Sludge Watch ==> USA MRSA - 2 million infected - 90, 000 die annually

[Maureen Reilly]

Sludgewatch Admin:

My guess is that the use of sewage effluent to irrigate crops, parks, golf 
courses, etc will be found to contribute to MRSA infections in communities.
Land application of sludge, too.

It is interesting that California - with its Title 22 water - the sewage 
effluent used to irrigate spinach, lettuce in the Salinas Valley - can 
continue to hide the incidence of infection.


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HEALTH
High staph infection rates in hospitals stun public health officials

New study reports lethal drug-resistant bacteria widespread

Sabin Russell, San Francisco Chronicle Medical Writer

Monday, June 25, 2007

Drug resistant breeds of staph bacteria are far more prevalent among 
hospitalized patients in the United States than previously thought, 
according to a new survey by an organization of nurses and technicians who 
specialize in infection control.

The study, released Sunday evening in advance of a San Jose health care 
convention, screened patients in hospitals and long-term care homes to 
detect MRSA, or methicillin-resistant Staphylococcus aureus, which is not 
only resistant to common antibiotics, but kills patients at 2 1/2 times the 
rate of more drug-susceptible staph germs.

In a survey of 1,237 hospitals and other residential health care centers 
such as nursing homes, researchers found that 3.4 percent of patients were 
infected with MRSA -- a rate 8.6 times greater than estimated by the Centers 
for Disease Control and Prevention. CDC epidemiologists estimated the rate 
at 0.4 percent in 2005.

Unseen until the late 1970s, MRSA now accounts for between 50 and 70 percent 
of all staph infections acquired in U.S. hospitals, and new strains of the 
bug have taken hold outside the health care setting, afflicting otherwise 
healthy individuals with "spider bite" boils that are difficult to treat, 
often recur, and can become life-threatening blood infections.

The latest study was conducted by the Association for Professionals in 
Infection Control & Epidemiology, or APIC, an organization whose 11,000 
members include nurses charged with keeping infections out of the health 
care setting.

It is estimated that each year 2 million Americans become infected during 
hospital stays, and at least 90,000 of them die. MRSA is a leading cause of 
hospital-borne infections.

"This study is a real wake-up call to health care workers,'' said Kathy 
Warye, chief executive of APIC. "It presents a much more comprehensive 
picture of the burden of MRSA.''

The survey was conducted in the fall of 2006, and represents a "snapshot" of 
MRSA rates during a single day in the participating institutions. The 
hospitals and nursing homes toted up the number of confirmed MRSA infections 
in their patient population on one day -- selected by each institution -- 
during the study period.

One of the more surprising findings was that 67 percent of MRSA cases were 
associated with patients who were hospitalized for non-surgical medical 
conditions. Most infection control efforts focus on the intensive care 
units, where patients with trauma or surgical wounds are deemed particularly 
vulnerable.

Warye said the study should prompt individual hospitals to conduct their own 
studies of where the MRSA risk exists. Other infection control efforts 
include isolation of infected patients, the use of barriers such as gloves, 
caps and gowns, and thorough cleaning of the facilities. "Hand hygiene is a 
critical component,'' she said. "It is still, first and foremost, the most 
important way to reduce risk of transmission.''

Unlike other MRSA surveys, this one also tallied cases of drug-resistant 
staph colonization among patients. About 1 in 3 institutions conducted what 
is known as active surveillance, swabbing the nostrils of newly admitted 
patients to see if they harbored MRSA. It is not uncommon for individuals to 
carry colonies of MRSA in the nose, vagina or rectum, but show no signs of 
illness. Infection control experts are concerned, however, that these same 
colonized patients might transmit their infections inadvertently to weaker 
patients in the hospital.

When the colonized patients were counted in addition to those infected, the 
MRSA rates in the participating institutions rose to 4.6 percent.

Lisa McGiffert, manager of Consumers Union's Stop Hospital Infections 
project, in Austin, Texas, said the survey results are strong evidence that 
the problem is severe and widespread. "These are dangerous infections, and 
there is not enough being done to protect patients from getting them,'' she 
said. "Hospitals are going to have to do more. They have to be more 
aggressive, and it's just not happening.''

McGiffert has been advocating for state laws that would require hospitals to 
report their infection rates. Seventeen states have done so, but Gov. Arnold 
Schwarzenegger vetoed a bill in 2005 that would have added California to 
that list.

Accurate data on hospital-borne infections are hard to come by, in part 
because of industry objections to reporting their rates. The Centers for 
Disease Control and Prevention makes estimates based primarily on discharge 
data from about 300 representative hospitals that share the information 
confidentially with the federal agency.

Dr. William Jarvis, a former CDC scientist who consulted with APIC on the 
survey, said that the federal data are based primarily on reports from 
teaching hospitals, while the new study -- with much broader institutional 
participation -- shows that the MRSA problem extends well beyond the 
nation's largest medical centers.