Staph
superbug often a menace at care facilities [6/25/07] - Methicillin-resistant
Staphylococcus aureus may be infecting as many as 5 percent of hospital
and nursing home patients, according to a comprehensive study.
Superbugs
more widespread than thought
Step
up the superbug battle, CDC tells hospitals - 10/19/06 - Hospitals
need to step up efforts to prevent infections with drug-resistant "superbugs,"
which are becoming more and more of a threat to patients, the U.S. Centers
for Disease Control and Prevention said Thursday.
MRSA
superbug found in baby ward of flagship hospital - Four babies were
found to be carrying MRSA at Edinburgh Royal Infirmary
Virulent
staph germ once confined to hospitals emerging in jails, gyms and schools
[2/26/06] " There are few statistics on the disease, because resistant
staph infections are not routinely reported to the CDC. But one study published
last year in the journal Emerging Infectious Diseases estimated there were
about 126,000 cases from 1999 to 2000 — twice the number of hepatitis B
cases each year."
From Emerging Infectious Diseases: Antimicrobial
Resistance Determinants and Future Control by Stephan Harbarth; Matthew
H. Samore [June, 2005] [Medscape registration is free]
"Antibiotic therapy, if indiscriminately used, may
turn out to be a medicinal flood that temporarily cleans and heals, but
ultimately destroys life itself." Felix Marti-Ibanez,
1955
"At the beginning of the 21st century, antimicrobial resistance is common,
has developed against every class of antimicrobial drug, and appears to
be spreading into new clinical niches"
Medical
errors edging up in US, study finds - 5/2/05 - WASHINGTON, May
2 (Reuters) - Hospital-acquired infections are worsening in the United
States, even though the problem is widely recognized, according to a report
issued on Monday. . . .Such infections include antibiotic-resistant bacteria
that are very difficult to treat, including staphylococcus and streptococcus
infections.
Superbug
kills two-day-old baby - Luke Day, born to Glynis Day, died at 36 hours
from the MRSA superbug in Ipswich on 2/2/05
Superbugs
kill mum 11 weeks after birth - Jacqui Munro, 28, died from a flesh-eating
bug after having her daughter Rachael by Caesarean at the Princess Royal
Maternity Hospital in Glasgow.
Several hundred women die every year in the United States from hospital-acquired
infections, but it's so hush-hush here that we rarely hear about them.
In particular, I know of a maternal death at our local hospital, but the
story never appeared in the news.
Dangerous
Germ Becoming More Common By Rob Stein, Washington Post Staff Writer,
4/7/05 - A comprehensive analysis of these methicillin-resistant Staphylococcus
aureus (MRSA) infections found that 8% to 20% were community acquired.
Outbreaks
of Pertussis Associated with Hospitals --- Kentucky, Pennsylvania, and
Oregon, 2003 [1/28/05] from the CDC.
Neckwear
as germ-spreader? More than a stain on your tie - A new study provides
a good lesson in cleanliness and could be a boon for the sale of tie clips
and bow ties. [By Damon Adams, AMNews staff. June 21, 2004.]
What's new concerning vancomycin-resistant enterococci (VRE)? Find out
in this easy-to-navigate
collection of recent MEDLINE abstracts compiled by the editors at Medscape
Infectious Diseases. [Medscape, 2000. © 2000 Medscape, Inc.]
Association
Between Method of Delivery and Maternal Rehospitalization
Mona Lydon-Rochelle, MPH, PhD, CNM; Victoria L. Holt, MPH, PhD; Diane
P. Martin, MA, PhD; Thomas R. Easterling, MD
JAMA - Vol. 283 No. 18, May 10, 2000 [not yet in Medline]
"Conclusions - Women with cesarean and assisted vaginal deliveries
were at increased risk for rehospitalization, particularly with infectious
morbidities."
Emerging
Infections -- Another Warning from The New England Journal of Medicine
- Editorial -- April 27, 2000 -- Vol. 342, No. 17 - "On a good day, we
hold them at bay. On a bad day, they're winning,'' said Dr. Michael Osterholm.
