Re: MRSA control in hospitals should apply everywhere

[Guest guest]

> [article] About a third of people have the germ on their skin or in

their nose but aren't sick. They are said to be " colonized "

A third of people are colonized with SA, not MRSA. MRSA colonization

is more like 5%, if I remember.

Screening people on intake so you can put them into a MRSA zone if

necessary, seems smart. Not only does it kill people (a lot of whom

are pretty moribund anyway), it also costs $89 zillion dollars per

case. However, you swab em, you plate em..... you wait...... for the

stuff to grow...... that's what I don't get: where are the new

patients treated while you wait for the test? In their own sector I

guess, perhaps treated with an intermediate level of caution. Anyway

if it really cuts MRSA by 70%, I'm sure it's probably well worth it,

however it works.

[Guest guest]

WHAT??? What about the decades of preaching that "nose swabs" are useless and staph growth should be discounted as contaminants and/or "normal" flora??? What have Tony & I been saying for ages? Just because it's labeled "harmless" doesn't mean it is. Just because you don't have a 105 fever doesn't mean you're not sick either. Sheesh. penny p.s. I do give credit to the people who did this study. Now let's see if anyone pays any attention. By the way, anyone hear the big commotion yesterday all over the news about the latest scare of life threatening and/or permanently disfiguring bacteria coming from your local pedicure shop? Cosmetologists have all been ordered to stop using spa foot baths. (Gee, you'd think they would have been ordered to give all their patients whey

protein to boost their immune systems instead.) a Carnes <pj7@...> wrote: Thanks to Gill who originally posted this on EuroLyme. This relates to the work Dr. Shoemaker is doing on MRSA. - a Carnes http://news./s/ap/20070207/ap_on_he_me/battling_superbugsDoctors say superbug can be controlledBy JOANN LOVIGLIO, Associated Press WriterTue Feb 6, 10:04 PM ETHospitals can successfully tackle the alarming spread of a dangerous and drug-resistant staph infection with an aggressive program to immediately identify and quarantine patients carrying the superbug, infectious

disease doctors said at a conference Tuesday.A pilot program started at the Pittsburgh Veterans Affairs Healthcare System in late 2001 has dramatically reduced the rate of the potentially deadly germ, called methicillin-resistant Staphylococcus aureus, or MRSA. It is resistant to most antibiotics and usually acquired in hospitals and nursing homes.MRSA infections in the Pittsburgh VA surgical care unit have dropped more than 70 percent, infectious diseases director Dr. Muder said."You don't necessarily have to do it the way we did it, but you can do it," Muder told members of the Association for Professionals in Infection Control & Epidemiology at a meeting at the University of Pennsylvania.VA guidelines require that all patients get their noses swabbed to screen for MRSA upon admission and discharge. Those with the bug are isolated from other patients, treated by health care

workers in gowns and gloves, and with equipment — from blood pressure cuffs to stethoscopes — that gets disinfected after each use.There are also administrative changes such as weekly briefings and data sharing as well as an aggressive push for strict hand-washing policies.VA officials decided to roll out the experiment to its 150-plus hospitals nationwide after seeing the Pittsburgh results, Muder said. They'll start testing for MRSA in intensive care units next month and expand incrementally until everyone is getting screened, he said.MRSA is a big problem in health care settings, where patients have invasive catheters and open wounds, and is primarily spread from patient to patient on the contaminated hands, equipment and clothing of health care workers. When it gets into the body, it can cause anything from flesh-eating infections to pneumonia.About a third of people have the germ on their skin or

in their nose but aren't sick. They are said to be "colonized" but not infected with MRSA — but they can still spread the germ.CDC estimates that about 90,000 people die from hospital-acquired infections annually. About 17,000 of those deaths involve MRSA.Other hospitals have myriad anti-MRSA approaches — a few places screen everyone, some test just high-risk patients such as those who have weak immune systems or live in nursing homes, and others screen just those in high-risk units like intensive care."Having different hospitals doing it different ways will help us see what works," said Dr. Harold Standiford, the University of land Medical Center's infection control chief, who also gave a presentation at the program. "It's going to be a continual process."The Centers for Disease Control and Infection suggests screening at-risk patients but stops short of recommending universal testing. That is

criticized by advocates for across-the-board screening who say Denmark, Finland and the Netherlands essentially eradicated soaring MRSA rates using that method.Muder said hospitals should have flexibility to tailor their own programs."The CDC says that if whatever approach you're using is not working, you need to become tougher and do universal screening," he said. "They're trying to avoid a one-size-fits-all approach."One U.S. hospital taking a more aggressive stance is ton Northwestern Healthcare in Illinois. In addition to screening everyone, MRSA carriers also get special soap washes and antibiotic nasal cream, and the hospital uses a new gene-based MRSA test that provides results in hours as opposed to days.The faster test is more expensive — $27, as opposed to $9 for the traditional test — but pays for itself in the long run, said Dr. Lance , ton Northwestern's

infectious disease director. The hospital saves about $25,000 in uncovered medical costs per patient for every MRSA case they can prevent, he said."This is a really nasty bug, and it's becoming more apparent that we don't have to live with it," Standiford said. "Now we have new techniques and good studies to show that they're effective."

