Patient Safety Blog

One-third of new HIV cases in the U.S. are due to injection drug use, and HIV/AIDS has decimated the African-American community in particular. That is why it is no surprise that the NAACP and other advocacy groups chose Thursday--which was National Black HIV/AIDS Awareness Day--to call on Congress to repeal a ban on federal funding for needle exchange programs. There is some political controversy over this ban, because many politicians are afraid to look like they are supporting drug use, but public health advocacy groups are generally in favor of repealing the ban because of the demonstrated effects of needle exchange programs.

A quote from a supporter of repeal from the article:

Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, on Wednesday said that he supports needle-exchange programs. In a separate statement, Fauci said the high rates of HIV/AIDS among blacks require "drastic action." He added, "In particular, black leaders -- religious, secular and political -- have a key role to play in reducing the stigma often associated with HIV/AIDS and influencing African-Americans to get tested, counseled and treated" (Crary, AP/Seattle Times, 2/6).

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MRSA or methicillin-resistant staphylococcus aureus, a "superbug" infection usually contracted in hospitals, is now being transmitted during male-male sexual encounters. This news comes just a few months after MRSA was discovered in some Virginia schools. As the linked pages note, MRSA is highly drug resistant and can be deadly. It comes in many strains and is often difficult to treat, requiring expensive antibiotic regimes. The discovery of MRSA in schools and among sexually active gay men is disturbing because it indicates that this "superbug" is no longer an exclusively hospital-based phenomenon and may start becoming more common in the general population, where researcher Binh Diep says it would be "unstoppable."

In San Francisco, researchers found that sexually active gay men were 13 times more likely to have MRSA than sexually active heterosexuals. It is passed on in the same way as other sexually transmitted diseases: unprotected and skin-abrading sex.

The best way to avoid getting MRSA in any fashion is through simply practicing good hygiene and washing with soap and water. This is why, as this blog has discussed before, it is vitally important for healthcare professionals to wash their hands before examining or treating patients.

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An article in the New Yorker by Atul Gawande highlights the simple ways in which hospitals can be made less dangerous places for their patients. A checklist to make sure intensive care doctors and nurses handle catheters correctly has been proven to dramatically reduce the risk of deadly infections. Gawande focuses on the work of Peter Pronovost, MD, an intensive care specialist at Johns Hopkins Hospital who consults with hospitals around the country to spread his gospel of routinizing simple procedures. For example, on catheter infections, Pronovost's work was first published in December 2006 in the New England Journal of Medicine. In 108 ICU's across Michigan, they were able to virtually wipe out catheter-based infection by enforcing a required checklist of five interventions: hand-washing before handling a catheter, full-body draping when inserting a central venous catheter, scrubbing the skin with chlorhexidine, avoiding catheters in the groin, and removing unneeded catheters as soon as possible. All hospitals should implement these simple ideas which can prevent deadly infections and save lives. Dr. Pronovost is a pioneer in patient safety research.

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Posted In: Communication , Infections , Standard of Care--Hospitals

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Recently, a 17-year-old in Bedford County, Virginia died of an infection known as MRSA . MRSA stands for “methicillin-resistant staphylococcus aureus” and is also referred to as a “staph infection” or a “superbug.” MRSA is a particular kind of staph infection that is resistant to common antibiotics. The MRSA bacteria was found in many other schools in Virginia as well as over the country, and Bedford County schools were closed down as a result.

These developments are unusual and surprising because MRSA generally turns up in hospitals, rather than in schools or other places in the community.

Things to know about MRSA:

1)It is spread through skin-to-skin contact. Alternately, it can be spread through surfaces or objects that many people have touched or through personal items such as towels.

2)MRSA is easy to prevent but can be difficult to cure. Basic hygiene is the number one factor in preventing this infection. Hand-washing is especially important. Other factors include keeping personal items clean, using disinfectants and being careful about use of antibiotics. Overuse of antibiotics is what prompts bacteria to evolve into resistant strains.

3)As most MRSA cases occur in hospitals, it is important to be especially vigilant about the hygiene about those around you if you or a loved one is admitted to the hospital. Do not be shy about asking if doctors, nurses, or other caretakers have washed their hands. Lack of such basic measures has led to deaths in the past, as can be seen by examining the case of Maureen Daly and others.

Another useful resource are these FAQs about schools, kids and MRSA.

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Posted In: Infections

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