If you or someone you know has suffered a Medical Error or Hospital Infection, if you are a Caregiver, or a Medical Provider - be sure to take a look at the new website:

                                 www.PatientSafetyASAP.org   

It is a helpful working resource for patients everywhere who are looking for information, resources and help.  The 'Be Knowledgeable' section contains interactive tools to assist patients in many ways.  A must see site!

Possible breast surgery cases may be one result of heightened vigilance

By Marshall Allen

The number of suspected infections reported by Southern Nevada health care providers has increased significantly in recent months, probably because they are more vigilant after last year's hepatitis C crisis, the state's medical epidemiologist says.

Case in point: A reported cluster of 16 possible infections related to breast expander surgeries in Las Vegas has triggered a multiagency probe that's being led by the Southern Nevada Health District, the organization that investigated the hepatitis C outbreak.

Breast expander procedures generally follow a mastectomy, serving to expand breast tissue over time in order to insert an implant. An expander can be likened to a balloon, and after insertion it is filled with incremental additions of fluid to expand the space where the implant will rest.

It's rare to observe a cluster of possible breast expander infections, said Dr. Ihsan Azzam, the state medical epidemiologist, who works for the Nevada State Health Division. Azzam said the investigation is in its early weeks, so it's unclear whether there is an actual outbreak or a false positive — as is the case with many reports of observed infections.

What is clear is that health providers are attuned to the potential that diseases are being spread in Las Vegas health facilities, which Azzam says is a good thing.

"This is a clear example that new partners are coming aboard," Azzam said of the more responsive medical community. "People are more aware and conscious. People are reporting everything. Since the outbreak of hepatitis C, we have a significantly larger number of reports from doctors, nurses, physician assistants ... That really helps me."

There are so many variables that it could take weeks to understand the cause of the possible breast expander infections, which have been observed at multiple hospitals, sources said. University Medical Center is one of the locations.

UMC officials said the potential problem was identified by an admitting technician who had a gut feeling there were an unusually high number of women coming to the hospital with breast-related infections. The technician turned over a list of 15 patient names to the hospital's infection control department, which began an internal investigation to determine any common links.

Dr. Alan Greenberg, medical director of UMC's infectious disease department, said he typically sees two or three of the same type of infections in a given year, and that not all 15 initial UMC cases involved breast expander procedures. The UMC investigation, which is ongoing, has confirmed three cases of breast expander infections and one related to a breast augmentation procedure. One of the infections came after the patient suffered trauma at the site, he said.

Greenberg said there are no known links between the procedures at this time, "but because everyone is on heightened alert and there's a more frequent admission rate for this diagnosis than in the past, we noticed."

Greenberg said he has contacted surgical groups in Las Vegas that perform the procedures and they have been cooperative — checking to see whether they've changed any techniques or implant materials. He said the emphasis on infection prevention is standard in hospitals, which is different from the outpatient clinic that caused the hepatitis C outbreak, which has no such structures in place.

A review of medical literature shows that infections can be a complication in a small percentage of breast expander procedures. The initial challenge, Azzam said, is to confirm that the women involved have actual infections and not some other problem, such as dead tissue. Then it will be a matter of going step-by-step through the process of each procedure to determine any common factors that could have caused an infection. Because there are many variables — the type of device, facility where the operation took place, staff involved, location of follow-up appointments and more — determining the source of the infection is a challenge, Azzam said.

A source familiar with the investigation said a single surgeon may be a common link among patients who suffered complications. The surgeon did not return the Sun's phone calls. Other doctors told the Sun that the same surgeon performing the procedures shouldn't suggest he is to blame.

UMC officials said each patient had multiple doctors, so it's too early to say whether one was in common.

Officials from the Southern Nevada Health District confirmed they are investigating the infections, but would not comment on the situation.

"It's so fluid we don't really know what it is," a Health District official said. "It's really preliminary."

The Centers for Disease Control and Prevention is assisting in the investigation.

Hospitals and nursing homes remain the bug's prime breeding ground, with patients with weakened immune systems being most vulnerable. Critically ill patients are at particular high risk, in part because of the number of invasive procedures that they require in the intensive care unit (ICU).

In some prior studies, washing with tea tree oil has been shown to be effective in removing MRSA on the skin.

Therefore, Blackwood and colleagues are evaluating the effect of daily washing with a 5 percent tea tree oil preparation on new MRSA infections among ICU patients. The 5 percent tea tree oil wash is being compared with a standard body wash (Johnson's Baby Softwash).

