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Infection Prevention eBug Bytes April 2015

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Title: Infection Prevention eBug Bytes April 2015


1
Infection Prevention eBug Bytes April 2015
E.Coli in cell division (every 20 minutes)
2
CDC's plan to battle nightmare infections
  • A group of Chicago hospitals has managed to cut
    by half the number of infections caused by an
    especially deadly type of superbug. The CDC is
    pointing to the success of the Chicago Prevention
    Epicenter, one of five such CDC-funded programs
    nationally that coordinate research between local
    scientists and public health officials. The
    Chicago study focused on four long-term acute
    care hospitals, which tend to have above average
    rates of carbapenem-resistant Enterobacteriaceae,
    or CRE, called a "nightmare bacteria" because
    even the strongest antibiotics fail to subdue it.
  • The program involved testing all patients for CRE
    infections at the time of admission and again two
    weeks later. Patients who developed CRE were
    isolated in a private room or in a ward with
    other CRE-infected patients. Healthcare workers
    wore protective gowns while tending to them,
    using some of the procedures used when caring for
    patients with Ebola. All infected patients were
    bathed in chlorhexidine gluconate, an antiseptic
    commonly used in hospitals. At the end of three
    years, cases of CRE infections fell by half.
    While the CDC has no regulatory authority, the
    government's Center for Medicare and Medicaid
    health insurance programs require all
    participating hospitals to develop a stewardship
    strategy within three years. Failure to do so
    would disqualify them from the health plans.
  • The president's plan for the CDC calls for a 60
    percent reduction in CRE infections by the end of
    this decade and halving infections caused by
    clostridium difficile, as well as MRSA
    bloodstream infections. Source Reuters -
    Battling Nightmare Infections - March 29 2015

3
Bacteria from Texan cattle yards are now airborne
  • A new study says the DNA from antibiotic-resistant
    bacteria found in American cattle yards has
    become airborne, creating a new pathway by which
    such bacteria can potentially spread to humans
    and hinder treatment of life-threatening
    infections. Researchers gathered airborne
    particulate matter (PM) from around 10 commercial
    cattle yards within a 200 mile radius of Lubbock,
    TX over a period of six-months. They found the
    air downwind of the yards contained antibiotics,
    bacteria and a "significantly greater" number of
    microbial communities containing
    antibiotic-resistant genes. That's according to
    the study to be published in next month's issue
    of Environmental Health Perspectives. Co-author
    Phil Smith told the Texas Tribune that the
    bacteria could be active for a long time and
    "could be traveling for long distances."Because
    antibodies are poorly absorbed by cows they are
    released into the environment through excretion.
    Once in the environment, bacteria will undergo
    natural selection and genes that have acquired
    natural immunities will survive. The genes that
    have gone airborne are contained in dried fecal
    matter that has become dust and gets picked up by
    winds as they whip through the stockyards.

4
A new strain of Enterovirus D68
  • Scientists have linked a specific strain of the
    respiratory illness enterovirus D68 to the
    previously-unexplained rash of childhood
    paralysis and muscle weakness that struck dozens
    of children between 2012 and 2014. Researchers
    found the genetic imprint of a relatively new
    strain of enterovirus D68 -- B1 -- in children
    who developed acute flaccid myelitis (paralysis
    or muscle weakening) after having a fever or
    respiratory illness. After checking patients'
    respiratory secretions, blood and cerebrospinal
    fluid for a variety of different pathogens, they
    couldn't find any other probable cause of the
    paralysis in these children. While this study
    strengthens the link between EV-D68 and sudden
    paralysis or muscle weakening in pediatric
    patients, it doesn't definitively establish the
    virus as the cause of acute flaccid myelitis. Nor
    does it explain by which mechanism EV-D68 may
    cause paralysis. But the finding points to the
    urgency for further research of EV-D68 and a
    possible vaccine. The B1 strain of EV-D68 emerged
    around four years ago, and is similar to other
    viruses like EV-D70 or poliovirus, which cause
    nerve damage and paralysis. It was the most
    dominant strain of EV-D68 circulating during the
    2014 outbreak, and only a small minority of
    children -- 115 across 34 states -- went on to
    develop paralysis or muscle weakening between
    Aug. 2014 and Mar. 2015. Source
    Enterovirus D68 Paralysis - Huffington Post

5
Recalls of Ice Cream, Hummus Spur Listeria
Warnings
  • As U.S. health officials deal with nationwide
    recalls of Blue Bell ice cream and Sabra Dipping
    Co. hummus, consumers are getting up to speed on
    a little known but potentially fatal bacteria,
    listeria.
  • Listeria-tainted ice cream is linked to a total
    of five illnesses and three deaths in Texas and
    Kansas, the U.S. Centers for Disease Control and
    Prevention said Thursday. Also this week, Sabra
    recalled 30,000 cases of classic hummus, because
    of listeria-contamination concerns. About 260
    deaths occur as a result -- far fewer than the
    number linked to salmonella, another foodborne
    illness. Most people who eat food contaminated by
    listeria won't become very ill. They can have
    nausea, vomiting, muscle ache and diarrhea. There
    is a more invasive type of illness that can
    affect people with weakened immune systems, such
    as those who have HIV, or people with diabetes,
    heart disease, pregnant women, infants and the
    frail elderly. Listeria has been found in
    unpasteurized dairy products and in ready-to-eat
    meats, especially hot dogs and deli meats. Unlike
    most other bacteria, listeria can grow and
    multiply in the refrigerator. Listeria bacteria
    can live in a food-processing factory for years,
    sometimes contaminating food products.
    http//www.cdc.gov/listeria/

