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Author Topic:   Antibiotic-resistant Infections
Gary Peterson
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posted 01-07-2000 05:09 AM     Click Here to See the Profile for Gary Peterson   Click Here to Email Gary Peterson     Edit/Delete Message   Reply w/Quote
July 17, 2004 - Methicillin-resistant Staphylococcus aureus (MRSA), a drug-resistant "superbug" found in hospitals, has a close cousin that is affecting athletes, prisoners and small children in growing numbers across the United States. Reuters article via Yahoo. (link is no longer available)

The Centers for Disease Control and Prevention (CDC) has released a draft report on a public health action plant to combat antimicrobial resistance. 15-page Executive Summary (pdf format).

February 27, 2004 - Deaths in Britain from an increasingly drug-resistant superbug are 15 times higher than they were a decade ago, according to new figures released this week. Story from AP/Yahoo. (link is no longer available)

February 13, 2004 - The Centers for Disease Control and Prevention (CDC) has released a tip sheet specifically for dialysis patients on preventing antimicrobial resistance.

Tips for Dialysis Patients to Prevent Antibiotic Resistance - 2-page pdf document from the CDC
Among the 13 points listed is:
"Since you are part of your healthcare team, do not be afraid to remind doctors or nurses to clean their hands. This includes washing their hands with soap and water or using an alcohol-based handrub before working with you."
The tip sheet is part of the CDC's overall Campaign to Prevent Antimicrobial REsistance in Healthcare Settings web site.

October 21, 2003 - In the past few years, California jails have seen a large jump in methicillin resistant Staphylococcus aureus (MRSA). According to a study published in the November 15 issue of Clinical Infectious Diseases, not only are the rates of MRSA increasing, but newer, drug-resistant strains are appearing at an increasingly fast pace outside the hospital environment. Summary from EurekAlert.

MRSA has emerged recently as a more frequent cause of skin and soft tissue infections in the community, particularly in correctional facilities such as prisons, jails, and detention centers. This report from MMWR/CDC summarizes recent investigations of MRSA transmission among inmates of correctional facilities in Georgia, California, and Texas. Page from the MMWR/CDC.

September 24, 2003 - A case report describing linezolid failure in a dialysis patient with enterococcal endocarditis may be the first reported clinical failure of linezolid in a patient with a drug-susceptible Enterococcus faecalis infection. Summary from Doctor's Guide.

September 18, 2003 - Two studies on staph infections in dialysis patient populations, both sponsored by Nabi Biopharmaceuticals and executed by Duke University Medical Center, were presented at the 43rd annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) in Chicago, IL. Press release from Nabil Biopharmaceuticals. (link is no longer available)

Nabi Biopharmaceuticals is planning to initiate a confirmatory Phase III clinical trial with StaphVAX® in the United States in approximately 3,000 ESRD patients during the 4th quarter of 2003.


September 16, 2003 - The Centers for Disease Control and Prevention (CDC) has updated information on antibiotic-resistant infections on its web site:

June 17, 2003 - A new class of antibiotics offers massive benefits to today's patients - but could place future generations in danger, say experts. Story from the BBC.

May 17, 2003 - Nabi Biopharmaceuticlas expects to start final testing of its Staph vaccine later this year and expects to complete it by the end of 2005. That's when the company hopes to seek approval for the drug from the Food and Drug Administration; the approval process is likely to take six months to a year. The company's big study involves testing StaphVAX on renal dialysis patients. Story from PalmBeachPost.com. (link is no longer available)

April 19, 2003 - A Michigan State University study found people undergoing hemodialysis are 257 times more likely to contract invasive Staphylococcus aureus (ISA) infections than the general population. Story from Health Scout News/Yahoo. (link is no longer available)

"Population-Based Study of the Epidemiology of and the Risk Factors for Invasive Staphylococcus aureus Infections" - abstract from the Journal of Infectious Diseases

April 4, 2003 - The Centers for Disease Control and Prevention has reported the first case of vanomycin resistance involving the Staphylococcus aureus bacterium, the most common cause of skin infections in the United States. Vanomycin has been considered the most reliable drug for treating these infections, which have long demonstrated resistance to other traditional first-line drug treatments. News item from the AHA (American Hospital Association).

