Thursday, September 25, 2008

CDC Campaign Targets MRSA Infections

A national campaign to teach parents how to protect kids from skin infections caused by dangerous methicillin-resistant Staphylococcus aureus (MRSA) bacteria was launched this week by the U.S. Centers for Disease Control and Prevention.

MRSA, a type of staph bacteria that's resistant to certain antibiotics, can cause severe infections in people in hospitals and other health care facilities. It can also cause skin infections in healthy people who haven't recently been hospitalized, the CDC said.

Each year, Americans make more than 12 million visits to doctors for skin infections typical of those caused by staph infections. In some areas of the United States, MRSA accounts for more than half of such skin infections.

The new National MRSA Education Initiative highlights specific measures parents can take to protect themselves and their families from MRSA skin infections. The campaign will include Web sites, fact sheets, brochures, posters, radio and print public service announcements, mom blogging sites, Web banners, and mainstream media interviews. Information will also be shared through community and school groups, professional organizations, faith-based groups, and national health conferences.

MRSA is spread through direct contact with an infection, sharing personal items such as towels or razors that have touched infected skin, or by touching surfaces contaminated by MRSA.

Parents need to teach children about the signs and symptoms of MRSA skin infections, which appear as a bump or infected area on the skin that may be red, swollen, painful, warm to the touch, or contain pus or other drainage. Fever may be another symptom.

The CDC said parents also need to help children keep their cuts and scrapes clean and covered with a bandage and encourage children to have good hand washing and general hygiene habits.

"Well-informed parents are a child's best defense against MRSA and other skin infections. Recognizing the signs and receiving treatment in the early stages of a skin infection reduces the chances of infection becoming severe or spreading," Dr. Rachel Gorwitz, a pediatrician and medical epidemiologist with CDC's Division of Healthcare Quality Promotion, said in an agency news release.

Special Dyes and Lighting Kill MRSA, Research Shows

A new kind of paint that releases titanium dioxide when exposed to fluorescent light and a green dye for wounds that gives off toxic molecules when activated by near-infrared light could both kill the deadly superbug known as MRSA, two new studies claim.

MRSA stands for methicillin-resistant Staphylococcus aureus . It's a strain of staph that's resistant to many antibiotics commonly used to treat it, and it can be fatal. Both reports were presented Tuesday at the Society for General Microbiology Autumn meeting at Trinity College in Dublin.

In the first study, British researcher Lucia Caballero, from Manchester Metropolitan University, found that paint that contained particles of titanium dioxide killed bacteria when it absorbed ultraviolet light.

"If this turns out, the impact is sure to be positive in the area of health," Caballero said.

The same reaction occurs when paints containing titanium dioxide are exposed to infrared light. The researchers found that the paint containing titanium dioxide successfully killed bacteria when the concentration of these nanoparticles was stronger than the normal paint. In fact, they found that all E. coli were killed with fluorescent lights.

"There are many circumstances where it is necessary or desirable to remove or to kill microorganisms found in a biological host or on surfaces," Caballero said. "Maintenance of hygienic standards is essential in hospitals, pharma and the food industry. Surface hygiene could be improved by the action of fluorescent light on catalytic surfaces, such as paints containing nanotitanium, for retarding contamination and saving on cost of cleaning maintenance."

In the second report, Dr. Ghada Omar, from University College London, found that 99 percent of the MRSA bacteria in infected wounds could be killed using a green dye that gives off toxic molecules when activated by infrared light.

"The chemicals produced when the dye is activated harm the bacteria in such a wide variety of ways that it is unlikely bacteria could ever develop resistance to the treatment," Omar said in a statement. "This makes it ideal, and possibly the only option, for treating infections with multiple drug-resistant bacteria, including MRSA."

Infected wounds are a major problem for thousands of hospital patients. Up to 9 percent of hospital-acquired infections occur during surgery and contribute to 77 percent of deaths from operations. These infections increase the length of time patients remain in hospital and increase costs, Omar noted.