[Guest guest]

But, they're not saying the people that come in swabbing out MRSA

are sick because of MRSA... they're just saying that they bear

MRSA... and that they want to keep that MRSA under wraps, because it

can spread from a person whether or not it is making that person

sick.

I'm certainly not denying that SA might be important as a cryptic

cause of disease... but I don't think they are saying that... they

are focused on preventing the various disease statuses already well

accepted as being caused by SA, that are commonly acquired in the

hospital.

>

> WHAT??? What about the decades of preaching that " nose swabs " are

useless and staph growth should be discounted as contaminants

and/or " normal " flora???

>

> What have Tony & I been saying for ages? Just because it's

labeled " harmless " doesn't mean it is. Just because you don't have a

105 fever doesn't mean you're not sick either.

>

> Sheesh.

>

> penny

>

> p.s. I do give credit to the people who did this study. Now

let's see if anyone pays any attention.

>

> By the way, anyone hear the big commotion yesterday all over the

news about the latest scare of life threatening and/or permanently

disfiguring bacteria coming from your local pedicure shop?

Cosmetologists have all been ordered to stop using spa foot baths.

(Gee, you'd think they would have been ordered to give all their

patients whey protein to boost their immune systems instead.)

[Guest guest]

Penny, I figured you and Tony would appreciate this latest study. I

am waiting to see if Dr. Shoemaker will comment.

a

>

> WHAT??? What about the decades of preaching that " nose swabs " are

useless and staph growth should be discounted as contaminants

and/or " normal " flora???

>

> What have Tony & I been saying for ages? Just because it's

labeled " harmless " doesn't mean it is. Just because you don't have a

105 fever doesn't mean you're not sick either.

>

> Sheesh.

>

> penny

>

> p.s. I do give credit to the people who did this study. Now let's

see if anyone pays any attention.

>

> By the way, anyone hear the big commotion yesterday all over the

news about the latest scare of life threatening and/or permanently

disfiguring bacteria coming from your local pedicure shop?

Cosmetologists have all been ordered to stop using spa foot baths.

(Gee, you'd think they would have been ordered to give all their

patients whey protein to boost their immune systems instead.)

>

>

>

>

>

>

>

> a Carnes <pj7@...> wrote:

> Thanks to Gill who originally posted this on EuroLyme.

This relates to the work Dr. Shoemaker is doing on MRSA. - a

Carnes

>

> http://news./s/ap/20070207/ap_on_he_me/battling_superbugs

>

> Doctors say superbug can be controlled

>

> By JOANN LOVIGLIO, Associated Press WriterTue Feb 6, 10:04 PM ET

>

> Hospitals can successfully tackle the alarming spread of a

dangerous and

> drug-resistant staph infection with an aggressive program to

immediately

> identify and quarantine patients carrying the superbug, infectious

> disease doctors said at a conference Tuesday.

>

> A pilot program started at the Pittsburgh Veterans Affairs

Healthcare

> System in late 2001 has dramatically reduced the rate of the

potentially

> deadly germ, called methicillin-resistant Staphylococcus aureus, or

> MRSA. It is resistant to most antibiotics and usually acquired in

> hospitals and nursing homes.

>

> MRSA infections in the Pittsburgh VA surgical care unit have

dropped

> more than 70 percent, infectious diseases director Dr. Muder

said.

>

> " You don't necessarily have to do it the way we did it, but you can

do

> it, " Muder told members of the Association for Professionals in

> Infection Control & Epidemiology at a meeting at the University of

> Pennsylvania.

>

> VA guidelines require that all patients get their noses swabbed to

> screen for MRSA upon admission and discharge. Those with the bug

are

> isolated from other patients, treated by health care workers in

gowns

> and gloves, and with equipment — from blood pressure cuffs to

> stethoscopes — that gets disinfected after each use.

>

> There are also administrative changes such as weekly briefings and

data

> sharing as well as an aggressive push for strict hand-washing

policies.

>

> VA officials decided to roll out the experiment to its 150-plus

> hospitals nationwide after seeing the Pittsburgh results, Muder

said.

> They'll start testing for MRSA in intensive care units next month

and

> expand incrementally until everyone is getting screened, he said.

>

> MRSA is a big problem in health care settings, where patients have

> invasive catheters and open wounds, and is primarily spread from

patient

> to patient on the contaminated hands, equipment and clothing of

health

> care workers. When it gets into the body, it can cause anything

from

> flesh-eating infections to pneumonia.

>

> About a third of people have the germ on their skin or in their

nose but

> aren't sick. They are said to be " colonized " but not infected with

MRSA

> — but they can still spread the germ.