Another report on this story from Reuters. (link is no longer available)

March 4, 2003 - The Massachusetts Department of Public Health is investigating how five men in Boston were infected with methicillin-resistant Staphylococcus aureus, or MRSA. Story from AP/Yahoo. (link is no longer available)

February 20, 2003 - Cipro, the antibiotic that became a household word during the 2001 anthrax scare, is becoming increasingly ineffective against other dangerous germs because of overuse, a study in the Journal of the American Medical Association (JAMA) found. Story from AP/Yahoo. (link is no longer available)

"Antibiotic Resistance Among Gram-Negative Bacilli in US Intensive Care Units" - abstract from JAMA

February 7, 2003 - The Centers for Disease Control and Prevention (CDC) has issued a dispatch on the drug-resistant staph skin infections that have shown up recently in correctional facilities, athletic teams, and gay men in Los Angeles.
"Public Health Dispatch: Outbreaks of Community-Associated Methicillin-Resistant Staphylococcus aureus Skin Infections - Los Angeles County, California, 2002-2003" - report from MMWR™
The FDA on Feb. 5 announced a final rule that will require new labels on antibiotics to warn physicians to prescribe the treatments only for bacterial infections to help prevent overuse, a practice that can lead to growth of antibiotic-resistant bacteria. Summary from Kaiser Network.

University of Chicago researchers have discovered how Staphylococcus aureus, a common cause of life-threatening infections, acquires iron from its host's red blood cells, a critical step in causing disease. The discovery suggests new ways to combat this common pathogen, which infects 500,000 hospital patients a year and has grown ominously resistant to antibiotics. Press release from the University of Chicago Hospitals.

February 5, 2003 - The latest issue of Clinical Infectious Diseases contains a major article on infections caused by Staphylococcus aureus with reduced vancomycin susceptibility. The study finds that dialysis and/or ESRD are not risk factors for these infections.

"Epidemiological and Microbiological Characterization of Infections Caused by Staphylococcus aureus with Reduced Susceptibility to Vancomycin, United States, 1997-2001" - abstract from Clinical Infectious Diseases

January 30, 2003 - Public health officials in San Francisco said they are alerting local labs to be on the lookout for a particular aggressive strain of drug-resistant staph that has shown up in gay men in Los Angeles. Story from the San Francisco Examiner. (link is no longer available)

December 13, 2002 - A study published in this week's issue of the British Medical Journal (BMJ) reports that MRSA (methicillin-resistant staphylococcus aureus) is apprearing on a growing number of death certificates, increasing from 13 in 1993 to 114 in 1998. Summary from the BBC.

"Mortality from methicillin resistant Staphylococcus aureus in England and Wales: analysis of death certificates" - full-text article from BMJ

November 22, 2002 - An extensive article has been published about Sherryl Carter, the dialysis patient who was the first person in the U.S. to develop a vancomycin-resistant staph infection. Article from the Detroit Free Press.

An entire wing of a surgical floor was shut down while a surgeon debrided Carter's foot. She was transported on a gurney, a soft stretcher, rather than on an expensive operating table the hospital might have had to destroy. Doctors were able to save her foot.

November 19, 2002 - An article in this week's issue of The Annals of Internal Medicine says that hospitals and disease surveillance agencies should consider adding a third category -- "health care-associated infections" -- to the system currently used to classify bloodstream infections in patients. The proposed new category would describe those infections originating in non-hospital medical settings, such as nursing homes, outpatient dialysis and chemotherapy clinics and home health services. Story from AScribe News/Northern Light. (link is no longer available)

"Health Care–Associated Bloodstream Infections in Adults: A Reason To Change the Accepted Definition of Community-Acquired Infections" - abstract from Annals of Internal Medicine

Summary for Patients - from Annals of Internal Medicine

Earlier this year, the first U.S. case of vancomycin-resistant S. aureus was documented in a Detroit-area dialysis patient. Health affairs report from the Detroit Free Press.

November 4, 2002 - The Centers for Disease Control and Prevention (CDC) yesterday announced a campaign aimed at nephrologists to prevent antimicrobial resistance in dialysis patients. Press release from the CDC.

