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Beware, patients: Killer bug plagues hospitals |
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Written by Administrator
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Wednesday, 11 October 2006 16:25 |
Robyn Shelton | Sentinel Medical Writer- July 13, 2008
More Americans are getting sick from a potentially fatal bacterial infection usually caught by people in hospitals or nursing homes.
The bug -- Clostridium difficile -- is linked to an estimated 500,000 hospitalizations each year and is contributing to as many as 30,000 deaths nationwide, according to the Centers for Disease Control and Prevention. It has become a major health threat -- especially for the elderly -- since a new strain emerged in 2000 that is resistant to some antibiotics.
The problem is both simple and complicated. Many cases could be prevented if health-care workers diligently washed their hands to avoid spreading the bacteria among patients. But even with the best efforts, experts say, C. difficile is a tough bug to kill.
"These bacteria can live for long periods of time in a hospital room. They probably will survive a nuclear holocaust together with the cockroaches," said Dr. Barry Sieger, an infectious-diseases specialist for Orlando Health. "They live on bedrails, on the telephone, the TV remote, everything the patient has touched." In the environment, C. difficile exists in a state of hibernation called a spore. People can pick up spores on their hands and ingest them when eating. Some carry spores in their guts and never get sick. Others are not so lucky.
Problems usually start after a patient is put on a prolonged course of antibiotics, which kill many bacteria that live in the digestive tract. C. difficile then becomes active, churning out toxins that can lead to severe diarrhea, dehydration and weight loss. Some patients develop a dangerous infection that requires surgery to remove the colon.
But more often, it contributes to a patient's overall deterioration.
"In the past, we've thought of Clostridium difficile as more of a nuisance; patients get diarrhea and we put them on antibiotics and that's that," said Dr. L. Clifford McDonald, a medical epidemiologist who studies the bacteria for the CDC. "But C. difficile can be debilitating . . . it can be the proverbial straw that breaks the camel's back."
C. difficile is not a reportable disease, so doctors don't have a strict count of cases annually. But studies show steep increases in patients hospitalized with the infections, climbing about 23 percent annually. In Florida, hospitalizations surged from 6,254 in 1997 to 23,370 by 2006, according to the Florida Department of Health.
The numbers include patients who are hospitalized multiple times a year for recurrent bouts. Sieger said 20 percent to 30 percent of patients suffer a relapse.
An ongoing ordeal
Billie Jeanne Bargar of Windermere worries about falling ill yet again with C. difficile. "I always know when it's starting; I just have the worst feeling," Bargar said.
The 80-year-old said she caught the bacteria during a 2004 stay at Health Central hospital in Ocoee. She went through a harrowing nine-month period in 2004 and 2005, making repeated trips to the emergency room and dropping to 108 pounds. Calls to the hospital last week were not returned.
An infectious-diseases specialist eventually got the illness under control with a strong antibiotic called vancomycin.
But Bargar has not been the same since she first caught the bacteria.
Gone are the two-mile walks in her neighborhood and afternoons strolling aroundSeaWorld. Her daughter had to retire to look after Bargar. The entire family -- four generations share a home -- dreads another relapse.
"If she gets the least bit nauseous, everybody panics," said Jeanne Coker, Bargar's granddaughter.
Using greater care
As much as 90 percent of cases are caught in health-care settings, said Dr. Fred Arthur Zar, an infectious-diseases expert with the University of Illinois at Chicago. Zar said health-care facilities need to be relentless to curb the bacteria.
For example, alcohol-based gels do not kill the spore form of C. difficile. That means old-fashioned hand-washing is required with soap and water. Also, most disinfectants do not kill the spores. Cleaning staff need to use a diluted bleach solution to eradicate them, he said.
"The traditional methods that we have to clean rooms just aren't designed to get rid of these spores," Zar said.
Doctors also could do a lot to reduce C. difficile by using antibiotics more carefully, said Dr. Jaime Carrizosa, a Florida Hospital infectious-diseases specialist.
"We are using too many antibiotics and stronger antibiotics and not using them appropriately," Carrizosa said. "As long as we are doing that, bacteria are going to become more virulent." |
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Last Updated on Sunday, 13 July 2008 19:16 |
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Whoops! Anti-Bacterial Wipes Can Spread Disease |
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Written by Administrator
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Wednesday, 11 October 2006 16:17 |
It may make you feel better to see a hospital orderly wiping down every surface in your room with an anti-bacterial wipe. But according to a new study, that wipe isnít killing bacteria on contact, and may be simply picking up bacteria from one surface and distributing it to others. In an era where antibiotic-resistant ìsuperbugsî like MRSA are a growing threat in hospitals, nurses and orderlies have understandably been wielding the wipes diligently. But when a team led by microbiologist Gareth Williams tested wipes after their use at several hospitals in Wales, they found that MRSA in particular could easily be spread by those handy little moist towelettes.
