A report on what has been described as the largest nationally representative study to date of deaths due to sepsis and pneumonia, appears in the 22 February issue of Archives of Internal Medicine.

Co-author Dr Ramanan Laxminarayan, who is leading Extending the Cure, an investigation into antibiotic resistance for the Washington DC based think-tank Resources for the Future, told the press that in many cases the conditions could have been avoided with better infection control in the hospitals.

“Infections that are acquired during the course of a hospital stay cost the United States a staggering amount in terms of lives lost and health care costs,” said Laxminarayan.

“Hospitals and other health care providers must act now to protect patients from this growing menace,” he urged.

The researchers said that hospital-acquired infections are caused by “superbugs”, germs that can’t be killed with common antibiotics.

Co-author Dr Anup Malani, a professor at the University of Chicago who is also working on Extending the Cure with Laxminarayan, said:

“These superbugs are increasingly difficult to treat and, in some cases, trigger infections that ultimately cause the body’s organs to shut down.”

Sepsis, a condition where the whole body goes into a state of inflammatory response, and pneumonia, an infection of the lungs and respiratory tract, are two conditions often caused by deadly microbes, including resistant bacteria such as MRSA (methicillin-resistant Staphylococcus aureus). Such infections usually lead to longer stays in hospital and can lead to serious complications and even death.

Laxminarayan and his colleagues examined data from 69 million records of patients discharged from hospitals in 40 states of the US (they used the Nationwide Inpatient Sample database).

The US Centers for Disease Control and Prevention (CDC) estimated in 2002 that 99,000 American deaths a year were linked to hospital-acquired infections. In this study the researchers focused on only the two most serious conditions, sepsis and pneumonia, and calculated deaths resulting directly from infections patients acquired while they were in hospital. Plus they concentrated on infections that they regarded as mostly preventable, such as when they result from a lapse in sterile technique during surgery.

They found that the cost of such infections can be high. For instance, developing sepsis after surgery resulted in an average of 11 extra days in hospital and an additional infection treatment cost of 33,000 dollars per patient.

However, the most alarming finding was that nearly 20 per cent of people who developed sepsis following surgery died as a result of the infection.

Malani, described this finding as a “tragedy” because:

“In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control – and they can die.”

When they looked at pneumonia, which can develop when disease-causing germs get into the lungs, for instance via a dirty ventilator tube (a clearly preventable post-surgery infection, as many are, said the authors), they found people who developed the condition after surgery stayed on average an extra 14 days in hospital at an additional treatment cost of 46,000 dollars per person. And in 11 per cent of cases the patient died as a result of the infection-related pneumonia.

Malani said:

“The nation urgently needs a comprehensive approach to reduce the risk posed by these deadly infections.”

“Improving infection control is a clear way to both improve patient outcomes and lower health care costs,” he added.

“Clinical and Economic Outcomes Attributable to Health Care-Associated Sepsis and Pneumonia.”
Michael R. Eber; Ramanan Laxminarayan; Eli N. Perencevich; Anup Malani.
Arch Intern Med, Vol. 170 No. 4, February 22, 2010, pp 347-353.

Since last year Michelle’s husband was sent to Iraq to do his duty for their country. While there he broke out with these boil like sores. Since he was in war they gave him an antibiotic and sent him on his way. This may be a good time to let you know that the R in MRSA means resistant. Resistant to Antibiotics. So he went about his job there with not a second thought.When he came home he was broke out again with 2 boils and man did they look nasty. Michelle sent him to the Williamsport hospital. They gave him more antibiotics and also too a culture of the puss that was seeping out and said they would call if anything showed up.

2 months later he once again broke out and she sent him back to the ER. The doctor looked up her husband’s records and noticed that it said MRSA positive. And no one called to let them know these results. Knowing that, the doctor put him on a medication that would work, but the meds only work to clear up the infected sore. All he told them was to keep it clean and finish all his meds. Nothing else. Since then her husband has gone back to the ER many times to get his sores drained and then packed with gauze.

Now here they are over a year later and what has happened since then. A month ago Michelle’s daughter broke out with 2 sores on her belly. Knowing what her husband looked like they took her straight to the hospital. The doctor that saw her daughter that night said it was spider bites. She took no culture at all even though they told her daughter that Michelle’s husband has MRSA. Within 3 days her sores got so much worse so we took her back out. The doctor they saw then was a GOD send. He took one look and knew right away that it was MRSA. He put her on the right meds and cultured it to be sure. 3 days later doctors called saying her daughter was positive.
A week after Michelle’s mother in law broke out with a sore, and a week after her Michelle herself broke out. They both tested positive. Worrying about their other 2 children they got them tested as well and they are also positive. They continue to break out at least once a month each. Right now Michelle’s husband has to have surgery on his recent one to clean it out.

She knows that if only the doctors would have informed them about MRSA and how it is spread over a year ago when her husband was diagnosed, their children, herself and her mother would be MRSA free.

Since Michelle’s curiosity about her MRSA case, she then went to her doctor that the kids see out at the Divine clinic to ask her questions. When she asked her about telling the schools her kids attend Michelle was in shock when she told her not to because she would cause a panic. She did anyways. What an awful doctor to say something like that. Not only would they have been putting all your kids in harm way of getting it but the teachers as well. Don’t worry parents, they now home school their children for your child’s safety and theirs. If her child gets your child’s cold or flu it could mean a hospital stay for theirs because MRSA weakens the immune system.

An Open Letter to the Newspaper

Michelle is outraged that the government hasn’t said a word about this. Especially when she was told from EVERY doctor she spoke to that MRSA is spreading like wild fire through Williamsport and surrounding areas. People need to know what they are in harm of and how to PREVENT it. This has even affected her husband’s jobs. He has lost 2 in the past year due to this. Mainly because he gets so sick and when he breaks out he is the most contagious and not to mention in pain.

