Drug Topics - February 11, 2008 - (Page HSE2) 2 HSE DRUG TOPICS FEBRUARY 11, 2008 www.drugtopics.com PhRMA reports that 11 drugs and four vaccines are under development to treat MRSA infections. for Professionals in Infection Control & Epidemiology (APIC) found that healthcare facilities are not doing enough to protect patients from MRSA infections. “We took this informal poll to get a sense of the pace of progress and what’s changed in the six months since our MRSA prevalence study,” said Kathy L. Warye, APIC’s CEO. “We are encouraged that many hospitals are empowering infection prevention professionals to implement more MRSA prevention measures.” In a nationwide MRSA Prevalence Study it published last June, APIC DT CAPSULE found that the germ was 8.6 times more common than previously estimated. The report also concluded that MRSA is found in all wards throughout most hospitals. Results from APIC’s online poll in December show that 41% of infection control professionals said their healthcare facility had not taken any new preventative measures since the MRSA prevalence study was published. The majority of respondents who thought their facility could do more to curb the spread of MRSA suggested simple measures to lower infection rates, such as screening high-risk patients for the germ, improving hand hygiene, and using gloves and gowns more frequently with patients who test positive for the bug. Stopping the spread The national attention given to MRSA has prompted different strategies by different groups to reduce infection rates. APIC and the global healthcare company Covidien have launched a Strike Out Infection national campaign, using baseball team manager Terry Francona as its celebrity spokesman. Francona had survived a staph infection following surgery in 2002. The campaign consists of a www.strikeoutinfection.com Web site where the public can learn more about deadly infections. Evanston Northwestern Healthcare began swabbing all patients at its three Illinois hospitals for the MRSA bacteria in 2005. The move helped reduce infection rates by 60%. “The goal of the program was always to reduce the risk of MRSA infection to patients cared for,” said Lance Peterson, M.D., FIDSA, FASCP, epidemiologist and founder of the MRSA program at Evanston. “We want people to come here for their health care and not go home with something unexpected that will later cause an infection.” The University of Pittsburgh Medical Center also screens patients for MRSA, and has cut infection rates in half since 2001. The screening is performed only on intensive care unit (ICU) patients but the hospital has started to expand the use of the tests. Intermountain Healthcare of Salt Lake City keeps a database of every patient who has been infected with MRSA at its 21 hospitals. Those who return to the hospital for some other reason are immediately tested and monitored by an infection-control nurse to determine whether they are carrying the bacteria. Better screening also has helped reduce infection rates at the Department of Veterans Affairs hospitals and the University of Texas Medical Branch in Galveston. The Department of Veterans Affairs cut infection rates 50% by performing nasal swabs and cultures on all incoming patients at its 153 hospitals, while the University of Texas screens all adult ICU patients each week for the bug. But skepticism about hospitalwide testing exists. “There is a lot of controversy regarding screening,” said Rybak. “It is very expensive and I’m not sure how effective it will be when rates of MRSA are now over 60% countrywide and there is such an influx of community-MRSA being introduced into the hospital.” Rybak explained that MRSA can colonize the skin, gastrointestinal tract, and other areas of the body and, therefore, merely swabbing the nose will not be enough to determine if a patient harbors MRSA. Some hospitals use different methods to minimize MRSA outbreaks. The University of Kansas Medical Center in Kansas City relies on secret observers to make sure the staff is practicing good hygiene. The “spies” pretend to look at a chart but actually watch to see whether employees wash up before touching a patient. The hospital talks to those who do not wash their hands and shares the data with each department. “Hand hygiene is very effective,” said Tomasz Z. Jodlowski, Pharm.D., assistant clinical professor in the College of Pharmacy at St. John’s University in Queens, N.Y. “Good services are important too, such as a good cleaning service and good laundry service.” Some states also have started mandating broader testing. In July, Pennsylvania Gov. Edward G. Rendell signed legislation requiring hospitals and nursing homes to report healthcare-associated infections and to implement comprehensive infection control plans. A month later, Illinois and New Jersey adopted legislation requiring hospitals to identify patients carrying MRSA and isolate them. So the fight against MRSA continues. THE AUTHOR is a writer based in New Jersey. http://www.drugtopics.com http://www.strikeoutinfection.com
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