A Cure for MRSA?

MRSA infections are increasing every year, resulting in over 75,000 cases in the U.S., causing around 10,000 deaths annually, states the CDC.MRSA starts resembling a pimple, and then evolves into a red crater of blackened puss. Left untreated, MRSA can cause death (Lowie, 2015).

For almost five years Lindsey, “Les” Shaw, a microbiologist at The University of South Florida, has been researching and developing a potential antibiotic to fight MRSA (Lowie, 2015).

“In December of 2014, Shaw’s team received a patent for their modified quinazoline, a class of compounds used to treat malaria and cancer. USF chemists believe that quinazoline-based compounds have potential antibacterial properties that could effectively eradicate MRSA” (Lowie, 2015).

In light of what we know about MRSA, do you believe a antibiotic will ever be developed that will fight MRSA?  Additionally, if this antibiotic works now, do you believe it will be effective forever?

Reference

Lowie, Z. (February 10, 2015). Researchers see weakness in MRSA’s resilience. The Oracle. Retrieved from http://www.usforacle.com/news/view.php/860219/Researchers-see-weakness-in-MRSAs-resili

How do you keep your work area clean?

As a paramedic, I was always concerned about the cleanliness of my work environment, the ambulance.  Maybe it was because of the occasional blood stain that could be found on the wheel of the cot or a backboard strap that was missed when cleaning?  The scary part is, sometimes it’s what looks clean that isn’t clean is more of a concern.  In a study by Stevenson, Bell, Hoet, and Lu (2010), almost one third of all the ambulances in Ohio that were swabbed and cultured had invisible MRSA inside of them.  If we cant see it, how do we protect ourselves?  I always made an effort at the beginning of my shift to disinfect common areas such as the seat, steering wheel, radio, report writing area, etc. of my squad to assist in this mission.  Any thoughts on what you do in your clinical area to help protect you and your patients from invisible bugs like MRSA?

Stevenson, K.B., Bell, C., Hoet, A., & Lu, B.  (2010).  MRSA Colonization in EMS Personnel and Equipment as a Risk Factor for Secondary Injury in Ohio Trauma Patients.  Final Project Report Ohio Division of EMS Injury Prevention Research Grant.  Retrieved from http://www.publicsafety.ohio.gov/links/EMS_Stevenson_MRSA%20Project_Final%20Report_1.pdf

MRSA Colonization in EMS Personnel and Equipment as a Risk Factor for Secondary Injury in Ohio Trauma Patients. 

Wash your hands… or else???

Infection prevention specialists often have a more clinical point of view than frontline staff when it comes to hand hygiene (McAlearney & Hefner, 2014).  Frontline staff tend to feel that the interpersonal skills associated with hand washing education is just as important as the information itself.  McAlearney & Hefner found that a friendly face, a warm smile, and frequent repetition help frontline staff to use good hand washing techniques more frequently. What do you think about the importance of how hand washing information is communicated?  Does it matter if it’s done in a friendly and caring way, or should it be done solely by presenting the facts?  Based on how you answered, how might compliance with hand washing protocols be affected?

McAlearney, A. S., & Hefner, J. L. (2014). Facilitating central-line associated bloodstream infection prevention: A qualitative study comparing perspectives of infection control professionals and frontline staff. American Journal of Infection Control, 42, S216-S222.  http://dx.doi.org/10.1016/j.ajic.2014.4.006

 Facilitating central-line associated bloodstream infection prevention: A qualitative study comparing perspectives of infection control professionals and frontline staff

How often do YOU wash YOUR hands?

Healthcare workers strongly agree that preventive behaviors such as hand washing reduce the spread of MRSA (Siebert, Speroni, Oh, DeVoe, & Jacobsen, 2014).  Most healthcare workers self-report that they “almost always” wash their hands consistently, even though Siebert et al. report that anonymous observations reveal much lower rates of hand washing compliance.  Even support staff who do not have direct patient contact need to be scrupulous with their hand hygiene, because infection can be spread by using a community pen to sign a form, or by reaching over to move a trash can closer to the bed. Why do healthcare workers misrepresent the frequency with which they wash their hands?  How often do you wash your hands? 

Siebert, D. J., Speroni, K. G., Oh, K. M., DeVoe, M. C., & Jacobsen, K. H. (2014). Knowledge, perceptions, and practices of methicillin-resistant staphylococcus aureus transmission prevention among health care workers in acute-care settings. American Journal of Infection Control 42, 254-259. http://dx.doi.org/10.1016/j.ajic.2013.09.005

 

Knowledge, perceptions, and practices of methicillin-resistant staphylococcus aureus transmission prevention among health care workers in acute-care settings. 

More precautions = less care?

Healthcare workers generally feel a deep sense of responsibility to patients for prevention of MRSA and other infections.  But one study shows patients who are on contact precautions receive fewer hourly visits and have less direct contact time with healthcare workers than those who are not on contact precautions (Siebert, Speroni, Oh, DeVoe, & Jacobsen, 2014).  Working with patients in isolation is reported by healthcare workers to be an on-the-job stressor and may impact the level of care that our most vulnerable patients receive.  Have you observed it to be true that patients in isolation receive less frequent contact by healthcare workers?  What might be some reasons why healthcare workers pay less attention to patients in isolation? How do you think this problem be addressed?

Siebert, D. J., Speroni, K. G., Oh, K. M., DeVoe, M. C., & Jacobsen, K. H. (2014). Preventing transmission of MRSA: A qualitative study of health care workers’ attitudes and suggestions. American Journal of Infection Control 42, 405-411. http://dx.doi.org/10.1016/j.ajic.2013.10.008

 

Preventing transmission of MRSA: A qualitative study of health care workers’ attitudes and suggestions.

Ways to Reduce HAIs Incidents

Healthcare-acquired infections (HAIs), or infections patients get while being treated for other conditions, are responsible for 99,000 deaths and $35 billion in additional medical costs annually in the U.S.  Despite the scope of the problem, medical researchers agree on a simple and cost-effective method to prevent up to 70% of HAIs: good hand hygiene.  This article describes the attempt of a 274-bed acute care hospital in Phoenix, Arizona, to eliminate HAIs after experiencing four instances of HAIs (one per quarter) in 2014, with baseline hand hygiene compliance of 57%.  Education was provided to address four opportunities: hospital staff underwent training to replace handshakes with fist-bumps; patients were instructed to ask of anyone entering their room, “Did you wash your hands?”; nursing, ancillary, and medical staff were trained in proper hand washing techniques; and staff were trained in hands-free use of door pulls in all patient rooms.  Certain staff received training to anonymously observe hand-washing opportunities on all units to assess compliance with hygiene protocols.  Staff who performed acceptable hand hygiene were immediately rewarded; staff who failed their hygiene opportunity were politely corrected and educated on the importance of hand hygiene.  Results showed that over a three-month period, compliance to hand hygiene protocols increased to 93% (N = 637, p = .05) with zero instances of HAIs, representing savings to the facility in the first quarter of over $120,000.  The results of this study show that increasing awareness and reinforcing positive behaviors among healthcare workers and patients are practical and inexpensive ways to reduce the incidence of HAIs in hospitals.