>

> CDC estimates that about 90,000 people die from hospital-acquired

> infections annually. About 17,000 of those deaths involve MRSA.

>

> Other hospitals have myriad anti-MRSA approaches — a few places

screen

> everyone, some test just high-risk patients such as those who have

weak

> immune systems or live in nursing homes, and others screen just

those in

> high-risk units like intensive care.

>

> " Having different hospitals doing it different ways will help us

see

> what works, " said Dr. Harold Standiford, the University of land

> Medical Center's infection control chief, who also gave a

presentation

> at the program. " It's going to be a continual process. "

>

> The Centers for Disease Control and Infection suggests screening at-

risk

> patients but stops short of recommending universal testing. That is

> criticized by advocates for across-the-board screening who say

Denmark,

> Finland and the Netherlands essentially eradicated soaring MRSA

rates

> using that method.

>

> Muder said hospitals should have flexibility to tailor their own

programs.

>

> " The CDC says that if whatever approach you're using is not

working, you

> need to become tougher and do universal screening, " he

said. " They're

> trying to avoid a one-size-fits-all approach. "

>

> One U.S. hospital taking a more aggressive stance is ton

> Northwestern Healthcare in Illinois. In addition to screening

everyone,

> MRSA carriers also get special soap washes and antibiotic nasal

cream,

> and the hospital uses a new gene-based MRSA test that provides

results

> in hours as opposed to days.

>

> The faster test is more expensive — $27, as opposed to $9 for the

> traditional test — but pays for itself in the long run, said Dr.

Lance

> , ton Northwestern's infectious disease director. The

> hospital saves about $25,000 in uncovered medical costs per patient

for

> every MRSA case they can prevent, he said.

>

> " This is a really nasty bug, and it's becoming more apparent that

we

> don't have to live with it, " Standiford said. " Now we have new

> techniques and good studies to show that they're effective. "

>

[Guest guest]

IF you look at my case - my husband and I both had colonization with

antibiotic resistant staph. So then when I get my throat examined a

year or so after treating the colonization I get really sick.

Shoemaker thinks I may need to be retested and retreated. Now I just

have to get my local doc to order one more test.....

a

>

> But, they're not saying the people that come in swabbing out MRSA

> are sick because of MRSA... they're just saying that they bear

> MRSA... and that they want to keep that MRSA under wraps, because

it

> can spread from a person whether or not it is making that person

> sick.

>

> I'm certainly not denying that SA might be important as a cryptic

> cause of disease... but I don't think they are saying that... they

> are focused on preventing the various disease statuses already well

> accepted as being caused by SA, that are commonly acquired in the

> hospital.

>

>

>

>

> >

> > WHAT??? What about the decades of preaching that " nose swabs " are

> useless and staph growth should be discounted as contaminants

> and/or " normal " flora???

> >

> > What have Tony & I been saying for ages? Just because it's

> labeled " harmless " doesn't mean it is. Just because you don't have

a

> 105 fever doesn't mean you're not sick either.

> >

> > Sheesh.

> >

> > penny

> >

> > p.s. I do give credit to the people who did this study. Now

> let's see if anyone pays any attention.

> >

> > By the way, anyone hear the big commotion yesterday all over

the

> news about the latest scare of life threatening and/or permanently

> disfiguring bacteria coming from your local pedicure shop?

> Cosmetologists have all been ordered to stop using spa foot baths.

> (Gee, you'd think they would have been ordered to give all their

> patients whey protein to boost their immune systems instead.)

>

[Guest guest]

> Despite the fact that my experience and many others with

osteomyelitis show just the opposite. What's in our bones, is also in

our noses. If you grew the stuff in sick people's noses, noted which

drugs they were resistant to and sensitive to, then treated

accordingly, a lot more people would have a chance at seeing

improvement. The only people getting that care right now are listless

birds, and other pets. Listless humans don't rate.

Oh... I knew that you had gotten sensitivities taken on isolates from

the jaw... I didn't know really that you'd had sensitivities taken on

sinus isolates. How well did the sensitivities match? How far apart

were the isolates taken?

I must admit... I'm a lot more focused on acquired genomic resistance

now that I have worsened from September to Jan, right over top of a

period of faithful use of my own personal tried-n-true drugs. Sometimes

experience is the only teacher! At least I did always remain officially

open to the potential importance of genomic resistance in the past -

but I didn't really go around thinking about it as much of a threat to

me personally.

[Guest guest]

Hmm interesting. One theme in Mattman's book is that she claims a lot

of apparantly local infections are actually also in the blood, if you

use the right culture methods. TB for example. I don't know if anyone

else claims to have recovered TB from the blood, or only her. I am

pretty sure, from what I've heard in class, that the official view is

that it isn't found there.

If something is in your blood, of course, it can get anywhere.

> There's a microbiologist here at UCSD who says it absolutely makes

sense that whatever cronic infection is causing you problems will show

up in your sinuses and elsewhere.