The CDC’s National Healthcare Safety Network (NHSN) (If you think we have too many governmental organizations now, just wait) has compiled its first (Yes, first) State-Specific Summary and Report on Healthcare-Associated Infections.

The results of the NHSN’s 18 page (including references) report are not entirely clear.  However there are [...]]]> Source:  US Centers for Disease Control & Prevention

The CDC’s National Healthcare Safety Network (NHSN) (If you think we have too many governmental organizations now, just wait) has compiled its first (Yes, first) State-Specific Summary and Report on Healthcare-Associated Infections.

The results of the NHSN’s 18 page (including references) report are not entirely clear.  However there are some interesting things which can be discerned from the Government-speak and statistical analysis.  Between January of 2009 and June of 2009 (That’s 6 months)  The State of New Jersey reported 72 central line-associated bloodstream infections from 100 different healthcare facilities in the state. The facilities are not specifically identified in the report.  Neither do we know, for example, if 1 or 2 of those facilities accounted for the majority of the 72 blood stream infections from central-lines.

During the same time frame, the Commonwealth of Pennsylvania reported 204 central line-associated bloodstream infections from 253 different healthcare facilities. You may be wondering how this compares with infections in the State of Rhode Island.  Well Rhode Island reported only 1-4 central line-associated bloodstream infections from 16 healthcare facilities between January 2009 and June 2009.  New York reported 182 central line-associated bloodstream infections from 182 facilities.

Here’s where it gets interesting.  Well to us anyway.  Between January 2009 and June 2009, 818 hospital-associated infections were observed in the Commonwealth of Pennsylvania. Oddly, the NHSN predicted that number would be 1,176.83 which at first glance might suggest that Pennsylvania hospitals are doing something right.  That is until you recognize that there were 818 hospital-associated infections observed and who knows how many others might have been unobserved or unreported as hospital-associated infections.

During the same time frame, the State of New Jersey reported 183 observed hospital-associated infections which was close to the predicted 222.97.

So what does this all mean?  First of all, the report is the result of a limited mandate to report specifically on central line-associated blood stream infections.  Although it is clear from the total number of observed infections in the report that more types of infections were reported.

The back story: From June 2008 to December 2008, Pennsylvania’s own Department of Health reported 13,771 hospital-acquired infections, the most common were Urinary Tract Infections from catheters (UTI’s) (24.83%), surgical site infections (22.23%) and intestinal infections (18.15%).  So why is the CDC concerned only with central line-associated blood stream infections?  Good question.  30% of Pennsylvania hospitals using central lines had more infections than expected as compared with the rest of the US. Therefore Pennsylvania was flagged for reporting.

The State of New Jersey, late to the infection reporting party, only implemented legislation requiring reporting in 2007.  Accordingly, the NJ Department of Health and Senior Services first report on State hospital-associated infections will not be released until the end of 2010.  We await that report.

~Posted by D.M. Schwadron, Esquire

All it takes is one editorial…or something like that.  The respected Brit Medical journal The Lancet has published an editorial tied to a current study by physicians in the U.S. and in Greece on obesity and antibiotic dosage.  The argument? With rising waistline sizes, the doses of antibiotics currently administered to [...]]]> Source:  BBC Health; The Lancet

All it takes is one editorial…or something like that.  The respected Brit Medical journal The Lancet has published an editorial tied to a current study by physicians in the U.S. and in Greece on obesity and antibiotic dosage.  The argument? With rising waistline sizes, the doses of antibiotics currently administered to patients need to rise as well.

Why? Simple really.  The size and density of body fat can significantly alter the efficacy (that’s a fancy word for how well it works) of antibiotics. More fat creates the need for more antibiotics which brings me back to our current theme –antibiotic resistance.  More antibiotics being administered creates the potential for more resistant bugs.

Europe you aren’t immune either (Yes, pun intended), currently 1 in 4 adults in England are classifiable as “obese”.  This is up 15% from 1993 numbers according to the BBC.  You gave us law and language and we gave you fast food.  Ahh…the beauty of cultural exchange.

At any rate, I’m not following the call for higher doses of already powerful and very prevalent antibiotic and antimicrobial medications.  We’ll see if I’m right in the long term.

~Posted by D.M. Schwadron, Esquire

Bacteria are living things.  Specifically, single-celled organisms found both in our bodies and upon our skin.  Bacteria have apparently evolved with us and most bacteria are not harmful.  A virus is an organism which requires a host (cells of the body) in which to live.