The CDC has set up a web page with Tools for Clinicians who treat dialysis patients. Among the available resources:


The campaign centers around four key strategies for preventing antimicrobial resistance in healthcare settings:
  1. preventing infection
  2. diagnosing and treating infection effectively
  3. using antimicrobials wisely
  4. preventing transmission of drug-resistant pathogens

This campaign gives nephrologists 12 steps to protect their patients from this ongoing risk:

Action Step 1: Vaccinate Staff and Patients

  • Get influenza vaccine

  • Give influenza and pneumococcal vaccine to patients in addition to routine vaccines (e.g. hepatitis B)

Action Step 2: Get the Catheters Out
Hemodialysis

  • Use catheters only when essential

  • Maximize use of fistulas/grafts

  • Remove catheters when they are no longer essential
Peritoneal Dialysis

  • Remove/replace infected catheters

Action Step 3: Optimize Access Care

  • Follow established KDOQI and CDC Guidelines for access care

  • Use proper insertion and catheter-care protocols

  • Remove access device when infected

  • Use the correct catheter

Action Step 4: Target the Pathogen

  • Obtain appropriate cultures

  • Target empiric therapy to likely pathogens

  • Target definitive therapy to known pathogens

  • Optimize timing, regimen, dose, route, and duration

Action Step 5: Access the Experts

  • Consult the appropriate expert for complicated infections

Action Step 6: Use Local Data

  • Know your local antibiogram

  • Get previous microbiology results when patients transfer to your facility

Action Step 7: Know When to Say "No" to Vanco

  • Follow CDC guidelines for vancomycin use

  • Consider 1st generation cephalosporins instead of vancomycin

Action Step 8: Treat Infection, Not Contamination or Colonization

  • Use proper antisepsis for drawing blood cultures

  • Get one peripheral vein blood culture, if possible

  • Avoid culturing vascular catheter tips

  • Treat bacteremia, not the catheter tip

Action Step 9: Stop Antimicrobial Treatment

  • When infection is treated

  • When infection is not diagnosed

Action Step 10: Follow Infection Control Precautions

  • Use standard infection control precautions for dialysis centers

  • Consult local infection control experts

Action Step 11: Practice Hand Hygiene

  • Wash your hands or use an alcohol-based handrub

  • Set an example

Action Step 12: Partner With Your Patients

  • Educate on access care and infection control measures

  • Re-educate regularly


October 25, 2002 - Antibacterial soap are a waste of time, experts now say. Story from Reuters/Yahoo.(link is no longer available)

"It makes you wonder why they call it antibacterial, because according to our research, it isn't any more so than plain soaps," Elaine Larson, associate dean for research at the Columbia University School of Nursing in New York, said in a statement.

October 12, 2002 - The second documented case of infection caused by vancomycin-resistant S. aureus (VRSA) (vancomycin MIC >32 µg/mL) in the United States has been reported in Pennsylvania. (Morbidity and Mortality Weekly Review) MMWR update from the CDC (Centers for Disease Control and Prevention).

October 1, 2002 - Studies show that, at best, only 48 percent of medical workers follow hand hygiene guidelines. Some reports find compliance as low as 12 percent. Story from the Boston Globe.(link is no longer available)

New study findings add to growing concerns that widespread use of products containing the antibacterial agent triclosan may be promoting the growth of dangerous superbugs. Story from Reuters Health/Yahoo.(link is no longer available)

More and more hospital are turning to alcohol-based hand rub systems to reduce in-hospital infection rates of resistant organisms. Study summary from Doctor's Guide.

September 20, 2002 - The latest issue of Fortune magazine contains an article on "superbugs" that focuses on the first case of vancomycin-resistant S. aureus (VRSA) (vancomycin MIC >32 µg/mL) in the United States in July of this year. This case was reported in a dialysis patient in Michigan. Story from Fortune.(link is no longer available) (See July 3 entry below).

According to the article, 90,000 Americans die every year from infections acquired in hospitals.

August 21, 2002 - Consumer products such as soaps and lotions often contain germ-killing antimicrobials, but there is scant evidence they are helpful in preventing infections, according to an American Medical Association (AMA) committee. Story from Reuters Health/Yahoo. (link is no longer available)

August 6, 2002 - The Boston Globe is running a story today on the growing problem of antibiotic-resistant microorganisms (or superbugs).

Here is "Revenge of the Bugs" (link is no longer available) from the Boston Globe. An excerpt:

"In 1995 alone, the 13,500 cases of staph infections in New York City hospitals cost an estimated $435 million to treat, $32,000 per patient, compared to the typical cost of $13,200 for other hospitalized patients."