Dr. Pascal James Imperato, Dean and Distinguished Service Professor of the Graduate Program in Public Health at SUNY Downstate Medical Center in Brooklyn, said a lot more work needs to be done before these technologies become practical.

"It's very much in the experimental stage at this point," Imperato said. "It's an interesting new development, but one is going to have to see many more studies to determine whether or not this is really going to work."

Dr. Marc Siegel, an associate professor of medicine at New York University School of Medicine, thinks that basic cleanliness can do more to remove the threat of hospital infections than these new technologies.

"This technology is very promising, Health but it gets us away from the real issue, which is that we have a problem with cleanliness and sterility in hospitals," Siegel said. "The real issue is that doctors don't change their coats, change their gloves enough. We are not using hand wipes."

U.S. Barred 33 TB-Infected People From Flying Over Past Year

Thirty-three would-be air travelers with suspected or confirmed infectious tuberculosis were placed on the U.S. government's public health "Do Not Board" list in the first year of its existence, a federal report released Thursday showed.

Authorized under the Aviation and Transportation Security Act of 2001, the list was instituted on June 1, 2007 by the U.S Centers for Disease Control and Prevention and the Department of Homeland Security, according to an article in the Sept. 19 issue of Morbidity and Mortality Weekly Report , a CDC publication.

"Before June 2007, we had a system to prevent travel which was mostly based on local action," explained Dr. Francisco Alvarado-Ramy, co-author of the report and a CDC quarantine public health officer based in San Juan, Puerto Rico. "We have moved from predominantly a decentralized system to a centralized one We're formally tapping all U.S. government resources which add additional layers of protection to prevent persons with serious communicable diseases which pose a serious public health threat from boarding the plane."

In the year after institution of the list, U.S. state and local or territorial health departments asked the CDC to include 42 people on the list, all of whom had confirmed or suspected tuberculosis (TB), including multi-drug resistant (MDR) TB and extensively drug-resistant (XDR) TB. In the end, 33 individuals met the criteria to be placed on the list. The most requests (seven) came from Texas, followed by California (five).

The issue gained prominence in 2007 after a Georgia man who flew to Europe for his wedding was subsequently quarantined after it was discovered that he had XDR TB. That highly visible case "highlighted some of the vulnerabilities to the existing system," said Dr. Martin Cetron, director of the CDC's director of division of global migration and quarantine.

Almost half of those barred from flights over the past year were citizens of countries designated by the World Health Organization as TB "high-burden" countries. Two of the individuals on the list were known to have attempted to evade U.S. air travel restrictions, although it is unclear what, exactly, this meant.

The CDC reviews the list on a monthly basis, determining who is eligible for removal -- once a person is deemed to be no longer contagious, his or her name is removed from the Do Not Board list within 24 hours, the report's authors said. Between June 2007 and May 2008, 55 percent of the 33 people on the list were removed either because they were no longer contagious or did not have TB. Those removed had been on the list for a median of 26 days. Those persons not removed from the list had been on the list for a median of 72 days.

Officials said they are on the look-out for "diseases of consequence," such as SARS, TB, a pandemic strain of influenza and hemorrhagic fevers such as Ebola, Cetron said.

Monday, September 8, 2008

Is There a Doctor in the House Physician Liability Fears and the Quality of Care in Nursing Homes

The physicians who provide medical care to nursing home residents do so as facility medical directors and as attending physicians. These physicians are personally at risk of malpractice litigation and liability, Fairly Health even for patient care when the physician is not present at the facility, in addition to the facilities’ institutional risk regarding resident care. In recent years, a widespread perception has arisen among nursing home physicians that this legal environment is becoming increasingly intimidating and constricting.

In 2007 the California HealthCare Foundation partnered with The Commonwealth Fund to support Professor Marshall Kapp of Southern Illinois University in a study of nursing home physician anxiety about legal liability.

