Transcript File - Working Toward Zero HAIs

Unit Based Champions
Infection Prevention
eBug Bytes
February 2012
High Levels of MRSA Bacteria in U.S.
Retail Meat Products, Study Suggests




Retail pork products in the U.S. have a higher prevalence of methicillinresistant Staphylococcus aureus bacteria (MRSA) than previously identified,
according to new research by the University of Iowa College of Public
Health and the Institute for Agriculture and Trade Policy.
The study, published Jan. 19 in the online science journal PLoS ONE,
represents the largest sampling of raw meat products for MRSA
contamination to date in the U.S. The researchers collected 395 raw pork
samples from 36 stores in Iowa, Minnesota and New Jersey. Of these
samples, 26 -- or about 7 percent -- carried MRSA
Reference:
Ashley M. O'Brien, Blake M. Hanson, Sarah A. Farina, James Y. Wu, Jacob E.
Simmering, Shylo E. Wardyn, Brett M. Forshey, Marie E. Kulick, David B.
Wallinga, Tara C. Smith. MRSA in Conventional and Alternative
Retail Pork Products. PLoS ONE, 2012; 7 (1): e30092 DOI:
10.1371/journal.pone.0030092
Study Suggests Use of Antimicrobial
Scrubs May Reduce Bacterial Burden
on Healthcare Worker Apparel


32 healthcare workers wore four pairs of identically appearing control
scrubs and study scrubs impregnated with an antimicrobial, or germ-killing,
compound over the course of four months, washing them regularly.
Participants also received identical hand hygiene educational sessions every
four weeks, and researchers assessed compliance with hand hygiene
practices. Researchers conducted once weekly, unannounced, garment and
hand cultures of participants at the start and end of each shift where they
obtained two samples from the garment’s abdominal area and cargo pant
pocket – two areas of high-touch and high bacterial colonization.
According to Bearman, although the scrubs did not impact the degree of
MRSA on the healthcare workers’ hands, the antimicrobial scrubs were
effective in reducing the burden of MRSA on healthcare worker apparel.

The scrubs tested in the study were manufactured by Vestagen Technical Textiles.

Bearman collaborated with VCU researchers Kakotan Sanogo, Michael P. Stevens,
MD, Curtis Sessler, MD, Richard Wenzel, MD, along with Adriana Rosato, PhD,
Methodist Hospital Research Institute and Kara Elam, doctoral student, University
of Mississippi.
Pairing Masks and Handwashing Could
Drastically Slow Spread of Pandemic Flu

The University of Michigen “M-Flu study” was the first of its kind and
received international exposure when launched in 2006. The team of M-Flu
researchers recruited more than 1,000 students in U-M residence halls. The
students were assigned to groups who wore masks, wore masks and
practiced hand hygiene, or did neither. They were monitored for the
presence of flu symptoms or the flu. A new report shows the second-year
results (2007-2008) of up to a 75 percent reduction in flu-like illness over
the study period when using hand hygiene and wearing surgical masks
in residence halls
The goal of M-Flu was to estimate the reduction in rate of flu infection and
illness attributed to masks and hand sanitizers, and masks alone during two
flu seasons. Students in both studies were asked to wear masks in the
residence halls for six hours per day and clean their hands with an alcohol
based hand sanitizer in addition to soap and water hand washing.

The M-Flu study was a collaboration among the School of Public Health, University of Michigan Housing and
the University Health Service. In addition to Aiello and Monto, authors include current students or graduates
of the U-M SPH: Rebecca Coulborn, Brian Davis, and Vanessa Perez; and a colleague at Wayne State
University, Monica Uddin. The paper, "Facemasks hand hygiene and influenza among young adults: A
randomized intervention trial" was scheduled to appear in PLoS ONE on Jan. 25, 2012.
Legionella Found in Water
at Las Vegas Resort


The Southern Nevada Health District has received reports that three
guests who stayed at the Luxor Resort were diagnosed with Legionnaires’
disease. The first two cases were reported in the spring of 2011. At that
time the health district conducted an environmental assessment and
collected bulk water samples from the Luxor. Results of the water samples
did not detect Legionella bacteria and the environmental assessment
indicated guests were not at increased risk of contracting Legionnaire’s
disease at that time. Both patients have recovered from their illness.
The third case was reported to the health district in January 2012. At the
time of the report, the patient was deceased. Based on this latest report the
health district initiated a new epidemiological and environmental
investigation. At this time environmental sampling was positive for
Legionella bacteria. The Luxor has been working cooperatively with the
health district to implement and complete a comprehensive remediation
process in accordance with recommended guidelines. To date, no additional
cases of disease have been reported. Legionella bacteria exist in fresh water
and are commonly found throughout the environment. Symptoms include
high fever, chills, cough, and some people may also suffer from muscle aches
and headaches.
Norovirus Is the Leading Cause of
Infection Outbreaks in U.S. Hospitals