In an era where antibiotic-resistant ìsuperbugsî like MRSA are a growing threat in hospitals, nurses and orderlies have understandably been wielding the wipes diligently. But when a team led by microbiologist Gareth Williams tested wipes after their use at several hospitals in Wales, they found that MRSA in particular could easily be spread by those handy little moist towelettes. Dr Williams said: ìWhat is remarkable is that some of these wipes actually have the words ëkills MRSAí written on the box.î We found that, under the conditions we observed in actual hospitals, this wasnít the caseî [BBC News]. So whatís a nervous nurse ó or kindergarten teacher, or fitness club manager ó to do? Williams recommends that a wipe be used one time, to clean one surface, and then discarded. But all those institutions that have adopted the anti-bacterial wipes as a symbol of cleanliness and sanitation might be better off with a scrub brush. Commenting on the story, professor Donna Duberg of Saint Louis University said the publicís over-enthusiasm for disinfecting products can have damaging results over the long term. ìWe use way too many antibacterial agents,î Duberg said, adding that the overuse of products like wipes, soaps and cleansers that contain these substances can lead bacteria to become resistant to our methods of extermination. ìI personally believe there isnít anything that good, hot soapy water canít clean,î she said [ABC News]. |
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Last Updated on Sunday, 13 July 2008 20:01 |
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Germs Lurking All Around You |
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Written by Administrator
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Wednesday, 11 October 2006 09:18 |
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Posted: 8:12 PM Oct 25, 2007 Last Updated: 8:13 PM Oct 25, 2007 Reporter: Bill Murray Email Address:
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The first is your kitchen sink kitchen sinks are dirtier than most bathrooms. There are typically more than 500,000 bacteria per square inch in the drain alone. Plus your sponge, basin and faucet handles are crawling with bacteria as well. You can reduce the risk by sanitizing sponges by running them through the dishwasher's drying cycle, which will kill 99.9 percent of bacteria on them. As for the sink, clean it twice a week with a solution of one tablespoon of chlorine bleach and one quart of water. Another one is a load of wet laundry any time you transfer underwear from the washer to the dryer, you're getting E Coli on your hands. Just one soiled undergarment can spread bacteria to the whole load and machine. You can reduce the risk by running your washer at 150 degrees. Next are ATM buttons. If you're not careful, you might pick up more than quick cash from your local ATM. These buttons have more gunk on them than most public-bathroom doorknobs. ATMs aren't frequently cleaned, and are regularly touched, which is a perfect combination for a lot of germs. You can reduce the risk by carrying an alcohol-based hand sanitizer with you and rub it on hands after visits. Also be sure to do it after you handle paper money, which actually carries quite a few germs, too. Then thereís the hotel room remote control. What's the first thing you do when you settle in at a hotel? You grab the remote control and switch on the television, which you and the hundreds of other guests who've stayed there have done. How dirty is it? A recent study tested various surfaces for the cold virus after a group of sick people had stayed overnight and found the virus on the remote, door handles, light switches, pens and faucet handles. You can reduce the risk by cleaning the remote control, phone, clock radio, door handles and light switches with germicidal wipes. Another big germfest is the neighborhood playground. Itís best to go on a warm sunny day. Apparently, the sun's ultraviolet light is an effective disinfectant. This list was compiled by Health Magazine. 80 percent of infections are spread through hand contact, so wash those hands with warm, soapy water. |
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Last Updated on Saturday, 28 June 2008 02:33 |
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Germ warfare in your home |
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Written by Administrator
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Wednesday, 11 October 2006 09:14 |
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Germ warfare in your home Warning: What you are about to read isn't pretty November 13, 2007
If you're a regular reader of "Health" magazine, you already know what I'm about to say. But it wouldn't hurt to hear it again. And with Thanksgiving upon us, a little review of kitchen cleanliness (make that all-over-the-house cleanliness) is not such a bad idea. Advance warning ó this topic is somewhat unsettling. "Germs lurk where you least expect them," according to the recent issue of Health magazine. As illustration, I just transferred a load of wet laundry from the washer to the dryer. The cycle finished about an hour ago, but I delayed in making the transfer. I know better. I know those clothes should move the minute the washer stops churning and spinning. That's especially important if I'm washing a load of underwear. (A family's underwear should be washed apart from other laundered items, by the way.) There's "about a gram of feces in every dirty piece of underwear." The potential for tiny pathogens to spread throughout your load of laundry is substantial. Other reminders include watching your water temperature. Opt for warm/hot. Your wash water should be 150 degrees ó check it using a candy thermometer. And wash those white undies with bleach ó use the real thing, not the color-safe version, it has notably less protective "punch." Other places where germs linger longer include the bottom of your purse, your telephone and the computer keyboard at home or at the office. That would be the same computer keyboard you've been pecking away at for more than two years, the one you have hardly ever wiped down. One especially big problem is the television's remote control. That's particularly true in hotel rooms ó some planning-ahead-people carry a zip lock bag with them when they travel and pop in the remote before they even think about changing a channel. Here's a big one. Don't forget the bacteria-friendly flush handles on toilets. The toilets in your home or in a public rest room can become their own virtual hotel for nasty disease-causing germs. Let disinfectant and germicidal wipes become your new best friend; carry them everywhere. I started this column by saying I was going to prepare you for a germ-free kitchen in which to do your Thanksgiving preparations. This is a challenge. The truth is (direct quotes from Health magazine again) "your kitchen sink is dirtier than most bathrooms." There are "more than 500,000 bacteria per square inch in the drain alone." The kitchen sponge and those little green scrubbers are particularly notorious. Sanitize those items regularly by running them through the dishwasher. And wash your sink area down at least once a week with one tablespoon of bleach to one quart of water ó pour any remaining solution (after you've done a complete scrub down) into the drain. You'll feel better afterward ó guaranteed. I work for Oregon State University Extension Service and we have a whole package of materials on germs and kitchen/household cleanliness. Check out http://extension.oregonstate.edu/catalog. I'm quoting Health magazine's Frances-Largeman Roth when I say "the fight is in your hands." Wash them regularly by the way. And you've heard this from me before: 15-20 seconds, warm water, soap, lots of friction. Sharon Johnson is an associate professor in health and human services at Oregon State University and on the faculty of the OSU Extension. E-mail her at
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or call 776-7371, Ext. 210. |
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Last Updated on Saturday, 28 June 2008 02:34 |
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