Resistant Bacteria Now Acquired from the Community
CDC's Morbidity and Mortality Weekly ReportAugust 20, 1999 / 48(32);707-710
Four
Pediatric Deaths from Community-Acquired Methicillin-Resistant Staphylococcus
aureus -- Minnesota and North Dakota, 1997-1999
08/20/99
- CDC Reports on Drug-Resistant Staph
CDC Reports on Drug-Resistant Staph
ATLANTA (AP) _ Federal health officials have confirmed the deaths of
four Midwestern children linked to drug-resistant staph infections they
acquired outside a hospital setting.
Drug-resistant staph was once largely confined to hospitals and nursing
homes, but the children's deaths in Minnesota and North Dakota show it
may be spreading to communities, the Centers for Disease Control and Prevention
said Thursday.
``These are the first deaths we're aware of that have appeared in the
United States and in medical literature,'' said Dr. J. Todd Weber of the
CDC's National Center for Infectious Diseases. ``How rare or how common
it is, we don't know yet.''
The children, ages 1 to 13, acquired methicillin-resistant staphylococcus
aureus infections between 1997 and 1999. None of the children had been
recently hospitalized before their deaths, the CDC said.
Staph bacteria are the No. 1 cause of hospital-acquired infections
in the United States, blamed for 13 percent of the 2 million hospital infections
annually.
Half of staph bacteria infections contracted by hospital patients in
1997 were resistant to a large class of antibiotics, up from 1974, when
only 2 percent were drug-resistant, the CDC said.
Death
from Vancomycin-intermediate S. aureus (VISA) in April, 1999 - report
from the Centers for Disease Control (CDC)
Antibiotic
Resistance in Canada - Deadly germ now resistant to 'superbug' drugs
- New strains of bacteria multiplying across Canada
02/22/99
'Supergerm'
Kills Hong Kong Woman
A strain of staphylococcus aureus that cannot be controlled with
even the strongest antibiotics killed a middle-aged Hong Kong woman.
This is the third reported case of vancomycin-resistant staph.
``We are
getting into the terminal stage. It is very dangerous; the bacteria have
broken the last defense,'' Yuen Kwok-yung, a microbiologist at the
hospital and the University of Hong Kong, was quoted as telling the
newspaper.
For several
years, doctors have been warning of the emergence of drug-resistant
bacteria. Bacteria become more deadly as they mutate to survive increasing
potent drugs.
Yuen told
the Post that a decade earlier, Hong Kong doctors discovered a case
of streptococcus pneumonia that was resistant to penicillin, but
now 70 percent of the cases here are resistant.
Enterobacter
cloacae Bloodstream Infections Associated with Contaminated Prefilled Saline
Syringes -- California, November 1998
U.S.
disease experts want better ``superbug'' watch
Reuters - May 14, 1998
Virtually all strains of the common staph bacterium are now resistant
to penicillin, other bugs are
rapidly developing drug-resistant forms, . . .
Despite repeated warnings that soon some infections would emerge that
no drugs could treat, no one has taken concerted action, he said, and the
U.S. government is not helping.
``Antibiotic-resistant bacteria generate a minimum of $4 billion to
$5 billion in costs to U.S. society and individuals yearly, and in 1992
the 19,000 deaths directly caused by hospital-acquired infections made
them the 11th leading cause of death in the U.S. population,'' they
wrote.
Intrapartum
Administration of Ampicilln Prophylaxis in GBS Mothers May Raise Risk of
Neonatal E. coli Infection
Ob.Gyn.News April 15, 1998
Despite aggressive treatment, six babies died of fulminant early-onset
E. coli infection during the entire study period; all six had ampicillin-resistant
organisms, and the mothers of four had received intrapartum ampicillin.
Superbugs
take hold
New Scientist - 25 April 1998
David Livermore, [director of Britain's PHLS's Antibiotic Reference
Unit] says his team has found a strain of Pseudomonas aeruginosa
resistant to "just about everything", including the current antibiotics
of last resort, carbapenems.
Flesh-Eating Bacteria
In an article dated March 11, 1998, the Tri-City Herald (in Washington
state) reported that a new mother died from necrotizing fascitis.
"Norma Orozco, 21, had delivered a baby at Our Lady of Lourdes Health Center
and was healthy when she left the hospital. . . . " She returned
to the hospital 1 1/2 days later (Feb. 28) and was diagnosed with necrotizing
fascitis; emergency surgery was performed to try to halt the progress of
the infection. She was then transported on March 1 to Harborview
Medical Center in Seattle. "She arrived in critical condition and
died Thursday [3/5], according to Harborview spokesman Larry Zalin."
