Spring Break
Vigilance stops dangerous hospital-borne infections
Issue date: 12/4/08
We know we should do it, but we often don't wash our hands. While for you and me it may merely mean succumbing to a cold, for health care workers, it can mean spreading bacteria to a patient. And not just any old bacterium, but a multi drug resistant organism, MDRO, that has the potential to cause difficult-to-treat infections.
Adults in intensive care units (ICUs) are routinely screened for MDROs upon admission to the unit, but this precautionary practice is not extended to the pediatric care unit (PICU). Children are checked for the bacteria some time during their stay - but not at the outset - making undetected MDROs possible. A group of physicians at Hopkins Hospital implemented the screening system used in the ICU in the PICU.
"We know that the percent of antibiotic resistant bacteria are increasing in the pediatric intensive care unit (PICU), but there is not a lot of data characterizing the problem with MDRO infections in the PICU," Aaron Milstone, a pediatric infectious disease specialist and the first author on the study, said in an e-mail interview.
Milstone's study tracked two MDROs: methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). "Our main goal was to determine whether cultures sent during clinical care reflect the burden of MRSA and VRE in the PICU," Milstone said.
A patient can be colonized with MDRO and not show symptoms. However, an asymptomatic person can spread the bacteria to someone who could become infected.
"We focused our study mainly on colonization. [By] screening cultures [we can] identify colonized patients who can serve unknowingly as a reservoir and spread infection to other people. If a patient has VRE and their nurse or doctor is unaware, if good handwashing is not practiced, then dirty hands can carry VRE to the next patient. The next patient can become colonized and is at risk of an infection due to VRE," Milstone said.
If a patient is known to have an MDRO, approaches like isolation are implemented to impede transmission to others. "Identifying colonized patients and isolating them is one strategy to prevent transmission and reduce infections. This has never been studied in children," Milstone said.
Adults in intensive care units (ICUs) are routinely screened for MDROs upon admission to the unit, but this precautionary practice is not extended to the pediatric care unit (PICU). Children are checked for the bacteria some time during their stay - but not at the outset - making undetected MDROs possible. A group of physicians at Hopkins Hospital implemented the screening system used in the ICU in the PICU.
"We know that the percent of antibiotic resistant bacteria are increasing in the pediatric intensive care unit (PICU), but there is not a lot of data characterizing the problem with MDRO infections in the PICU," Aaron Milstone, a pediatric infectious disease specialist and the first author on the study, said in an e-mail interview.
Milstone's study tracked two MDROs: methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). "Our main goal was to determine whether cultures sent during clinical care reflect the burden of MRSA and VRE in the PICU," Milstone said.
A patient can be colonized with MDRO and not show symptoms. However, an asymptomatic person can spread the bacteria to someone who could become infected.
"We focused our study mainly on colonization. [By] screening cultures [we can] identify colonized patients who can serve unknowingly as a reservoir and spread infection to other people. If a patient has VRE and their nurse or doctor is unaware, if good handwashing is not practiced, then dirty hands can carry VRE to the next patient. The next patient can become colonized and is at risk of an infection due to VRE," Milstone said.
If a patient is known to have an MDRO, approaches like isolation are implemented to impede transmission to others. "Identifying colonized patients and isolating them is one strategy to prevent transmission and reduce infections. This has never been studied in children," Milstone said.
Viewing Comments 1 - 3 of 3
Caroline Pellyn
posted 3/07/09 @ 12:06 AM EST
Thanks to author! I like articles like this about title , very interesting.
Jan Downing
posted 4/17/09 @ 3:36 AM EST
A think this new storie have some mistakes.
Anna Reed
posted 7/04/09 @ 2:46 AM EST
I have to agree with teh poster above... :/ looks like a lot of hot air to me.
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