"We started this trial in November 2007," Blackwood said. "We aim to complete it in November 2010."

If tea tree oil body wash proves effective against MRSA, widespread implementation of such a simple prevention tool has the potential to improve patient outcomes and reduce healthcare costs, the researchers say.

Copyright 2009 Reuters.

URL: http://www.msnbc.msn.com/id/28473019/from/ET/

MRSA colonization common in emergency department personnel

By Will Boggs, MD.

NEW YORK (Reuters Health) - Health care workers in emergency departments are often carriers of the methicillin-resistant Staphylococcus aureus, or (MRSA), potentially putting patients at risk, according to two reports in the Annals of Emergency Medicine.

Testing positive for MRSA is sometimes transient among health care workers, but unfortunately the results of this study, along with the findings of the second report, reinforce concerns that MRSA carriers are an important part of the transmission of MRSA among patients, Dr. Elise O. Lovell from Advocate Christ Medical Center, Oak Lawn, Illinois, told Reuters Health.

Lovell and colleagues collected nasal swabs from a sample of 105 emergency department staff at their institution. Sixteen subjects (15 percent) tested positive for MRSA, including 12 nurses, 2 physicians, and 2 technicians.

The MRSA positivity rates in our emergency department health care workers is "much higher than that found in the general US population, but is similar to rates seen in other studies of non-ED medical personnel," Dr. Lovell said.

In the second report, Dr. Brian P. Suffoletto and colleagues from the University of Pittsburgh Department of Emergency Medicine measured the prevalence of Staphylococcus aureus and MRSA in 255 emergency department health care workers.

Just under one third of nasal cultures (31.8 percent) were positive for S. aureus, the researchers report, and the overall prevalence of MRSA 0was 4.3 percent.

None of the demographic and exposure characteristics examined were significantly associated with MRSA colonization, the investigators say, but MRSA colonization was restricted to nurses, nursing assistants, and radiology and respiratory technicians.

"The varying prevalence among the different health care workers was unexpected," Suffoletto told Reuters Health.

The relationship between MRSA-positive ED personnel and patient transmission is "still largely unexplored," Suffoletto continued. First we will need to establish if MRSA in ED personnel is transient or persistent. "Then we wish to determine the rate of unprotected contacts between ED personnel and patients.".

Both Lovell and Suffoletto stressed the importance of using universal infection control practices in the emergency department.

"It's been demonstrated repeatedly that these hygiene techniques are poorly followed in the ED, yet they represent the best (and simplest) way to minimize the spread of MRSA between our patients and to keep our patients and ourselves safe," Lovell said.

"The findings in these reports may have important implications for infection control practice," agrees Dr. John A. Jernigan from the U.S. Centers for Disease Control and Prevention, Atlanta, writing in a related editorial.

"Better implementation of current recommendations for preventing transmission of MRSA and other multidrug-resistant organisms will likely yield important benefits for both patients and health care personnel."

SOURCE: Annals of Emergency Medicine, November 2008

MRSA   SURVIVORS   NETWORK
Dedicated to Providing Awareness, Education and Support  

For Immediate Release:
January 12, 2009  

"Activism Marks First World MRSA Day" 

Chicago-based MRSA Survivors Network announces the first "World MRSA Day" to be held October 2, 2009 and commemorated each year after on this date. October will also be designated "MRSA Awareness Month" and will call attention to the worldwide epidemic.  MRSA was first discovered by Patricia Jevons, a microbiologist in the UK on Oct. 2, 1960 and nearly fifty years later, MRSA has spread worldwide.

Leading consumer patient advocates in their countries are lending their voice to the call of world unity in leadership and commitment in preventing and stopping MRSA, which is pandemic and rising at alarming rates in healthcare facilities and in the community. They call upon healthcare officials and leaders to step up and take a more aggressive and comprehensive approach to eradicate this preventable disease and focus on a broad and pro-active prevention program.

The hope of "World MRSA Day" is to bring people together every year to remind them of those who have lost their lives or have diminished health because of a preventable disease. By working together, whether as an advocate, scientist, healthcare worker, policy maker, student, caregiver or a patient living with MRSA we can collectively heighten the awareness and educate others on prevention.

To help provide education and awareness, a variety of events, exhibits, materials, candlelight vigils and commemoration programs are being planned and will be announced later.

For more information contact:
MRSA Survivors Network
Jeanine Thomas – National Spokesperson for MRSA - USA
630 654-4588
jthomas@mrsasurvivors.org
www.mrsasurvviors.org