreaks among newborns in Los Angeles. Dr. Dawn M Terashita, of the LA County Health Department described the cases in Washington DC at a meeting of the American Society for Microbiology. Infants in the neonatal intensive care unit are a "vulnerable population," she told Reuters Health. MRSA outbreaks are common in newborn nurseries, and the main way the infection is spread is thought to be person-to-person via hand contact. Earlier this year, Terashita and her colleagues investigated two separate MRSA situations in neonatal intensive care units in which they suspected transmission via breast milk.
ic Newcastle
Today we tell you the truth about hospital superbug MRSA. The Chronicle can reveal that the public is only told about a small fraction of infections in the region because of a loophole in they way they are reported. Hospitals are only required to monitor and report blood infections of MRSA, known as bacteraemia reports. Trusts in the North East reported 305 such cases between April 2003 and March 2004. But these figures do not include the hundreds of patients in our hospitals who are "barrier nursed" in isolation because of MRSA infections. Tony Field of the MRSA Support Group said today: "This is a case of the Government tricking people into believing there's not a problem. When you see there are under 100 cases of MRSA at a large hospital you don't think it's too bad. But the truth is there are hundreds of infections that we're not being told about."
HighWire -- Medline Abstract
A study has been carried out at a large teaching hospital to estimate how often the gloves of a healthcare worker are contaminated with MRSA after contact with a colonized patient. The effectiveness of handwashing procedures to decontaminate the health professionals' hands was also investigated, together with how well different healthcare professional groups complied with handwashing procedures. The study showed that about 17% (9-25%) of contacts between a healthcare worker and a MRSA-colonized patient results in transmission of MRSA from a patient to the gloves of a healthcare worker. Different health professional groups have different rates of compliance with infection control procedures. Non-contact staff (cleaners, food services) had the shortest handwashing times. In this study, glove use compliance rates were 75% or above in all healthcare worker groups except doctors whose compliance was only 27%.
MRSA colonization of nares, either present at admission to the hospital or acquired during hospitalization, increases the risk for MRSA infection. Identifying MRSA colonization at admission could target a high-risk population that may benefit from interventions to decrease the risk for subsequent MRSA infection
This short extract is from a longer study on those entering hospital with MRSA colonisation. Well worth a read - backs up the screening and iisolation strategy.
Journal of Clinical Microbiology
The most striking temporal shift in the dominance of MRSA clones was the replacement of the multidrug-resistant and highly epidemic Iberian clone by the so-called British EMRSA-16 clone during the 5-year surveillance period. Our results are in accordance with previously stated findings showing the worldwide hospital dominance of relatively few pandemic and presumably virulent MRSA clones. We report for the first time the detection in Spain of the British EMRSA-15 and pediatric clones, as well as the abrupt replacement of the Iberian by the EMRSA-16 as the major MRSA clone.
HighWire -- Medline Abstract
Other identified risk factors were diabetes mellitus (p = 0.001) and the first 15 days of central line placement (p = 0.025). Although chronic liver disease and hypertension could not be identified as significant risk factors, they clearly showed association. Other risk factors were not significantly different from controls. CONCLUSION: It is suggested that greater care is required for the elderly, diabetic patients with a central venous line in place especially during the first fifteen days of its introduction.
Sunday Life
Medical staff are largely to blame for the superbug epidemic sweeping Northern Ireland hospitals, it was claimed last night. And an MRSA support group is demanding that, in future, all doctors and nurses should wear protective face-masks, in a bid to slash the number of people dying from infections picked up on dirty wards.
"Doctors, nurses and other medical staff are constantly breathing in the atmosphere and infected dust particles of the hospital, and naturally breathing it out again. "They thus become the main transmitters, yet infected breath is being totally overlooked by those in the Northern Ireland health regime."
Medscape
Detailed look at MRSA trends throughout Europe and the increase in cases
Reuters
This is a must read article. Below is only a short extract
What's particularly worrisome, one researcher told Reuters Health, is that these infections are being acquired in the community -- not the hospital, as has been the usual case until now. In Corpus Christi, Texas, the occurrence of community-acquired MRSA infections in children, which started occurring in the 1990s, "has now reached epidemic proportions," Dr. Kevin Purcell and colleagues warned..In 1999, there were 9 cases of community-acquired MRSA documented at Driscoll Children's Hospital. The number jumped to 36 in 2000, 105 in 2001, 278 in 2002, and 459 in 2003. Purcell told Reuters Health that among 1002 cases of MRSA skin infections seen in Corpus Christi children between 1990-2003, 93 percent occurred outside the hospital, and 98 percent of these children had no risk factors that would increase their likelihood of catching MRSA.