The site of the infection was the episiotomy wound. This is particularly
tragic because episiotomies
are rarely indicated, and this woman's death was probably preventable.
Even when tearing does occur, the wound is less extensive and heals better,
with less infection. Many midwives report a suture rate around 15%.
It is imperative that women ask their care providers three questions:
-
What is their episiotomy rate?
-
What is their suturing rate for either episiotomies or tearing?
-
What are they doing to reduce their suturing rate?
The Midwife
Archives contains more information about assisting women in giving
birth without suffering a perineal wound. (Mirror
site for the Midwife Archives.)
Moms
Contract Flesh-Eating Disease During Cesaran Sections - Tuesday, 28
August 2001 15:24 (ET)
Strep
A Oubreak in Texas
Austin American-Statesman, February/March, 1998
Tissue-destroying
bacterium kills S.C. college freshman
The August Chronicle Online, March 12, 1998
The same bacterium causing the Texas outbreak turns up in South Carolina.
Testing
continues for flesh-eating bacteria in a Quebec Obstetrics Ward
Montreal Gazette, December 15, 1997
Seventy new mothers and newborns and eighty hospital employees are
being tested for the deadly strain of streptococcus A which killed one
new mother and has infected another in a Quebec hospital.
Woman
dies from flesh-destroying bacteria
Rochester, New York, August 12, 1997
Woman dies from infection acquired at the time of a Cesarean section
Drug-resistant
gonorrhea identified
Thursday May 28 6:18 PM EDT - UPI Science News
Get ready for more superbugs, disease experts say
New drug-resistant "superbugs," bacteria that defy all known antibiotics,
are virtually certain to pop up soon unless doctors and hospitals crack
down on procedures, health experts said Tuesday. Careless use of antibiotics
and slipshod hygiene were almost certainly responsible for the rise of
bacteria that resist the last-defense drugs - methicillin and vancomycin
- they said. "We've seen dramatic increases ... in the past decade," said
Dr. William Jarvis, acting director of the hospital infections program
at the Centers for Disease Control and Prevention in Atlanta. See http://www.infobeat.com/stories/cgi/story.cgi?id=2553735543-7c5
Hospital infections, drug resistance rise in U.S.
March 11, 1998 - Reuters - Mike Cooper
The rate at which patients pick up an infection while being treated
in a U.S. hospital has increased 36 percent in the past 20 years.
Dr. William Jarvis of the Centers for Disease Control and Prevention (CDC)
told researchers at an international conference on emerging infectious
diseases, ``We estimate that today 2 million patients develop
a hospital-acquired infection in the United States each year. Of that
number, 90,000 die as a result of those infections.'' [This
is more than all accidental deaths in the U.S.]
There were 9.77 hospital-acquired infections per 1,000 patient-days
in 1995, compared with 7.18 in 1975, Jarvis said.
He said the rate had risen in part because hospitals were using more
invasive procedures -- using breathing tubes and intravenous catheters,
for example -- to treat patients.
Not only are hospital patients at increased risk for infection but the
infectious diseases are increasingly resistant to drugs commonly used to
treat them.
``In at least 70 percent of the hospital-acquired infections that occur,
the organism is resistant to at least one antibiotic. In 35 to 40 percent
of infections, the organism is actually resistant to the best drug you
would use to treat that organism,'' Jarvis said.
Study
finds rise in infection rate in U.S. hospitals
CJ Online, Topeka KS - Thursday, March 12, 1998
U.S.
hospital infection rate on the rise since 1975
News-Star Online - March 12, 1998
Newborns Infected by Rare Dog Yeast Carried by Health Care Workers
Outbreak
of hospital yeast infection traced to dogs
The News & Observer on the Web - March 11, 1998
UPI Science News, March 11, 1998
Federal health researchers found pet dogs of health care workers probably
were the source of an epidemic of yeast infections in an intensive care
nursery. A study in The New England Journal of Medicine says the workers
spread the infections to infants after petting their dogs at home.
An
epidemic of Malassezia pachydermatis in an intensive care nursery associated
with colonization of health care workers' pet dogs.
Chang HJ, Miller HL, et al.
