Oct. 14, 2008
Superbugs Bad, Deadly, But Not Doomsday
Hospital Infection Ratings Not Yet Consumer Friendly
By Tony Rutherford
Huntingtonnews.net Reporter
Huntington, WV (HNN) – You’ve seen the sensationalized magazine covers and news reports --- a new super virus (bug) has entered one or more countries for which there is no cure. That’s also been the premise of numerous films, too, even prior to the birth of the more biological terroristic kind as opposed to an outer space plague plunging to the planet.
At the first annual Joan C. Edwards School of Medicine Infectious Diseases/Critical Care Symposium, Dr. Laurel Preheim wiped out apocalyptic visions, but warned the antibiotic resistant forms of staph infection can make you sick and even kill you. Dr. Preheim, member of Infectious Disease departments at three Nebraska hospital and author of 150 scientific articles, the constant research battles with MRSA (antibiotic resistant staph) infections in communities. These deadly, evolving germs spread worldwide in the 70s and 80s, before the much publicized strains that have seemingly at random struck in nearly all states.
These “bugs” stick to skin well and can exist in a boil, bite, or cut. “They are established in the community and are spreading in the community even without the use of antibiotics,” Dr. Preheim said. “We’re have people coming in with community associated MRSA strains who have never been in the hospital, never seen antibiotics.”
About 1% of the general population have them on their skin, but only a few get sick. Media attention has been drawn to deaths of student athletes who contacted the disease playing contact sports. Since the MERSA germs mutate and development resistance to previously effective antibiotics, MERSA in 2005 replaced AIDS as the leader in estimated U.S. deaths (19,000 in 2005 to 15,789 in 2004 for AIDS).
Dr. Preheim admitted “there is fear” of wide spread, severe biological infection outbreaks, but “we do have agents that are effective. We just have to use them carefully because over time if we overuse these drugs or use them inappropriately then their life [span] becomes limited.” The Fellow of the American College of the American College of Physicians referred to a tendency of doctors to prescribe a just in case antibiotic for various illnesses, like colds or viruses. Overuse of the drugs lead to resistant strains.
Healing drugs of the past have become useless --- some within a year --- due to the virulent bacteria.
New exploration continues for replacement pharmaceuticals. “Fortunately, we have new agents (drugs) being explored, so there’s hope around the corner but each drug must be used very carefully,” Dr. Preheim explained.
Community developed MRSA can develop in group living conditions (such as military or the incarcerated ), animals, recent flu or pneumonia, and then to be most harmful of children under two and seniors age 65 and up.
Although the Nebraska doctor’s talk did not focus on health care facilities, different strains often occur in health care facilities, particularly among long term care patients. In addition, workers must take precautions (washing hands, masks, gowns) when treating infected patients as contact with body fluids could infect a provider.
It’s not necessarily a coincidence, but Marshall University’s Joan C. Edwards School of Medicine recently received permission from the Institutional Review Board to research MRSA infections in the Huntington area.
Following the first lecture, Dr. Mark Rupp, professor at the University of Nebraska Medical Center, turned to disease spreading from inappropriate catheter use or use of other bionic (or prosthetic) body parts. In other words, we have the technology to replace worn parts of the body, but the substitute could generate rapid infection spreading, for instance, at the surgical wound.
Publicity about acquiring deadly, nearly untreatable infections at medical centers and nursing homes has brought discussion about making facility ratings available to the public. Rupp explained finding such a system has to date not been an easy task. He jokingly used a cartoon to illustrate that the system might be worse than lack of knowledge. In the cartoon, a patient heads for the hospital that has marketed a zero surgery infection rate, yet the unstated (or missing) data indicates, the hospital has a 100% mortality (death) rate for surgeries.
“It’s not a simple situation,” Rupp said. “I’m very much in support of this from a philosophical stand point. We need greater transparency throughout medical care , and, in particular , infection control and reporting complications.” However, the potential for such user friendly (i.e. for non medically schooled individuals) systems come with, in his words, “equitable” issues.
“You have to ensure that hospitals are using the same systems, the same definitions, the same rigors of case finding. You do not want to penalize a hospital that’s doing a good job in reporting versus a hospital that buries their head in the sand and says ‘we don’t have that problem here,’ the Epidemiology expert added, Under those circumstances, the public report of one hospital would “look” much better than another one when “that may not be the truth.”
For instance, he proposed that the reports consider the seriousness of patient illnesses at the specific hospital. “ You have do risk stratification. Not all patients are created equal, so an older, frailer, sicker patient with a lot more things going on is going to be more at risk than a young healthy person that goes in for an elective procedure.” Thus, the dilemmas of creating the ratings. “We haven’t figured how to do that in the most helpful responsible way. Right now, its incumbent on hospitals to do the best they can.”
However, the researchers with over 200 published articles to his credit does not advocate a free pass by his statement. “ There has to be oversight mechanisms … some sort of a third party doing spot checking and surveillance … looking at case records to make sure when they find an infected patient that it has been reported. And if they find someone not playing by the rules, there needs to be some penalties.”
The day long symposium included noted physicians from Vanderbilt University, Case Western Reserve University and George Washington University. Other topics covered were Clostridium infection, management of Sepsis, prevention of hospital acquired ventilation pneumonia, and institution financial impact from infections.