"Ninety-four percent of the community-acquired MRSA cases were localized infections of the skin and soft tissues, meaning that 6 percent were invasive and potentially life-threatening infections (e.g. sepsis, pneumonia, toxic shock syndrome)," he said. Nearly all of the MRSA infections were susceptible to other antibiotics
WTOV9.com
Methicillin Resistant Staphylococcus Aureus; it's known in the medical community as MRSA (mer-sa). It has health officials a bit concerned because the bacteria is usually seen in hospitals amongst ill patients. But now it's being reported in two West Virginia high schools. Surprisingly, 40% of humans have it on their skin in a dormant state. Marshall County's Health physician Dr. Kenneth Allen, told NEWS 9 that it's actually wide spread through out the community. "The skin can protect you from the bacteria if it's in tact. But if the skin is broken, you could get infected. " said Allen. And if the bacteria infects your blood or your organs, it could lead to death. So far a half a dozen football players in Mason and Roane counties were treated for infections. But to date, it has been reported in Marshall and Calhoun counties as well. High school athletes are at a slightly greater risk because of the environment in which they work.
Infectious Disease News
Community MRSA has a different genetic make up to MRSA. It is starting to leak into the hospital system. It may be more infectious than the hospital variety
A study conducted by the Minnesota Department of Public Heath found that 12% of MRSA cases were community-associated. The median age was much younger in the community group (23 years as opposed to 68 years) and 75% of the community isolates were from skin sources. In contrast, many cases of health care–associated MRSA were from respiratory sources (22%) or from urine (20%).Certain staphylococcal virulence factors and toxins were more likely found in CA-MRSA isolates than in health care-associated isolates including Panton-Valentine leukocidin and enterotoxins A, C, H and K.
“We are starting to see reports of hospital transmissions of CA-MRSA,” Lynfield said. In recent reports, several postpartum women developed skin and soft-tissue infections: five women had to be rehospitalized and three underwent drainage. “Pulsed-field gel electrophoresis [PFGE] showed that the isolate was indistinguishable to the CA-MRSA strain MW2,” Lynfield said.
Infectious Disease News
“MRSA is spreading in tertiary care and community hospitals, regardless of the size of the hospital,” said Keith Kaye, MD, MPH, assistant professor of medicine at Duke University Medical Center. “MRSA is also becoming established in health care–associated settings or among patients with health care contact. These health care–associated MRSA isolates essentially have escaped from the hospital setting and have now colonized patients residing in the community.”
This longer report from and infection control conference is worth checking
this is north scotland
This feature is detailed and well researched. It suggests that:
1 in 5 who get MRSA die as a result
5% of patients have it before entering the hospital
Ward cleanliness, while important, is not the major factor in it's spread, but unwashed hands may be
Screening and Isolation are key policies
Well worth a read
Journal of Clinical Microbiology
Classical MRSA factors such as hospital visits or antibiotic use were not thought to be factors in the MRSA outbreak in a military camp. This extract hints at the causes but for those keen to know you will have to buy the entire article.
HighWire -- Medline Abstract
This Tiawanese study suggested that all the children treated had the same strain of MRSA. All of these studies beg the question as to what the health authorities are doing to help avert a situation where the majority of the population are colonised by MRSA
HighWire -- Medline Abstract
This study observed the growth of a genetically distinct strain of MRSA from one ward to the whole hospital. How are staff screened for superbugs and should they be?