N Engl J Med 1998 Mar 12;338(11):706-711
Overuse
of antibiotics in the former Soviet Union causes proliferation of resistant
bacteria
October, 1997
100% of Bay Area Hospitals Surveyed Infected
with VRE
San Francisco Examiner, Sept. 14, 1997
Resistant bacteria on rise in Bay hospitals
Once-benign bug has mutated into potential killer
Abstract of Bay Area Study from California Department
of Health Services
Overview
of Vancomycin-Resistant Staph.
Third
U.S. Case of Vancomycin-Resistant Staph. - March, 1998
For some reason, this case wasn't widely reported in the media.
Superbugs
Evolve in the Hospital Setting; Lead Doctor in Japanese VISA Report Delves
Into Mystery of Strain's Emergence
Japan reports 25 different strains of resistant staph - Sept. 30, 1997
Second
case of resistant staph reported in the U.S. - August, 1997 - New Jersey
- Another
Report - [LARGE
FILE - CDC Report - (259KB)]
First
case of resistant staph reported in the U.S. - July, 1997 - Michigan
- Another
Report - And
Another Report - [CDC
Report]
First case of
resistant staph identified in Japan - June, 1996 - [CDC
Report]
Bacteria
growing immune to last-ditch defenses
In other words, we have to accept that bugs, not us, are unstoppable.
Editorial by Elizabeth Jarnagin, Amarillo Globe-News, Web posted
5/30/97
Four Newborn Deaths at Children's Hospital in Boston
Nursery Fungal Infection Kills Three Babies
WHO Calls
For Curtailment Of Antibiotic Use In Animals (Oct. 22, 1997)
Additional Stories
Scientists
assessing threat from bacteria lurking in hospitals
Laura Beil/The Dallas Morning News, September 20, 1997
Article about antibiotic-resistant
bacteria and emerging diseases, such as Ebola and hantavirus.
New antibiotic-resistant
bacteria worrying hospitals
Los Angeles
Times (The Detroit News), February 21, 1996
Natural
Born Killers
by David Petechuk and Mark Collins
Disease-causing microbes, once considered near extinction, are returning
with a fury — and scientists are fighting back.
Surveillance for Vancomycin-Resistant Enterococci (VRE), San Francisco
Bay Area, 1993-96. JON ROSENBERG, DUC VUGIA, WILLIAM JARVIS for the California
Emerging Infections Program. California Department of Health Services,
Berkeley, CA, and Centers for Disease Control and Prevention, Atlanta,
GA
After conducting testing to determine the proficiency of hospital laboratories
in detecting vancomycin resistance in enterococci, we initiated active
laboratory-based surveillance for clinical isolates of VRE at 30 laboratories
serving 33 general acute care hospitals in three San Francisco Bay area
counties in January 1995. Laboratories were surveyed by questionnaire for
the occurrence of clinical isolates for 1993-94. Laboratories were capable
of detecting high- and moderate-level resistance to vancomycin. The number
of hospitals reporting >= 1 patient clinical isolate was 1 (3%) in 1993,
7 (21%) in 1994, 31 (94%) in 1995, and 33 (100%) in 1996. The number of
patient isolates increased from 20 in 1994 to 171 in 1995, and to 425 in
1996. The majority of isolates, 62% in 1995 and 57% in 1996, were from
urine, and were not associated with serious clinical disease. However,
the number of isolates from blood increased from 9 (6% of total) in 1995
to 44 (11.5% of total) in 1996. In the 20 laboratories reporting total
enterococcal isolates tested for vancomycin susceptibility in 1995, 101
(1.3%) of 7521 isolates were resistant. These data show that VRE emerged
and increased in number among many San Francisco Bay Area hospitals in
1994-96. The increasing prevalence of clinical isolation of VRE can be
viewed as a sentinel event, predictive of future increases in serious clinical
infections unless measures are taken to prevent the spread of vancomycin
resistance in this area.
Four Newborn Deaths at Children's Hospital in Boston
Two different reports about four newborn deaths at Children's Hospital
in Boston:
From: C-upi@clari.net (UPI)
Subject: Bacteria probed in infant deaths
Organization: Copyright 1997 by United Press International
Date: Mon, 15 Sep 1997 6:31:33 PDT
BOSTON, Sept. 15 (UPI) -- Public health officials say a fast-killing
and previously unknown strain of a common bacteria has killed four newborns
in the neonatal intensive care unit at Children's Hospital in Boston.
