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Impact of MRSA nasal colonization on surgical site infections after gastrointestinal surgery
Methicillin-resistant Staphylococcus (MRSA) nasal colonization is associated with longer hospital stays and an increase in surgical site infections (SSI) in patients undergoing major gastrointestinal surgery, according to a new study from Scott and White Memorial Hospital, Temple, TX.
Antibiotic-resistant organisms such as MRSA can cause infections after surgery. Many studies have shown that MRSA nasal colonization increases the risk of developing SSI, and there has been an effort to conduct swab testing to isolate those patients and decontaminate or reduce the risk of MRSA SSI.
Researchers led by Harry T. Papaconstantinou, MD, chief of colorectal surgery at Scott and White Memorial Hospital, sought to determine the type of infection that might occur post-gastrointestinal (GI) surgery in someone who receives a nasal swab that tests positive for MRSA. The majority of organisms that cause SSIs after GI surgery usually occur within the body cavity operated on, but MRSA tends to colonize on the skin. Therefore, researchers expected to find that nasal colonization of MRSA wouldn't have an effect, as it is not an organism that is routinely found or colonized in the GI tract.
Of the 1,137 patients identified, 6 percent were MRSA positive, 15 percent were MSSA positive and 79 percent were negative. One hundred and one patients experienced SSI (9 percent), with the MRSA-positive group associated with a higher rate of SSI when compared to the negative and methicillin-sensitive Staphylococcus aureus (MSSA)-positive groups (14 percent versus 9 percent versus 4 percent, respectively).
Researchers also looked at other potential risk factors and found that the nasal swab result was not an indication of developing an SSI. "I don't think MRSA colonization necessarily increases risk for developing SSI, but I do think that MRSA colonization affects what type of organism is involved in SSI," said Dr. Papaconstantinou. He added that if you examine the organism present in SSIs, of the patients who tested positive for MRSA, 70 percent of their wound infections stemmed from MRSA.
Dr. Papaconstantinou said it is instructive to look at this research and consider what it takes to do a nasal swab test, to identify those with Staph aureus and differentiate between MRSA and MSSA, and then look at what it would cost to decolonize those patients. The next step for this research is to conduct surveillance and eradication of MRSA in bowel surgery.
Investigators examined all patients who had nasal swab tests at Scott and White Memorial Hospital between December 2007 and August 2009, and who had also undergone major gastrointestinal surgery (surgery of the esophagus, stomach, small bowel, colon and rectum, liver, gallbladder, pancreas, etc.) Patients had a nasal swab test to determine their MRSA colonization status within 24 to 48 hours after admission and were grouped into one of three categories: MRSA swab-positive, MSSA swab-positive, or those who had neither and were considered negative.
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Apple’s iPad Touch Technology Used to Stop Hospital Infections
New Technology to Address All 5 WHO Hand Hygiene Moments!
ANNAPOLIS, MD - The statistics are alarming! One in twenty patients will be infected with a Healthcare-Associated Infection (HAI) with over one-hundred-thousand deaths this year from infections such as MRSA and C. diff, inadequate aseptic techniques during intravenous or urinary catheter insertion or surgical procedures, and ventilator-associated pneumonia at an annual hospital cost in excess of 30 billion dollars. The CDC is quoted as saying “over one half of all hospital infections are preventable and many HAIs can be avoided with the simple application of good hygiene practices by healthcare personnel”.
Current studies show that healthcare workers fail to comply with proper hand hygiene practices more than 60% of the time. The convenient means one uses to input and access information on the iPhone or iPad (capacitive touch technology) has now been incorporated into a system for monitoring hand hygiene compliance. Re-purposing this familiar iPad touch technology has resulted in a one-of-its-kind U.S. patent No. 7,893,842 being issued to Dr. Richard Deutsch of Annapolis, MD, for a hand hygiene monitoring and surveillance system that assures virtual 100% caregiver compliance with Federally recommended World Health Organization’s 5 Moments of HAI prevention and hand hygiene protocol.
Use of this technology should significantly reduce the scourge of HAIs via its application as a novel means of electronic surveillance, which is capable of determining the exact moment of actual physical contact between the healthcare worker (not unlike the iPhone user’s finger) and the patient or patient’s related medical devices such as their bed, intravenous catheter, urinary catheter, or ventilator (not unlike the iPhone screen itself), and then determining the healthcare worker’s hygiene status by correlating the detected patient contact with the healthcare worker’s previous activation of a system associated fixed or portable hand sanitizer. Detection of contact generates several animated color coded graphics reflecting the healthcare worker’s hand hygiene status on an iPad like display screen.
Failure to comply with required hand sanitizing creates a forensic visual recording of the hand hygiene violation with the subsequent identification and possible re-education of the non-compliant healthcare worker. In addition, this first-of-its-kind ability to determine actual patient contact provides an effective means of reducing staff workload by eliminating many unnecessary hand-cleaning procedures when patient contact is not required, e.g. when viewing a patient monitor! The world-renowned expert in HAIs Dr. William Jarvis is quoted as saying “Hand hygiene is a critical and essential element in HAI prevention. Any technology that can detect and promote hand hygiene during the most important healthcare worker activities, i.e., patient and patient medical device contact, should become the standard for promoting hand hygiene.”
Facilities for which this hand hygiene detection and compliance innovation should be considered include hospitals, outpatient medical facilities and long-term care facilities. Strategic partner inquiries welcomed. Pictures, descriptions and additional details for the Safe-Hands hygiene monitoring system can be found at http://www.SafeHandsNow.com
Contact:
Dr. Richard Deutsch / Healthquest Technologies Inc.
Phone: (410) 849-2724
E-Mail: Newideas@ix.netcom.com
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