HighWire -- Medline Abstract
This is a case study designed to suggest how already infected people might be tracked and treated should they return to or visit other medical facilities. All Medline articles can be purchased - the link takes you to a summary
HighWire -- Medline Abstract
Patients with long term eye issues or comprimised immunity could be prone to MRSA with initial research indicating a 3% figure amongst all eye infections. Full details via link
The Sun
LEVELS of killer superbug MRSA are rocketing in hospitals, a shock probe by The Sun reveals today. Seven of ten we tested have worse figures than eight months ago, despite a vowed blitz. Our team found dangerously high counts in places such as entrances to intensive care and even bone marrow treatment units
theledger.com
The National Audit Office, a government watchdog organization, announced this month that there had been an 8 percent increase in the number of all staphylococcus aureus, or staph, infections in the bloodstream, to 19,311 in 2004 from 17,933 in 2001. Of those, 40 percent were resistant to the antibiotic methicillin. But that reveals only a slice of the problem because the Department of Health, which began to keep figures on the infections in 2001, does not track the existence of staph infections outside the bloodstream, in wounds or in the urinary tract.
Guardian Unlimited
The review also found that hospital-acquired infections, such as the MRSA superbug, were also poorly recorded. The researchers said there was no specific code to indicate a case of MRSA had occurred.
ICDDR,B: Publication
The nasal carriage of S. aureus was 29.6% among the healthy individuals, while it was 44.4% among the healthcare workers. The colonization rate may range from 10% to more than 40% in normal adult population (7). Our figure of 29.6% correlates well within this. The nasal colonization rate of 44.4% is on the higher side probably due to nosocomial exposure among the healthcare workers. Data reported in other studies in tertiary care centres show a similar incidence
J. Antimicrob. Chemother
Recent years have brought alarming rises in the prevalence of resistance to some agents among certain groups of bacteria. Concern is growing that therapeutic options will become increasingly limited if resistance rates continue to rise. There is widespread agreement that action is required to reverse or at least slow this process
Telegraph
Officially the number of people infected by MRSA in the bloodstream - the dangerous place to get it - is about 7,600 a year. But this is a minimum. It is possible for someone to die of MRSA without a post-mortem test to discover whether it was the cause of death. Even if we take this minimum, though, how does it compare with the private sector?
sundaymirror.co.uk.
A TERRIFYING 11 out of 12 patients discharged from one hospital and sent back to a care home had the killer superbug MRSA. The shocking discovery was made by a former nurse who runs the home and tests every elderly resident when they return from treatment. And last night she claimed that the hospital knew...and didn't tell her so that they could free up beds.
this is staffordshire
A former health worker who says she contracted the superbug MRSA three times while on duty at the University Hospital of North Staffordshire today blamed the centre for ending her career. Samantha Hopkins, aged 34, was wide open to the sometimes fatal infection because she was already suffering from the skin condition which at one point covered so much of her body she needed to spend three weeks as a patient.
Dept of HealthScroll to the bottom of the linked page to download the 3 year overview of hospital MRSA infections
Government News Network
Professor Pat Troop, Chief Executive of the Health Protection Agency said:
'The increase we have seen in these infections over the last decade is caused by a combination of reasons including the fact that through the advances in modern medicine we are now able to keep patients alive for longer, but this means carrying out more invasive procedures which can lead to infection and also through the emergence of epidemic strains of MRSA (notably EMRSA 15 and 16) which can be more difficult to control.
Nursing Times
Edward Leigh, chairman of the Commons public accounts committee, said that infection control was being hampered by high bed occupancy levels, a lack of isolation facilities, and because too many patients with differing conditions were put together on the same wards.
HPA
This is not the most up to date information but it could form part of your research file on the subject
ITV
British hospitals are said to have one of the worst MRSA infection rates in Europe, outstripping countries such as Greece, Romania and Bulgaria.
swissinfo
A new scientific advisory panel is being set up to explain the dangers posed by infections that antibiotics can’t cure. The move follows a national survey showing that half of all Swiss believe, wrongly, that alternative drugs are available, should antibiotics fail.
Dermatology, June 2004
Microbiologic Evaluation of Skin Wounds: Alarming Trend Toward Antibiotic Resistance in an Inpatient Dermatology Service During a 10-Year Period
sundaymail
A NEW superbug at least as deadly as MRSA is sweeping Scottish hospitals.
Known victims of VRE (Vancomycin Resistant Enterococci) have soared by nearly 50 per cent but doctors believe many cases go unreported.
swissinfo
Swiss see doubling of MRSA infections in one year
Superbug death rate soars
Detailed information from a major medical site