MRSA (Mersa, Staph) Questions

Death certificates must record superbugs

Link: Death certificates must record superbugs - Telegraph.

Doctors must record superbugs caught by hospital patients on death certificates to quell public fears that infection numbers are being covered up, the chief medical officer has ruled. Death certificates must record superbugs Latest data show the rate of MRSA in Britain, one of the highest in Europe, is falling Sir Liam Donaldson has written to all doctors telling them to ensure "healthcare associated infections" (HCAIs) such as MRSA or C.difficile are routinely included on death certificates. He said an infection must be recorded if it directly led to a patient's death or was a contributory factor. It would still be "a matter of clinical judgement" to decide if an infection present at the time of death was a contributory factor. Sir Liam acknowledged that the public believed official figures released by the Government underestimated the number of deaths in which infection had played a part.

Australia - common infection policies needed

Link: HighWire Press -- Medline Abstract.

Surveillance programmes for hospital-acquired infections differ amongst the Australian states. Victoria, New South Wales, Queensland and South Australia have recent substantial initiatives in development of statewide programmes. Whilst the definitions for surgical site infections (SSIs) and bloodstream infections (BSI) developed by the Australian Infection Control Association (AICA) do not differ from the US National Nosocomial Infection Surveillance (NNIS) programme definitions for SSI and intensive care unit (ICU) acquired central line-associated BSI, only two states use NNIS risk adjustment methods in reporting infection rates. Differences exist in the surgical procedures under surveillance, ICU surveillance, hospital-wide BSI surveillance, staff health immunization surveillance, process measures such us surgical antibiotic prophylaxis and small hospital programmes. Only in the area of antibiotic use surveillance has national consensus been reached.

Tracking the hiden MRSA death toll

Link: SR.com: Drug-resistant staph on rise.

Nearly 500 people in Washington may have died with or because of MRSA between 2003 and 2005, according to a new review of state death certificate records conducted at the request of The Spokesman-Review. Analysis by Ann Lima, a state health department researcher, showed that possibly 145 people died in 2003, followed by 169 in 2004 and 168 in 2005 from antibiotic-resistant staph infections, including MRSA. While state health and medical experts cautioned that the figures have not been validated, they also noted that they may provide a rare glimpse of the mortality associated with MRSA, which is not classified as a reportable infection.

Staph infections on the rise in Maine

Link: Seacoastonline.com: Staph infections on the rise in Maine.

In Maine, hundreds of people are infected with the bacterium. The actual number of cases is hard to pin down because hospitals aren't required to report staph infections to the state. But one indicator comes from NorDx, which provides laboratory testing services in southern Maine. NorDx found that 822 people contracted MRSA last year, up from about 535 in 2000. Don Piper, chief medical technologist for NorDx, said some of the rise is due to NorDx's increasing volume of work. Still, the numbers are significant and worrisome because front-line antibiotics don't work on the bacterium, he said. "The treatment requires antibiotics that are less effective and may have more side effects," Piper said. MRSA, which has been called a "superbug," accounted for about 2 percent of all staph infections in the 1970s, according to the Association for Professionals in Infection Control & Epidemiology. It now accounts for more than 60 percent, the association said.

CDC Infection Tracking System Available to Hospitals

Link: CDC Infection Tracking System Available to Hospitals.

Web-based reporting network to track infections associated with health care. The National Healthcare Safety Network (NHSN) deveeloped by the Centers for Disease Control and Prevention (CDC), provides multiple options for data analysis and more flexibility for sharing information both within and outside a facility, including the general public, if the facility so chooses. The system builds upon CDC's National Nosocomial Infection Surveillance (NNIS) system which, was the gold standard system for tracking health care-associated infections for more than 30 years.

13 states have infection reporting, 14 pending

Link: States Attack Hospital-Acquired Infections - by Aricka Flowers - The Heartland Institute.

In March, the CDC released a report identifying dialysis patients as being especially susceptible to methicillin-resistant staphylococcus aureus (MRSA) infections. Though in healthy patients the infection tends not to have symptoms, it can cause deep tissue infections in minor cuts and lead to fatal pneumonia. Doctors also believe it further undermines the health of sick patients. Infections T1 As a result, 13 states to date this year have considered bills requiring hospitals to disclose infection rates to the public. Fourteen others have passed such laws over the past four years. (See tables 1 and 2.)

Superbug system is too little too late

Link: Evening News 24 - Superbug system is too little too late.

Health campaigners have criticised the NHS for introducing a new web-based system to improve monitoring of superbugs after 18 people died from Clostridium difficile in one outbreak in the county. The system, which will be rolled out this month, will enable hospital and primary care trusts to identify and focus on infection hotspots in the future. However, the move is being seen as too little too late and health campaigners have asked why the government waited until 18 people died from the bug at the James Paget Hospital in Gorleston to implement new infection control measures. Norwich North MP Ian Gibson said: “We have all this new technology, but it is not tried and tested until we hit an emergency situation like the one at the James Paget.

Internet to aid MRSA fight

Link: Journal of Clinical Microbiology.

A high level of discrimination was achieved using each of the three methodologies with discriminatory indices of between 89.5% and 91.9% with overlapping 95% confidence intervals. There was also a high level of concordance of groupings made using each method. MLST/SCCmec typing distinguished 10 groups containing at least two isolates and these correspond to the majority of nosocomial MRSA clones described in the literature. PFGE and spa typing resolved 34 and 31 subtypes respectively within these 10 MRSA clones with each subtype differing only slightly from the most common pattern using each method. The HARMONY group has found that the methods used in this study differ in their availability and affordability to European centres involved in MRSA surveillance. Here we demonstrate that the integration of such technologies is achievable, although common protocols (as we have developed for PFGE) may also be important, as is the use of centralised internet sites to facilitate data analysis. PFGE and spa typing data from analysis of MRSA isolates from the many centres that have access to the relevant equipment can be compared to reference patterns/sequences and clonal designations made. In the majority of cases these will correspond to those made by the (more expensive) method of choice - MLST/SCCmec typing and these alternative methods can therefore be used as frontline typing systems for multicentre surveillance of MRSA.

Aussie alarm over MRSA non reporting

Link: brisbanetimes.com.au.

ONE of the world's most aggressive and potentially fatal superbugs — once found only on hospital wards — has become more virulent and is now infecting healthy people in the community. A strain of golden staph can lead to serious blood infections or death, and more people are being infected by it. Experts want the State Government to establish a register to better monitor its growth. Already a number of people in Victoria have died from the superbug but exact numbers are not known, as the Department of Human Services says it does not hold the data on the number of Victorians infected with community or hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA).

Govt agency to use computers to track superbugs

Link: Technology boosts 'superbug' reporting.

WHAT TOOK THEM SO LONG!!!!!!!!!!!!

The Centers for Disease Control and Prevention is relying on software from TheraDoc, as well as a tool of its own making, to gather daily reports on antimicrobial use and resistance for a pilot project to address the so-called “superbugs” impact on public health. The information used to be gathered by hand, explained Jonathan Edwards, mathematical statistician at the CDC and a member of the National Healthcare Safety Network eSurveillance Project team.