The study was conducted to determine how often outbreak
investigations are initiated in U.S. hospitals, as well as the
triggers for investigations, types of organisms, and control measures
including unit closures. Thirty-five percent of the 822 hospitals responding
had investigated at least one outbreak in the previous two years. Four
organisms caused nearly 60 percent of the outbreaks: norovirus (18.2
percent), Staphylococcus aureus (17.5 percent), Acinetobacter spp (13.7
percent), and Clostridium difficile (10.3 percent). These results reflect 386
outbreak investigations reported by 289 hospitals over a 24-month period.
Medical/surgical units were the most common location of outbreak
investigations (25.7 percent), followed by surgical units (13.9 percent).
Nearly one-third (29.2 percent) of outbreaks were reported in a category
that included emergency departments, rehabilitation units, long-term acute
care hospitals, psychiatric/behavioral health units, and skilled nursing
facilities. According to the results, the average number of confirmed cases
per outbreak was 10.1 and the average duration was 58.4 days. Unit
closures were reported in 22.6 percent of the cases, causing an average
16.7 bed closures for 8.3 days. Source: AJICFebruary 2012,Volume 40, Issue 1
Playing Chicken With UTIs




Contaminated chicken meat may cause some human urinary tract
infections, researchers suggested. The majority of such infections are
caused by extraintestinal pathogenic Escherichia coli – dubbed ExPEC,
for short -- but physicians and researchers have long assumed the
bacteria involved always originated in the patient's own body, according
to Amee Manges, PhD, of McGill University in Montreal, and colleagues.
But ExPEC outbreaks in several countries in recent years hint at an
external source, the researchers reported in the March issue of
Emerging Infectious Diseases. The source is probably retail meat, they
argue, and the reservoir is most probably chicken. That conclusion is
based on genetic analysis comparing E. coli from samples of beef, pork,
and chicken with strains obtained from humans seeking treatment for
a urinary tract infection.
"We suspect that the transmission is occurring the same way other
foodborne agents are transferred,”– such things as poor food handling
or preparation, kitchen cross-contamination, and undercooking.
Primary source: Emerging Infectious Diseases
Bergeron CR, et al "Chicken as reservoir for human extraintestinal pathogenic
escherichia coli" Emerg Infect Dis 2012; DOI: 10.3201/eid1803.111099.
More Doctors 'Fire' Families for
Vaccine Refusers





Pediatricians fed up with parents who refuse to vaccinate their children
out of concern it can cause autism or other problems increasingly are
"firing" such families from their practices, raising questions about a
doctor's responsibility to these patients.
Medical associations don't recommend such patient bans, but the
practice appears to be growing, according to vaccine researchers.
In a study of Connecticut pediatricians published last year, some 30% of
133 doctors said they had asked a family to leave their practice for
vaccine refusal, and a recent survey of 909 Midwestern pediatricians
found that 21% reported discharging families for the same reason.
By comparison, in 2001 and 2006 about 6% of physicians said they
"routinely" stopped working with families due to parents' continued
vaccine refusal and 16% "sometimes" dismissed them, according to
surveys conducted then by the American Academy of Pediatrics.
Source: Wall Street Journal Feb 15 2012
Hepatitis C deaths up, baby
boomers most at risk

Deaths from liver-destroying hepatitis C are on the rise, and new data shows baby
boomers . One of every 33 baby boomers are living with hepatitis C infection.
Federal health officials are considering whether anyone born between 1945 and
1965 should get a one-time blood test to check if their livers harbor this ticking
time bomb. The reason: Two-thirds of people with hepatitis C are in this age group,
most unaware that a virus that takes a few decades to do its damage has festered
since their younger days.

The issue has taken new urgency since two drugs hit the market last summer that
promise to cure many more people than ever was possible. And research published
Monday says testing millions of the middle-aged to find those who need the pricey
treatment would be worth the cost, saving thousands of lives. Sharing a needle
while injecting illegal drugs is the biggest risk factor for becoming infected with this
blood-borne virus. But before 1992, when widespread testing of the blood supply
began, hepatitis C commonly was spread through blood transfusions. Plus, a onetime experiment with drugs way back in high school or college could have been
enough. A CDC study published Monday analyzed a decade of death records and
found an increase in death rates from hepatitis C. In fact, in 2007 there were 15,000
deaths related to hepatitis C, higher than previous estimates — and surpassing the
nearly 13,000 deaths caused by the better-known AIDS virus.

Source: Infectious Diseases MSNBC News – and www.cdc.gov