Wiping out MRSA

Garvey, M. et al. | Wiping out MRSA: effect of introducing a universal disinfection wipe in a large UK teaching hospital | Antimicrobial Resistance & Infection Control | 2018 7:155 | published: 19 December 2018

Background

Contamination of the inanimate environment around patients constitutes an important reservoir of MRSA. Here we describe the effect of introducing a universal disinfection wipe in all wards on the rates of MRSA acquisitions and bacteraemias across a large UK teaching hospital.

Methods

A segmented Poisson regression model was used to detect any significant changes in the monthly numbers per 100,000 bed days of MRSA acquisitions and bacteraemias from April 2013 – December 2017 across QEHB.

Results

From April 2013 to April 2016, cleaning of ward areas and multi-use patient equipment by nursing staff consisted of a two-wipe system. Firstly, a detergent wipe was used, which was followed by a disinfection step using an alcohol wipe. In May 2016, QEHB discontinued the use of a two-wipe system for cleaning and changed to a one wipe system utilising a combined cleaning and disinfection wipe containing a quaternary ammonium compound. The segmented Poisson regression model demonstrated that the rate of MRSA acquisition/100,000 patient bed days was affected by the introduction of the new wiping regime (20.7 to 9.4 per 100,000 patient bed days).

Discussion

Using a Poisson model we demonstrated that the average hospital acquisition rate of MRSA/100,000 patient bed days reduced by 6.3% per month after the introduction of the new universal wipe.

Conclusion

We suggest that using a simple one wipe system for nurse cleaning is an effective strategy to reduce the spread and incidence of healthcare associated MRSA.

Full article available here

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Double check patients with ‘penicillin allergy’ to avoid increased MRSA risk

NICE | October 2018 |Double check patients with ‘penicillin allergy’ to avoid increased MRSA risk

Healthcare staff should be aware of this and ensure that only people with a true allergy to penicillin are documented as such, NICE is urging.

penicillin-2946054_640.pngIncorrectly identifying people as allergic could also contribute to antimicrobial resistance, as these people are likely to instead be given broad-spectrum antibiotics.

The warning comes in a new medicines evidence commentary (MEC) on research conducted in the UK and published in the BMJ in June 2018 (Source: NICE).

Full details at NICE 

Incidence, prevalence, and management of MRSA bacteremia across patient populations

A review of recent developments in MRSA management and treatment | Critical Care

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Image source: Annie Cavanagh – Wellcome Images // CC BY-NC 4.0

Image shows clusters of methicillin-resistant Staphylococcus aureus bacteria.

Methicillin-resistant Staphylococcus aureus (MRSA) infection is still a major global healthcare problem. Of concern is S. aureus bacteremia, which exhibits high rates of morbidity and mortality and can cause metastatic or complicated infections such as infective endocarditis or sepsis. MRSA is responsible for most global S. aureus bacteremia cases, and compared with methicillin-sensitive S. aureus, MRSA infection is associated with poorer clinical outcomes. S. aureus virulence is affected by the unique combination of toxin and immune-modulatory gene products, which may differ by geographic location and healthcare- or community-associated acquisition.

Management of S. aureus bacteremia involves timely identification of the infecting strain and source of infection, proper choice of antibiotic treatment, and robust prevention strategies. Resistance and nonsusceptibility to first-line antimicrobials combined with a lack of equally effective alternatives complicates MRSA bacteremia treatment.

This review describes trends in epidemiology and factors that influence the incidence of MRSA bacteremia. Current and developing diagnostic tools, treatments, and prevention strategies are also discussed.

Full reference: Hassoun, A. et al. (2017) Incidence, prevalence, and management of MRSA bacteremia across patient populations—a review of recent developments in MRSA management and treatment. Critical Care. 21:211

Scientists stumble across new method of making antibiotics

Cancer researchers may have stumbled across a solution to reverse antibiotic drug resistance and stop infections like MRSA. | Via ScienceDaily

Experts warn we are decades behind in the race against superbugs having already exploited naturally occurring antibiotics, with the creation of new ones requiring time, money and ingenuity.

But a team of scientists at the University of Salford say they may have found a very simple way forward — even though they weren’t even looking for antibiotics.

And they have created and validated several new antibiotics already — many of which are as potent, or more so, than standard antibiotics, such as amoxicillin.

“A little like Alexander Fleming, we weren’t even looking for antibiotics rather researching into new compounds that might be effective against cancer stem cells,” explains Michael P. Lisanti, Chair of Translational Medicine at the University’s Biomedical Research Centre.

“I think we’ve accidentally invented a systemic way of creating new antibiotics which is simple, cheap and could be very significant in the fight against superbugs,” added Dr Federica Sotgia, a co-author on the study.

Full story at ScienceDaily

Full reference:  Bela Ozsvari et al.  Mitoriboscins: Mitochondrial-based therapeutics targeting cancer stem cells (CSCs), bacteria and pathogenic yeast | Oncotarget, Advance Publications | published online July 7th 2017

Researchers Find Door Handles to Be Significant Source of MRSA in Hospitals

The aim of this study by Saba, et al. (2017) was to determine the prevalence and antibiotic susceptibility of S. aureus and methicillin-resistant S. aureus (MRSA) in the environments of three hospitals in Ghana | Infection Control Today

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A total of 120 swab samples were taken from door handles, stair railings and other points of contact at Tamale Teaching Hospital, Tamale Central Hospital and Tamale West Hospital. The swab samples were directly plated on Mannitol Salt and Baird Parker agar plates and incubated at 37 °C (± 2) for 18 to 24 hours. An antibiotic susceptibility test was performed using the Clinical Laboratory Standard Institute’s guidelines. Isolates resistant to both cefoxitin and oxacillin were considered to be MRSA.

The researchers conclude that the high multi-drug resistance of MRSA in hospital environments in Ghana reinforces the need for the effective and routine cleaning of door handles in hospitals. Further investigation is required to understand whether S. aureus from door handles could be the possible causes of nosocomial diseases in the hospitals.

Read the full overview via Infection Control here

The original research abstract is available here

Collaboration with an infection control team for patients with infection after spine surgery

Kobayashi, K. et al. American Journal of Infection Control. Published online: 22 February 2017

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Highlights: 

  • The risk of infection after spine surgery has increased due to aging of society.
  • An infection control team (ICT) manages infected cases at our hospital.
  • The ICT guided use of antibiotics in 30 cases and investigated infection in 10.
  • The bacteria detection rate was 88% (35/40 patients) in cases treated by the ICT.
  • Early assistance from the ICT is a key to preventing onset of MRSA infection.

Read the full abstract here

Screening test recommendations for methicillin-resistant Staphylococcus aureus surveillance practices

Whittington, M.D. et al. American Journal of Infection Control. Published online: 23 January 2017

Highlights: 

  • Rapid screening tests reduce unnecessary surveillance costs.
  • Using polymerase chain reaction with universal preemptive isolation minimizes total costs.
  • Using chromogenic agar 24-hour with targeted isolation minimizes total costs.
  • Although polymerase chain reaction minimized inappropriate costs, the added cost per test was only offset with universal preemptive isolation.

Read the full abstract here