The deaths occurred in just over a month this summer, and officials
suspect it may have been responsible for another infant's death last year.
The hospital's Dr. Edward O'Rourke said it ``appears to be a strain
we have not dealt with before.''
State health official Dr. Bela Matyas says ``we are assuming we are
dealing with a new strain.''
He said there have been no reports of this strain of Pseudomonas aeruginosa
at other neonatal units, and that it is ``behaving quite unusually.''
Children's Hospital's neonatal intensive care unit was closed to new
admissions on Aug. 29 and will remain closed until at least the middle
of the week.
Officials reported the four infants that died this summer were already
critically ill when they contracted the bacteria.
The state Department of Public Health and the hospital today are investigating
whether the strain was found in at least three other infants on the ward
who did not die.
The 16-bed unit admits up to 600 extremely ill babies a year.
Officials say the outbreak has not spread to other units at the hospital,
even though the bacteria was detected on the hands of several workers.
Experts say Pseudomonas is a common bacteria found in moist soil. It
is often carried to humans on vegetables and fruit, but seldom makes healthy
people sick.
It is particularly harmful to premature infants or those with weakened
immune systems. [Editor's Note - All newborns have an immature immune system.
This is why hospitals recommend that newborns be kept away from hospitals
except in an emergency.]
San Jose Mercury News, Tuesday, September 16, 1997, page 5A:
Infant deaths have doctors focusing on bacterium
Doctors are trying to figure out how to fight an aggressive strain of
bacteria that has killed four babies this summer at Boston's Children's
Hospital.
The culprit appears to be an aggressive strain of the pseudomonas
aeruginosa bacteria, a common bug that infects thousands of critically
ill patients every years and is especially dangerous to premature babies.
To contain the infection, the hospital temporarily stopped accepting
new patients into its intensive care unit for newborns; it was expected
to reopen admissions this week. Researchers from the national Centers for
Disease Control and Prevention are monitoring the situation.
In June, three babies at Grace Hospital in Detroit died after being
infected with pseudomonas aeruginosa. That hospital closed its neonatal
intensive care unit after the outbreak and reopened it in a different part
of the building.
The CDC said Monday that it had not received reports of any other outbreaks
involving the same strain of bacteria in the past year. The bacterium is
one of many organisms carried by people and is normally harmless except
to those with weakened immune systems. In those people, it can cause a
rapidly progressing infection in the blood.
Edward O'Rourke, medical director of infection control at Boston's Children's
Hospital, said it appeared that the organism entered the intensive care
unit in February, when one infant became infected with it and recovered.
The bacterium was passed, possibly on the hands of employees or on hospital
equipment, to several other infants. O'Rourke said. Because Pseudomonas
is a common cause of hospital infections, and the infants in the Children's
Hospital unit are the sickest of the sick, the appearance of the bug and
the deaths in July of two infected infants was considered unusual but not
alarming.
Nevertheless, the hospital began investigating and instituted stricter
infection-control tactics. When a third infant died, in mid-August, still
more measures were instituted. Hospital staff members were required to
wash their hands with two types of anti-bacterial soap, and samples were
taken repeatedly from the hands of employees. A fourth infant died within
days of the third death.
After the fourth death, uninfected infants in the intensive care unti
were moved to other hospitals. Two babies who are infected with Pseudomonas
but whose illness is under control remain at Children's for treatment,
and are expected to survive.
Infectious-disease experts at the hospital and investigators from the
state public health department have removed and tested part of ceilings,
plumbing and air ducts to check for the organism. And swabs were taken
of the hands of employees in the intensive care unity. The bacterium was
found on some employees' hands, but not on the equipment.
The most common mode of transmission for infections in the hospital
is is on the hands of staff members as they move from patient to patient,
experts said.
Pseudomonas is a mild infectious agent that emerges as a serious
infection only in patients with severely depressed immune systems, like
burn victims and infants born prematurely. In those patients, it can be
fatal in as many as a third of the cases. [Editor's Note - All newborns
have an immature immune system. This is why hospitals recommend that newborns
be kept away from hospitals except in an emergency.]
Of the 2 million hospital-caused infections in the United States each
year, about 10 percent are caused by Pseudomonas, said Dr. William
Trick, of the hospital epidemiology branch of the Centers for Disease Control.
Pseudomonas
is the fifth most common infection found in hospitals.