The project examined the psychological aura of legal risk among nursing home physicians and its effect on the quality of medical care and quality of life for nursing home residents, including physician unwillingness to practice in nursing homes; premature or unnecessary resident transfers to hospitals; excessively or insufficiently aggressive medical treatment; Fairly Health and infringement on the autonomy of residents. The study included a review of relevant literature and laws, plus interviews with nursing home professionals drawn from practice, private organizations, and academia.

The study examined:

* The origins and nature of the climate of apprehension among physicians;
* The extent to which the anxieties are justified by the actual risks confronted;
* The relationship between the liability insurance landscape and physicians’ concerns; and
* The effects of these physician anxieties on the quality of care and quality of life of nursing home residents.

Health Minister Praise For Life-Saving Rbh

The Health Minister praised Royal Berkshire Hospital for potentially saving 13,000 women’s lives a year when he opened its sexual health and breast-screening clinic.

Secretary of State for Health The Rt Hon Alan Johnson praised the hard work of staff and said it was a monumental achievement for Reading to get 82 per cent of its female population to go for breast screening.

The number of people going through the doors into the sexual health clinic every week has doubled since it moved to Craven Road.

Mr Johnson said: “The centre is very friendly and welcoming and the staff are attentive.

This makes a huge difference to people coming into the unit, and it is thorough in its work.

“People are very lucky to have this kind of service so we want even more people to come along and get tested or screened.

“Patients can now be seen within 48 hours and the walk-in service at the sexual health clinic means that it is convenient for an even wider range of people.

“We are living in a society where people live longer and there have been huge advances in medical science, the death rate from breast cancer in particular has dramatically decreased from 50 per cent to 80 per cent as a result of effective screening and early treatment.

“The centre has been the result of a £2.5 million investment and has transformed the sexual health facilities from a hidden away portacabin was built in 1966, to this spectacular bright and airy space on the main road so people are aware of its existence.

“I think there can be a complacency about sexual health, especially among young people, but with a clinic like this, people are more open to the idea of getting help and advice against sexually transmitted infections.

“There has been a rise in infections like gonorrhoea and HIV and it is so important for facilities, like this one to exist.”

Alan Tang, consultant physician for contraceptive services at the hospital, said the centre had been a huge asset to the hospital and that since it moved it has increased the number of people seen in a week from 220 to 390.

Govt, LG Partner On Road Rehabilitation

Chairman, Igbo-Eze North Local Government, Hon Chijioke Ugwu has said efforts were on by the council to partner with the state government on rehabilitating bad rural roads in the area.

Noting that the state of dilapidation of the roads have made transportation difficult for the rural dwellers in the area health centres, Ugwu said his administration was determined to ensure that the problem is addressed by partnering with the state government.

He disclosed that the road rehabilitation would be in line with the ongoing road reconstruction in the state capital being embarked upon by Governor Sullivan Chime.

Ugwu who spoke with THISDAY shortly after the commissioning of projects executed by his council said a number of community roads requiring urgent attention has been identified and would soon be tackled.

"We are also proposing to construct the border road between Igboeze South and North which hopefully I intend to seek the assistance and partnership of the state government, and if possible not just grading the road but asphalting it so as to make it more solid", health centres he said.

Chime had during the commissioning of the projects in the local government charged council chairmen to always make the state government's 4-point agenda their guiding principles.

The governor who was represented on the occasion by the Commissioner for Local Government , Prof Frank Asogwa on the commissioning ceremony expressed satisfaction with what he saw on the ground in the local government.

He however charged the council chairman to keep the flag flying, adding that council chairmen have no excuse not to perform since they have been receiving their federal government monthly statutory allocations untouched.

Among the projects commissioned by the governor were newly constructed and renovated health centres, primary school classroom blocks and electricity projects.

Chime reiterated the commitment of his administration towards transforming the entire state including the rural areas health centres.

Ugwu attributed his achievements since assuming office as a result of non interference of the state government with their monthly federal statutory allocations.