Jan 13 2009

More Infection Warnings – Tools to Prevent Germy Spread

Betsy McCaughey, director of RID (Reduce Hospital Deaths) reminds us in her latest Wall Street Journal article that those hospital germs, the ones that cause death and debilitation, are everywhere.

In her most recent article, she points to doctors’ and nurses’ scrubs, coats, ties — their clothing.  MRSA, C.Diff. and other infectious pathogens cling to the fabric and get passed from patient to patient.

So — imagine that for a moment — the doctor brushes you with his white coat, that very item that represents his/her MD-dom — and passes an infection on to you which will make you very, very sick, or even kill you.

From Dr. McCaughey’s article:

The problem is that some medical personnel wear the same unlaundered uniforms to work day after day. They start their shift already carrying germs such as C.diff, drug-resistant enterococcus or staphylococcus. Doctors’ lab coats are probably the dirtiest. At the University of Maryland, 65% of medical personnel confess they change their lab coat less than once a week, though they know it’s contaminated. Fifteen percent admit they change it less than once a month. Superbugs such as staph can live on these polyester coats for up to 56 days.

Do unclean uniforms endanger patients? Absolutely. Health-care workers habitually touch their own uniforms. Studies confirm that the more bacteria found on surfaces touched often by doctors and nurses, the higher the risk that these bacteria will be carried to the patient and cause infection.

According to Dr. McCaughey, hospitals used to provide laundered uniforms and scrubs to their personnel, but that practice has gone by the wayside.

So, it seems like it would be a good practice to bring back.  Especially since Medicare is no longer paying for care for patients who acquire infections in the hospital, it seems that laundering that clothing would be far less expensive than having to eat the cost of caring for so many infected patients.

Today’s second warning comes from Bottom Line Health, one of my favorite publications.  I like Bottom Line because it doesn’t accept advertising, and it always brings in multiple points of view, e.g. the best of Eastern and Western medicine and ideas.

This notation comes from Jean-Yves Maillard, PhD from Cardiff University in Wales, UK who tells us that those disinfectant wipes we use on surfaces to kill bacteria (think clorox wipes, or those wipes they put near the shopping carts at supermarkets) may actually just spread those germs around.  We may not be killing those buggers at all!  Dr. Maillard suggests instead that we use one wipe per surface — or one swipe per wipe.

When it comes to these killer germs, we patients just can’t be too careful, can we?

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1 comment

    • Dan on April 19, 2009 at 9:51 am

    The Oldest Living Organism

    With medical institutional infections in particular, sometimes death is a good thing- for a vicious multi-cellular organism.
    There are a variety of different types of bacterial infections one can get from many different sources, yet some locations are more common than others. If bacteria are not beneficial for your health, as many bacteria are, they should die in order to restore your health.
    Bacteria are a simple life form, yet are incredibly productive and efficient. As with other life forms, they exist to reproduce, and does so about every hour. Bacteria mutate, evolve, and adapt according to the host in which they exist.
    To do this, it fully utilizes all available resources and energy to develop the protein that is essential for its survival in their host. Bacteria need exactly 7 genes to produce the essential ribosomes for their existence. Any more or less genes than 7, the bacteria is not maximizing its efficiency to survive and reproduce. Amazing.
    Strep infections are caused by what are called gram positive bacteria, and they are the most common bacteria that infect other humans. . Group A strep infections can cause diseases such as strep throat and pneumonia. Also, staph bacterial infections are gram positive as well that potentially infect humans, and do so often.
    Of all pathogenic, or disease-causing bacteria that exist, it is the MRSA, the methicillin resistant staff aureus bacteria, that are most concerning to health care providers in particular. This is because MRSA bacterial infections are the most difficult to cure when a patient suffers from their damage from being infected by these bacteria.
    Another difficult situation is when a patient is infected by VRE, Vancomycin Resistant Enterococci, which is another type of gram positive bacteria that exist.
    These MRSA and VRE bacteria are difficult to eradicate due to the fact that most antibiotics that are available to rid the patient of other bacterial infections, MRSA and VRE are resistant to the effectiveness of these antibiotics.
    MRSA and VRE infected patients are quite challenging for the health care provider who is attempting to cure patients infected with these particular bacterial infections.
    In many situations, pathogenic bacteria infect a patient already within a medical institution for another disease. When this occurs, it is called a nosocomial infection.
    Greater than 5 percent of nosocomial infections are determined to be MRSA infections, it has been reported. As a result, there are about 100,000 serious hospital infections, as well as about 20,000 deaths from MRSA infections annually.
    Since there are several types of pathogenic bacteria that exist, a diagnostic test called a culture and sensitivity is usually performed at a clinical laboratory to assure the correct antibiotic is selected for treatment, as the bacteria are identified with this diagnostic method.
    Typically, fluid from the area suspected of being infected is obtained from the patient suspected to have an infection and smeared on what is called a petrie dish. And then these dishes are incubated for 2 to 3 days. Gram positive bacteria stain during this process a dark violet or blue. Gram negative bacteria would be pink in color, and are capable of harm as well to a human being.
    When the culture is complete, technology that is available offers recommendations on the appropriate class or brand of antibiotic to treat the pathogenic bacteria present in another person- presuming the bacteria will not be resistant to the antibiotic recommended, as this happens on occasion.
    Usually, classes of antibiotics that are used to treat gram positive strep infections that are not VRE or MRSA bacteria are cephalosporins, macrolides, or general penicillins. If the microbe that is causing the infection is resistant to the antibiotic from such classes that are administered to the infected patient, other options should be considered for anti-microbial therapy.
    With two very powerful antibiotics in particular, which are methicillin and vancomycin, their frequent use in infected patients has resulted in VRE and MRSA bacteria that are now resistant to these antibiotics.
    When a patient is infected with VRE or MRSA bacteria, other selections for antimicrobial therapy that provide more efficacy should be selected for a patient infected with these types of infections. Such brands and types of antibiotics for MRSA and VRE bacteria include Zyvox, which has both IV and oral dosage options, and an antibiotic called Cubicin.
    However these antibiotics for antibiotic resistant bacteria are given usually due to infections that have progressed to a more serious nature within a patient infected in such a way, so a cure is not immediate when these antibiotics are selected for such patients.
    Progressive medical conditions with such infected patients include sepsis, or blood infection, osteomyelitis, or bone infection, as well as pneumonia, which is a serious lung infection. A hospital stay is normally required with such patients infected with MRSA and VRE infections that cause such diseases.
    This is because when the antibiotics that potentially cure the patient of these microbes are selected, they are usually given via IV administration, and are administered normally for several days, if not several weeks.
    There are numerous classes and types of antibiotics available, yet bacterial resistance to most of these antibiotics, with the exception of the two mentioned earlier, constantly remain a serious concern for the health care provider, and the MRSA and VRE infected patient.
    With MRSA at the top of the list of concerns for the health care providers, this infection continue to occur progressively, which amplifies the concerns of others.
    Medical institutions should possibly consider quarantine for those patients at their locations that have been determined to be infected with the MRSA and VRE bacteria more often in the future.
    http://www.cdc.gov/ncidod/dhqp/ar_mrsa_spotlight_2006.html
    Dan Abshear

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