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Unit Based Champions Infection Prevention eBug Bytes


Unit Based Champions Infection Prevention eBug Bytes December 2012 Investigators Conduct Meta- Analysis of Antimicrobial CVCs Antimicrobial catheters have been ... – PowerPoint PPT presentation

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Title: Unit Based Champions Infection Prevention eBug Bytes

Unit Based ChampionsInfection PreventioneBug
  • December 2012

Investigators Conduct Meta-Analysis of
Antimicrobial CVCs
Antimicrobial catheters have been utilized to
reduce risk of catheter colonization and
infection. Researchers sought to determine if
there is a greater than expected risk of
microorganism-specific colonization associated
with the use of antimicrobial central venous
catheters (CVCs). The researchers performed a
meta-analysis of 21 randomized, controlled trials
comparing the incidence of specific bacterial and
fungal species colonizing antimicrobial CVCs and
standard CVCs in hospitalized patients. The
proportion of minocycline-rifampin colonized CVCs
that were colonized with Candida species was
greater than the proportion associated with
standard colonized CVCs. In comparison, the
proportion of colonized chlorhexidine-silver
sulfadiazine CVCs specifically colonized with
Acinetobacter species or diphtheroids was less
than the proportion of similarly colonized
standard CVCs. No such differences were found
with CVCs colonized with staphylococci. Reference
Novikov A, et al. Impact of catheter
antimicrobial coating on species-specific risk of
catheter colonization a meta-analysis.
Antimicrobial Resistance and Infection Control
2012, 140 doi10.1186/2047-2994-1-40
Flesh-Eating Fungus Responsible for Five Deaths
in Wake of Massive Tornado
  • A fast growing, flesh-eating fungus killed 5
    people following a massive tornado that
    devastated Joplin, Mo., according to the Centers
    for Disease Control and Prevention (CDC). Health
    officials should be aware of infections caused by
    the fungus Apophysomyces, according to the
    studies, which tracked 13 people infected by the
    pathogen during the Class EF-5 tornado -- the
    most powerful category -- whose 200-plus mph
    winds plowed through Joplin on May 22, 2011,
    initially killing 160 and injuring more than
  • The common fungus -- which lives in soil, wood or
    water -- usually has no effect on people. But
    once it is introduced deep into the body through
    a blunt trauma puncture wound, it can grow
    quickly if the proper medical response is not
    immediate, the studies said. Five of the 13
    people infected through injuries suffered during
    the Joplin tornado died within two weeks.
  • Dr. Benjamin Park, chief of the Epidemiology Team
    at the CDC's Mycotic Diseases Branch, said the
    victims were infected when their injuries from
    the tornado were contaminated with debris from
    the storm, including gravel, wood and soil, as
    well as the aerosolized fungus.
  • Sources New England Journal of Medicine, 2012
    367 (23) 2194

'Sticky' Stomach Flu Virus Stands Up to Typical
Restaurant Dishwashing Measures
  • Restaurant dishes and silverware may be an
    overlooked place where people can catch stomach
    viruses. Norovirus is the leading cause of
    epidemic gastroenteritis and the major cause of
    foodborne illness worldwide, responsible for at
    least 50 of all gastroenteritis outbreaks in the
    United States.
  • To carry out the experiment, the research team
    infused cream cheese and reduced fat milk -- two
    foods that are known for being difficult to clean
    off -- with murine norovirus (MNV-1), Escherichia
    coli (E. coli K-12) or Listeria innocua (L.
    innocua). The scientists then applied the dairy
    products to stainless steel utensils, ceramic
    plates and glassware, and put the tableware
    through a variety of chlorine and quaternary
    ammonium compound (QAC)-based sanitary protocols
    delivered via a commercial dishwasher or hand
    washing. The team found that while both the
    commercial dishwasher and manual washing reduced
    bacterial loads of E. coli K-12 and L. innocua
    enough to meet safety standards, neither
    technique was able to significantly reduce the
    presence of MNV-1. Reference Lizanel Feliciano,
    Jianrong Li, Jaesung Lee, Melvin A. Pascall.
    Efficacies of Sodium Hypochlorite and Quaternary
    Ammonium Sanitizers for Reduction of Norovirus
    and Selected Bacteria during Ware-Washing
  • PLoS ONE, 2012 7 (12)

Surgeon infected 5 patients atCedars-Sinai,
hospital reports
  • Cedars-Sinai Medical Center, LA said Friday that
    a heart surgeon unwittingly infected five
    patients during valve replacement surgeries, due
    to tiny tears in his latex surgical glove,
    earlier this year. The infections caused four of
    the patients to need a second operation,
    officials said.
  • The infections occurred after the tears in the
    latex surgical gloves routinely worn by the
    doctor allowed bacteria from a skin inflammation
    on his hand to pass into the patients' hearts,
    according to the hospital. The patients survived
    the second operations and are still recovering,
    hospital officials said. Hospital officials
    called it a "very unusual occurrence" probably
    caused by an unfortunate confluence of events
    the nature of the surgery, the microscopic rips
    in the gloves and the surgeon's skin condition.
    Valve replacement requires the surgeon to use
    thick sutures and tie more than 100 knots, which
    can cause extra stress on the gloves.
  • The infections raise questions about what health
    conditions should prevent a surgeon from
    operating and how to get the best protection from
    surgical gloves. Surgeons with open sores or
    known infections aren't supposed to operate, but
    there is no national standard on what to do if
    they have skin inflammation