July 24, 2002 - Here are several articles on the increasing number of antibiotic-resistant infections:
"Drug-Resistant Germs Adapt, Thrive beyond Hospital Walls" - article from Hoover's/Chicago Tribune (link is no longer available)

"New antibiotic-resistant superbug found" - article from New Scientist

The Chicago Tribune is running a series of articles on "Unhealthy Hospitals" and the growing problem of infections acquired in hospitals. The Tribune requires readers to register to access their free articles. Click here to access Unhealthy Hospitals. (link is no longer available)

The American Hospital Association has released a statement saying the Chicago Tribune report on infections is misleading and focuses on old anecdotes. (link is no longer available)


July 16, 2002 - Here is an article from the July/August issue of U.S. Food and Drug Administration FDA Consumer magazine entitled, "The Battle of the Bugs: Fighting Antibiotic Resistance". According to the Centers for Disease Control and Prevention (CDC), virtually all significant bacterial infections in the world are becoming resistant to the antibiotic treatment of choice. This article gives an up-to-date summary of antibiotic resistance.

July 3, 2002 - The first documented case of infection caused by vancomycin-resistant S. aureus (VRSA) (vancomycin MIC >32 µg/mL) in the United States has been reported in a dialysis patient in Michigan. (Morbidity and Mortality Weekly Review) MMWR update from the CDC (Centers for Disease Control and Prevention).

Here is a news story on this development from the Dallas Morning News. (link is no longer available)

This outbreak has necessitated the near complete isolation of the patient in the dialysis center:

"After the identification of VRSA, the dialysis center initiated special precautions on the basis of CDC recommendations, including using gloves, gowns, and masks for all contacts with the patient; performing dialysis with a dedicated dialysis machine during the last shift of the day in an area separate from other patients; having a dialysis technician dedicated to providing care for the patient; using dedicated, noncritical patient-care items; and enhancing education of staff members about appropriate infection-control practices. Assessment of infection-control practices in other health-care settings in which the patient was treated is ongoing."

Here are a number of Internet-based resources on antibiotic-resistant organisms from the RenalWEB Infection Control Topic page.

May 30, 2002 - The latest issue of the Journal of Pharmacy Technology (JPT) has an article about the use of antibiograms in prescribing antibiotic therapy in dialysis centers.

Empiric vancomycin treatment is frequently used in hemodialysis patients because of ease of administration when methicillin-resistant Staphylococcus aureus (MRSA) infection is suspected. Differing rates of MRSA indicate that empiric antibiotic treatment should be based on a center-specific antibiogram. Here is the abstract from JPT. (link is no longer available)

March 27, 2002 - The Centers for Disease Control and Prevention (CDC) has issued new guidelines for doctors and hospitals to slow the growth of superbugs — powerful bacteria that develop resistance to overused antibiotics. Story from AP/Yahoo. (link is no longer available)

Here is the home page of the CDC's Campaign to Prevent Antimicrobial Resistance in Healthcare Settings.

Here are 12 Steps to Prevent Antimicrobial Resistance Among Hospitalized Adults. A PowerPoint™ slide presentation is also available.


March 4, 2002 - Antibiotic-resistant diseases are now plaguing outpatient dialysis centers. The most recent issue of the CDC journal Emerging Infectious Diseases contains a study entitled "Antibiotic Resistance Patterns of Bacterial Isolates from Blood in San Francisco County, California, 1996-1999.

The study confirmed that outpatient dialysis units and outpatient intravascular devices are reservoirs of colonization with MRSA and vancomycin-resistant Enterococcus (VRE) in many patients in the community. Awareness of this problem can prompt infection control personnel to ensure nasopharyngeal swabbing and eradication of MRSA in dialysis centers.

Here is a summary from EurekAlert entitled "Superbug dynasties conquer the globe". It summarizes findings of a major study of methicillin-resistant S. aureus (MRSA), the most important antibiotic-resistant bacterium or "superbug" dominating hospitals worldwide.

September 12, 2001 - This week's Journal of the American Medical Association (JAMA) has a study which reports that U.S. physicians are inappropriately prescribing antibiotics and are fueling the antibiotic-resistant organism problem. Here is an overview from the BBC.

Here is the abstract of the article entitled, "Antibiotic Treatment of Adults With Sore Throat by Community Primary Care Physicians" from JAMA.

July 30, 2001 - British researchers have found that transmission of methicillin-resistant Staphylococcus aureus (MRSA) could be reduced if nurses and other direct caregivers routinely donned protective masks.

Here is the abstract of the article entitled, "The usefulness of masks in preventing transient carriage of epidemic methicillin-resistant Staphylococcus aureus by healthcare workers" from the Journal of Hospital Infection. (link is no longer available)

July 20, 2001 - The current issue of the British medical journal The Lancet is reporting that a peritoneal dialysis patient has been the first to develop an infection that was resistant the new antibiotic Zyvox (linezolid), a little more than a year after the drug was introduced. Here is a summary from The Washington Post. (link is no longer available)

Here is a letter from Pharmacia, the manufacturers of Zyvox, on The Lancet article. (link is no longer available)

May 28, 2001 - This article from the BBC provides details on a possible significant discovery regarding drug-resistant "superbugs". Physicians may have spotted the precise moment when a new strain of superbug evolved in a patient.