Why is this distinction [...]]]> Source: U.S. Centers for Disease Control & Prevention

Bacteria are living things.  Specifically, single-celled organisms found both in our bodies and upon our skin.  Bacteria have apparently evolved with us and most bacteria are not harmful.  A virus is an organism which requires a host (cells of the body) in which to live.

Why is this distinction important?  Because colds and the flu are caused by viral not bacterial infection.  Treating a cold with an antibiotic (antibacterial or antimicrobial drug) will not have any beneficial effect to the patient.

So let’s ask the CDC-

Q.  What is an antibiotic? A: Antibiotics, also known as antimicrobial drugs, are drugs that fight infections caused by bacteria. Alexander Fleming discovered the first antibiotic, penicillin, in 1927. After the first use of antibiotics in the 1940s, they transformed medical care and dramatically reduced illness and death from infectious diseases.  Although antibiotics have many beneficial effects, their use has contributed to the problem of antibiotic resistance.

Q: What is antibiotic resistance? A: Antibiotic resistance is the ability of bacteria or other microbes to resist the effects of an antibiotic. Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply causing more harm.

Q.  Why should I care? A: Antibiotic resistance has been called one of the world’s most pressing public health problems. Almost every type of bacteria has become stronger and less responsive to antibiotic treatment when it is really needed. These antibiotic-resistant bacteria can quickly spread to family members, schoolmates, and co-workers – threatening the community with a new strain of infectious disease that is more difficult or impossible to cure and more expensive to treat. For this reason, antibiotic resistance is among CDC’s top concerns.  A common misconception is that a person’s body becomes resistant to specific drugs. However, it is microbes, not people, that become resistant to the drugs.

Wait, what? Okay here it is in a simplified and non-governmental approved format. Antibiotics are valuable medications.  However, they are overused both medically and agriculturally.  Very overused. The more bacteria are exposed to antibiotics, the greater the possibility of developing strains of bacterial infections that do not respond to antibiotics such as MRSA (Methicillin resistant Staphylococcus aureus) and VRE (vancomycin resistant enterococci) and before long ZOMG!  Well, maybe not Zombies.  Not yet anyway.

~Posted by David Marc Schwadron, Esquire

The vast majority of women who are pregnant are also taking at least one prescription drug. In our modern, hectic and stressful society, antidepressant and anti-anxiety medications are among them.  But are they really safe?

The answer is we really don’t exactly know…exactly. There are [...]]]> Source:  US Dpt. of Health & Human Services; www.womens.health.gov; Wall Street Journal

The vast majority of women who are pregnant are also taking at least one prescription drug. In our modern, hectic and stressful society, antidepressant and anti-anxiety medications are among them.  But are they really safe?

The answer is we really don’t exactly know…exactly. There are studies which show minimal issues but there is surprisingly little medical evidence to support the notion that the majority of common prescriptions are truly “safe” for your baby.  The following classifications demonstrate how much we don’t know.  The FDA is currently funding a study to evaluate about one million births between 2001 and 2007, the time when a number of these medications became quite popular.  Ask questions of your doctor.  lots of questions.  The good ones will answer you.

~Posted by David Marc Schwadron, Esquire

You might want to re-think those little hand sanitizer gels and wipes we are all fond of carrying around or the antibacterial soaps.  Researchers now believe that so-called super bugs (antibiotic resistant bacteria such as MRSA and VRE) can be taught drug resistance from resisting surface disinfectants.

The latest research involves Pseudomonas Aeruginosa [...]]]> Source: BBC Health

You might want to re-think those little hand sanitizer gels and wipes we are all fond of carrying around or the antibacterial soaps.  Researchers now believe that so-called super bugs (antibiotic resistant bacteria such as MRSA and VRE) can be taught drug resistance from resisting surface disinfectants.

The latest research involves Pseudomonas Aeruginosa a common hospital present and hospital acquired organism. Testing the bug with increasingly larger levels of disinfectants in a laboratory led to a surprising finding.  Not only did the bacteria become resistance to the disinfectant, it developed a resistance to Ciproflaxin (an antibiotic), to which it was not previously exposed.

Studies have previously shown that policies and procedures doing little other than requiring disinfectant wipes in hospitals did little to protect against MRSA and that they actually could spread the bug if the wipe was used upon more than one surface.

~Posted by David Marc Schwadron, Esquire