FDA to Hold Public Hearing on Antiseptic Patient
Preoperative Skin Preparation Products
  • The Food and Drug Administration (FDA) is holding
    a public hearing Dec. 12-13, 2012 to obtain input
    on how to address microbial contamination of
    patient preoperative skin preparation drug
    products. Currently, patient preoperative skin
    preparations are not required to be sterile.
    Bacteria can contaminate these products at the
    time of manufacture or during product use.
    Contaminated patient preoperative skin
    preparations have been associated with clinical
    infections and adverse outcomes. At this public
    hearing, the FDA is interested in obtaining
    public comment about certain scientific and
    product use issues related to patient
    preoperative skin preparations.
  • Patient preoperative skin preparations are
    over-the-counter (OTC) topical antiseptic drug
    products used to reduce the number of bacteria on
    the skin prior to medical procedures or
    injections. Although they are marketed
    predominantly to healthcare facilities, the use
    of these products extends beyond the healthcare
    facility setting. For example, consumers with
    medical conditions requiring regular injections
    (e.g., of insulin or heparin) may use these
    products at home.

Bed Bugs Not Repelled by Commercial Ultrasonic
Frequency Devices
  • According to an article in the Journal of
    Economic Entomology, commercial devices that
    produce ultrasound frequencies are NOT promising
    tools for repelling bed bugs. In "Efficacy of
    Commercially Available Ultrasonic Pest Repellent
    Devices to Affect Behavior of Bed Bugs
    (Hemiptera Cimicidae)," authors K. M. Yturralde
    and R. W. Hofstetter report the results of their
    tests of four commercially available electronic
    pest repellent devices designed to repel insect
    and mammalian pests by using sound. The devices,
    which were purchased online, were used according
    to manufacturers' instructions. A sound arena was
    created for each ultrasonic device, in addition
    to a control arena which featured no sound.
    However, the authors found that there were no
    significant differences in the number of bed bugs
    observed in the control (no sound) and sound
    arenas, and that bed bugs were neither deterred
    nor attracted to the arena with the sound device.
  • Bed bugs are commonly exposed to frequencies made
    by their host species (humans) and by appliances
    and machines found in homes. Therefore, it may be
    possible that bed bugs also would exploit sounds
    made by their human hosts, such as breathing or

Vaccine rule is said to hurt health efforts
  • Representatives from governments around the world
    will meet in Geneva next month in a session
    convened by the United Nations Environmental
    Program to prepare a global treaty to reduce
    health hazards by banning certain products and
    processes that release mercury into the
    environment. But a proposal that the ban include
    thimerosal, which has been used since the 1930s
    to prevent bacterial and fungal contamination in
    multidose vials of vaccines, has drawn strong
    criticism from pediatricians.
  • In the United States, thimerosal has not been
    used in children's vaccines since the early 2000s
    after the Food and Drug Administration and public
    health groups came under pressure from advocacy
    groups that believed there was an association
    between the compound and autism in children.
  • Since then, however, there has been a lot of
    research, and the evidence is overwhelming that
    thimerosal is not harmful. Science clearly
    documented no hazards from thimerosal in
    vaccines. The preservative plays a critical role
    in distribution of vaccine to the global
  • Source NY Times Dec 17 2012

 Beagle sniffs out bacterial infection
  • A 2-year-old beagle in the Netherlands has been
    trained to sniff out Clostridium difficile, a
    skill that could help doctors catch the deadly
    infection days before laboratory tests.
    Clostridium difficile infections often occur in
    people who are already taking antibiotics,
    causing symptoms that range from mild diarrhea to
    severe inflammation of the colon. And to make
    matters worse, the bug is particularly adept at
    spreading through hospitals, uncontrolled by the
    usual surface cleansers.
  • The clever canine, called Cliff, correctly
    identified 50 stool samples containing the
    bacterium, which kills 14,000 Americans each
    year, according to the U.S. Centers for Disease
    Control and Prevention. Cliff also identified 47
    of 50 stool samples that were Clostridium
    difficile-free (he couldn't make up his mind
    about the last three).
  • Laboratory tests for Clostridium difficile -
    dubbed C. diff - can take up to 48 hours. But
    Cliff gives his answer immediately by sitting or
    lying down. Stool from patients with the C. diff
    has a characteristic smell, often likened to
    horse manure, which Cliff learned to identify
    over two months of training. Now he can smell the
    bug even without the stool, correctly identifying
    25 of 30 patients with the infection and 265 of
    270 without

Hospital super-bug strains traced back to US,
  • Researchers have now shown that the
    gastrointestinal illness that spread to various
    hospitals across the world was caused by two
    different but related strains of Clostridium
    difficile. One of the strains originated in the
    U.S. while the other came from Canada. The
    outbreak occurred between 2002 and 2006 in
    hospitals across UK, U.S.A., Canada and Europe.
    Researchers were able to determine the source as
    well as track its spread across the countries.
    "We found that this outbreak came from two
    separate epidemic strains or lineages of C.
    difficile, FQR1 and FQR2, both emerging from
    North America over a very short period and
    rapidly spread between hospitals around the
    world. C. difficile produces highly resistant
    spores. These spores help the organism survive
    harsh conditions and spread to other geographical
    areas. The strains of C. difficile infection
    linked with the outbreak had developed resistance
    to a commonly used drug, fluoroquinolone. It was
    an effective treatment for C. difficile infection
    but these strains acquired resistance to this
    frontline antibiotic. It is now virtually useless
    against this organism, but resistance seems to
    have been a major factor in the continued
    evolution and persistence of these strains in
    hospitals and clinical settings.
  • Source Nature Genetics
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