April 27, 2001 - An advisory panel to the FDA recommended a new antibiotic, Ketek, for treating pneumonia, but stopped short of endorsing it for drug resistant infections, which are becoming more and more common. Here is the story from WebMD.

Here is an article from the BBC about "superbugs". The story says that despite guidance to curb the use of antibiotics, "superbug" strains are slow to disappear.

April 9, 2001 - Here is an article from the BBC about devastating hospital superbugs, which have harnessed the ability to beat antibiotics and to spread like wildfire.

Yahoo has a full news coverage page on antibiotics and microbiology. (link is no longer available)

April 2, 2001 - A study published in the March 1 issue of Clinical Infectious Diseases reports that gloves reduce but don't eliminate the risk of contamination of healthcare workers' hands with vancomycin-resistant enterococci (VRE). Here is a summary from the nurses.com web site.

March 22, 2001 - The Annals of Internal Medicine has published a position paper entitled, "Principles of Appropriate Antibiotic Use for Treatment of Acute Respiratory Tract Infections in Adults: Background, Specific Aims, and Methods". The abstract is on-line.

A summary of the paper is also provided by the nurses.com web site.

WebMD has an article about a new treatment that doesn't use antibiotics to treat strep infections.

December 28, 2000 - The Centers for Disease Control and Prevention (CDC) now reports that 1 in 4 strains of Streptococcus pneumoniae are resistant to penicillin.

The abstract of the CDC article appears in this week's issue of the New England Journal of Medicine (NEJM).

October 4, 2000 - Cases of bacteria that are resistant to antibiotics are on the rise and researchers are urging Congress to fund new efforts to develop new tools to fight these pathogens.

August 10, 2000 - With more and more microorganisms becoming resistant to today's antibiotics, managing drug-resistant infections is becoming an important topic for healthcare providers.

Here is an excellent article entitled "How drug-resistant microorganisms affect nursing" from the nurses.com web site.

The National Center for Infectious Diseases has several fact sheets and recommendations about MRSA and VRE from the Centers for Disease Control (CDC).

March 21, 2000 - Researchers at UCLA report that they are finding more instances of the bacteria that causes kidney infections becoming resistant to antibiotics. Kidney infections (pyelonephritis) are among the most common serious infections affecting women.

There is a report in this week's Journal of the American Medical Association that finds that trimethoprim/sulfamethoxazole or TMP/SMX (also known as Bactrim® and Septra®), a standard antibiotic for kidney infections, led to more treatment failures and increased costs than ciprofloxacin (Cipro®), a common fluoroquinolone antibiotic.


January 7, 2000 - The CDC's Morbidity and Mortality Weekly Report (MMWR) has reported a case of Staphylococcus aureus with Reduced Susceptibility to Vancomycin involving a dialysis patient in Illinois in April 1999.

For more information about Vancomycin-Intermediate Staphylococcus aureus (VISA), visit the VISA Information Page on the Antimicrobial Resistance listing on the CDC web site.

[This message has been edited by Gary Peterson (edited 12-22-2004).]

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Gary Peterson
Administrator
posted 03-22-2000 10:17 AM     Click Here to See the Profile for Gary Peterson   Click Here to Email Gary Peterson     Edit/Delete Message   Reply w/Quote
Message added to update "latest post" date.

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beaches4me
New Member
posted 03-20-2001 02:33 PM     Click Here to See the Profile for beaches4me   Click Here to Email beaches4me     Edit/Delete Message   Reply w/Quote
I have been diagnosed with Community Acqured MRSA. I do not work in a health care facility and do not use needles. I had sinus surgery to remove infection that could not be cleared with months of antibiotics. The infection was cultured and grew MRSA. I was treated with bactraban, rifampin and minicycline (sp?) I am alergic to pennicillan and sulfur). I have not been treaated with antibiotics for anything in over 2-3 years before this developed this past fall. I just finished the last of the 30 day supply of meds and will get another culture in 2 days. Noone can figure out how I got this and it is scary because I am tired of being ill and wonder exactly how long I have had this in my face! I have children and I have read of cases where children have been exposed and have died quickly. Please respond if you have been thru similar circumstances. Thank you.

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