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Superbugs Bad, Deadly, But Not Doomsday
Hospital Infection Ratings Not Yet Consumer Friendly
By Tony Rutherford
Huntingtonnews.net Reporter
Huntington, WV (HNN) – You’ve seen the sensationalized magazine covers and news reports --- a new super virus (bug) has entered one or more countries for which there is no cure. That’s also been the premise of numerous films, too, even prior to the birth of the more biological terroristic kind as opposed to an outer space plague plunging to the planet.
At the first annual Joan C. Edwards School of Medicine Infectious Diseases/Critical Care Symposium, Dr. Laurel Preheim wiped out apocalyptic visions, but warned the antibiotic resistant forms of staph infection can make you sick and even kill you. Dr. Preheim, member of Infectious Disease departments at three Nebraska hospital and author of 150 scientific articles, the constant research battles with MRSA (antibiotic resistant staph) infections in communities. These deadly, evolving germs spread worldwide in the 70s and 80s, before the much publicized strains that have seemingly at random struck in nearly all states.
These “bugs” stick to skin well and can exist in a boil, bite, or cut. “They are established in the community and are spreading in the community even without the use of antibiotics,” Dr. Preheim said. “We’re have people coming in with community associated MRSA strains who have never been in the hospital, never seen antibiotics.”
About 1% of the general population have them on their skin, but only a few get sick. Media attention has been drawn to deaths of student athletes who contacted the disease playing contact sports. Since the MERSA germs mutate and development resistance to previously effective antibiotics, MERSA in 2005 replaced AIDS as the leader in estimated U.S. deaths (19,000 in 2005 to 15,789 in 2004 for AIDS).
Dr. Preheim admitted “there is fear” of wide spread, severe biological infection outbreaks, but “we do have agents that are effective. We just have to use them carefully because over time if we overuse these drugs or use them inappropriately then their life [span] becomes limited.” The Fellow of the American College of the American College of Physicians referred to a tendency of doctors to prescribe a just in case antibiotic for various illnesses, like colds or viruses. Overuse of the drugs lead to resistant strains.
Healing drugs of the past have become useless --- some within a year --- due to the virulent bacteria.
New exploration continues for replacement pharmaceuticals. “Fortunately, we have new agents (drugs) being explored, so there’s hope around the corner but each drug must be used very carefully,” Dr. Preheim explained.
Community developed MRSA can develop in group living conditions (such as military or the incarcerated ), animals, recent flu or pneumonia, and then to be most harmful of children under two and seniors age 65 and up.
Although the Nebraska doctor’s talk did not focus on health care facilities, different strains often occur in health care facilities, particularly among long term care patients. In addition, workers must take precautions (washing hands, masks, gowns) when treating infected patients as contact with body fluids could infect a provider.
It’s not necessarily a coincidence, but Marshall University’s Joan C. Edwards School of Medicine recently received permission from the Institutional Review Board to research MRSA infections in the Huntington area.
Following the first lecture, Dr. Mark Rupp, professor at the University of Nebraska Medical Center, turned to disease spreading from inappropriate catheter use or use of other bionic (or prosthetic) body parts. In other words, we have the technology to replace worn parts of the body, but the substitute could generate rapid infection spreading, for instance, at the surgical wound.
Publicity about acquiring deadly, nearly untreatable infections at medical centers and nursing homes has brought discussion about making facility ratings available to the public. Rupp explained finding such a system has to date not been an easy task. He jokingly used a cartoon to illustrate that the system might be worse than lack of knowledge. In the cartoon, a patient heads for the hospital that has marketed a zero surgery infection rate, yet the unstated (or missing) data indicates, the hospital has a 100% mortality (death) rate for surgeries.
“It’s not a simple situation,” Rupp said. “I’m very much in support of this from a philosophical stand point. We need greater transparency throughout medical care , and, in particular , infection control and reporting complications.” However, the potential for such user friendly (i.e. for non medically schooled individuals) systems come with, in his words, “equitable” issues.
“You have to ensure that hospitals are using the same systems, the same definitions, the same rigors of case finding. You do not want to penalize a hospital that’s doing a good job in reporting versus a hospital that buries their head in the sand and says ‘we don’t have that problem here,’ the Epidemiology expert added, Under those circumstances, the public report of one hospital would “look” much better than another one when “that may not be the truth.”
For instance, he proposed that the reports consider the seriousness of patient illnesses at the specific hospital. “ You have do risk stratification. Not all patients are created equal, so an older, frailer, sicker patient with a lot more things going on is going to be more at risk than a young healthy person that goes in for an elective procedure.” Thus, the dilemmas of creating the ratings. “We haven’t figured how to do that in the most helpful responsible way. Right now, its incumbent on hospitals to do the best they can.”
However, the researchers with over 200 published articles to his credit does not advocate a free pass by his statement. “ There has to be oversight mechanisms … some sort of a third party doing spot checking and surveillance … looking at case records to make sure when they find an infected patient that it has been reported. And if they find someone not playing by the rules, there needs to be some penalties.”
The day long symposium included noted physicians from Vanderbilt University, Case Western Reserve University and George Washington University. Other topics covered were Clostridium infection, management of Sepsis, prevention of hospital acquired ventilation pneumonia, and institution financial impact from infections.
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Make HNN Your Homepage (IE Users Only)