6
Cancer rates among patients with hepatitis C are
increased compared to those not infected
  • Results recently announced at The International
    Liver CongressTM 2015 show that cancer rates in
    patients with the hepatitis C virus (HCV) were
    significantly increased compared to the non-HCV
    cohort. The researchers suggest an extrahepatic
    manifestation of HCV may be an increased risk of
    cancer. A retrospective study at Kaiser
    Permanente, Southern California, USA, was
    conducted. The study authors recorded all cancer
    diagnoses in patients over 18 years of age with
    or without HCV during 2008-2012. Within the
    timeframe of the study 145,210 patient years were
    included in the HCV cohort, and 13,948,826
    patient years were included in the non-HCV
    cohort. In the HCV cohort there were 2,213 cancer
    diagnoses (1,524/100,000) during the 5-year
    period and 1,654 cancer diagnoses when liver
    cancer was excluded (1,139/100,000). In the
    non-HCV cohort there were 84,419 cancer diagnoses
    (605/100,000) during the same 5-year period and
    83,795 (601/100,000) when liver cancer was
    excluded. When all cancers are considered the
    rate is 2.5 times higher in the HCV cohort when
    liver cancers are excluded, the rate is still
    almost 2 times higher. This data adds to the
    evidence bank linking hepatitis C with an
    increased risk of cancer, and highlights that
    there is still a long way to go in order to fully
    understand this complex and devastating disease
  • Source European Association for the Study of the
    Liver. "Cancer rates among patients with
    hepatitis C are increased compared to those not
    infected." ScienceDaily. ScienceDaily, 24 April
    2015

7
Are hospitals doing all they can to prevent C.
difficile infections?
  • Hospital patients are especially prone to
    developing C. diff infections, and suffering
    serious effects -- especially after they take
    antibiotics that disrupt the community of
    bacteria in their digestive systems. In a paper
    published online in Infection Control Hospital
    Epidemiology, the team from the University of
    Michigan Medical School and VA Ann Arbor
    Healthcare System reports the results of their
    survey of a national random sample of hospitals.
    Virtually all the hospitals had programs to
    monitor for C. diff infections, and use
    protective gear, separate hospital rooms and
    special cleaning techniques when treating a C.
    diff-infected patient, so that it doesn't spread
    to other patients. In addition to being present
    in bodily fluids, C. diff can form spores that
    can persist in the hospital environment for
    weeks. But the lack of antimicrobial
    stewardship programs, as antibiotic-limiting
    efforts are called, persists in nearly half of
    hospitals -- despite the fact that the infection
    control leaders surveyed almost all agree that
    such efforts have been proven to prevent C. diff
    infections. In addition to the lack of
    antimicrobial stewardship programs, the
    researchers also found a widespread lack of
    written policies to test patients for C. diff
    infection when they developed diarrhea while
    taking antibiotics or within several months of
    taking them. Nearly three-quarters of hospitals
    didn't have such policies, though diarrhea is a
    key symptom of C. diff -- and can lead to
    dangerous complications and death in vulnerable
    hospitalized patients. Source Clostridium
    Difficile Infection in the United States A
    National Study Assessing Preventive Practices
    Used and Perceptions of Practice Evidence.
    Infection Control Hospital Epidemiology, 2015

8
Never before seen tick-borne illness may be
'substantial health threat' to humans in many
parts of the world
  • Researchers tested 477 patients in northeastern
    China who had been bitten by a tick over a
    month-long period in the spring of 2014. Of
    those, 28, six percent, were found to have been
    infected by the new species of bacteria. This
    microbe is related to other Anaplasma bacteria,
    some of which can cause illness when transmitted
    from ticks to humans. The symptoms of A capra
    infection include fever, headache, and tiredness,
    dizziness and muscle aches. The researchers
    successfully treated the infection with
    antibiotics, particularly doxycycline.
  • Because no one knew the bacteria existed, no one
    has looked for it, and it is not clear how
    widespread it is. In China, the species appears
    to be common in goats - the researchers decided
    to call it "capra" because the word means "goat"
    in Latin. But it may also infect other animals.
    Currently, it is difficult to diagnose infection
    - there is no simple blood test. The bacterium is
    probably transmitted via a tick species known as
    the taiga tick. This species, which is closely
    related to the deer tick, lives in Eastern Europe
    and across Russia and Asia, including China and
    Japan. If this tick species transmits A capra
    throughout this area, human infection may be
    common.
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