She knows that there are many people out there that have MRSA and she asks whoever who are interested in starting a support group Williamsport Michelle to join and send emails to her at allthawaynavy5@aol.com. For those who are interested in learning more and reading others stories you may also visit the support site online at www.mrsasupport.co.uk. She believes there is A LOT more to learn.

As social human beings, it is our duties to inform and let others know about this MRSA issues, as it is for the sake of all.

Kevin Randleman was a MMA Heavyweight Champion. Known for his athleticism and explosive power, Randleman was one of the most feared fighter in MMA. Over the last two years, Kevin has been experiencing a number of issues. He spent some time in the hospital at the turn of the new year and just recently had a severe bout of staph infection and is still feeling the effects of it.

Almost died from MRSA 2 years ago, Randleman infected by the staph again and was hospitalized for 3 weeks.  Two of his organs was shut down as he battled to remain alive.

“I was in critical condition for almost three weeks and I am two weeks out of the hospital now.” He continued, “pain is just part of the healing, and it hurts a lot.”

Bellow are images from Kevin Randleman Blog, showing how widespread the infection are.

[View with PicLens]

Tanya was a happy professional chef who like travelling just before being infected by MRSA. Her life turned drastically in March 2007 when she, in age 30, was struggling her life against MRSA. It all began when she was doing her routines cutting off celery and accidentally cut her finger. She thought it’s just a usual thing happened; she then sterilized the wound with alcohol and bandaged it to continue her work.

The fact is that MRSA bacteria have spread fast into her body and bite repeatedly. In less than 60 hours all her fingers were quite gone by the bacteria. Tanya was infected by flesh-eating bacteria and 9 doctors worked hard to safe her life. Undoubtedly, the doctors saw clearly how it jumped from Tanya’s arm to her breast

The doctors immediately decided to amputate her arm and right shoulder, until then realized the bacteria has spread to her right breast. The only one way to keep her alive they then decided to continue amputating all her infected bodies.

It is a miracle for Tanya survives though she must remove her nine kgs flesh and muscles to clean it up from the bacteria. Still remains from her is just thin skin covering her ribs and right lung. “prick of pin can easily touch my lungs and kill me,” as Tanya showed her skin and bones as qouted from doctoroz.com Thursday, Oct 1st 2009.

It is a story of Rhoda. She is the mother of three beautiful daughters and five granddaughters and one grandson. Her oldest daughter is 30 years old and married with a junkie soldier for ten years. Her husband divorced her after she delivered an addicted baby and to get girls back. Because of that she left her husband’s house and went to jail for one year for changing a doctor’s prescription. Not long ago after she was released from jail, she started doing meth to keep her body slim, she started out smoking Meth and heroin whenever the drugs and her boyfriend were.

She returned to Council Bluffs and called from time to time telling me about different people talking about how to lance the bites and that she was draining them for her boyfriend.

Knowing that Rhoda had been diagnosed with CA-MRSA, her father was extremely upset because he already knew some about it being spread by needle sharing and that it was considered an STD, too.

She then started searching any info on the internet, and found herself cry so hard knowing the truth. She thought this was even getting worse since her drug addict doesn’t keep her in good health or good financial condition. As well as she has an autoimmune disease makes her even more likely to catch it, and she has Graves Disease and Fibromyalgia already.

It was very hard for her since she lived with her daughter. She was getting thinner and more depressed, she lost custody of all three of her daughters. Until the MRSA, her husband had been thinking about getting out of the Air Force after becoming a single father but really seemed to make the decision after the MRSA popped up and he moved to Minnesota last month with the girls. He had started carrying sanitary wipes and lotions and supplied the rest of us with them, too, once he did some reading online.

Rhoda tried isolate herself from the community, because she knew about ten people infected within a very small area who not only had CA-MRSA but who all seemed to be ignorant of precautions they should take to protect others or even how serious it was to take the full amount of antibiotics prescribed. Even her daughter would split her antibiotics with her boyfriend until she realized she had to be able to treat both of them to save her daughter.

Four months later Jami called Rhoda and said that her daughter had one that she couldn’t get to drain because it is hurting her so. Rhoda went there to help her daughter. Jami sat up in bed and pulled her gown up and her robe down just exposing the boil under her right breast and Rhoda tried to get at it but her clothes kept getting in the way. They worked hard on it and ended up being too deep to drain so she had to go to the ER and get it lanced.

It was not just that MRSA case shocked Rhoda, Jami told her that she was pregnant also. Rhoda then started praying to God to help them on this
Somehow they were already being blessed. That ER trip changed everything. Jami is no longer addicted to drugs. Rhoda went to visit her for the first time since hearing she is pregnant and she looked wonderful. Since stopping shooting up the Meth, Jami gained about ten pounds, and is taking the antibiotics and I didn’t see one boil on her.

She knows she likely won’t be able to keep this baby because she used Meth during the first month of pregnancy and she already has a police record for this. And she is struggling to get off of the heroin which might be easier now that she isn’t in constant pain from the boils. She is pro choice but can’t bring herself to have an abortion but is comforted that Rhoda has the means and is more than willing to take custody of this child if she carries him/her full term. Rhoda and Jami still snuggle up together like she is a little girl sometimes and talk about the new baby and there is Life in Rhoda’s daughter again in the midst of this tragedy.

All that Rhoda hopes is that Jami stays free of the boils and can get off of all of the drugs. She thinks of Jami’s Meth addiction and will do whatever she can to help her daughter, doctor’s care if necessary.

Rhoda thinks that this long story into the problem of drug addiction might be useful for people who have contracted this through sharing needles and moreover share the problems if they see this.

As many as 1.2 million hospital patients are infected with dangerous, drug-resistant staph infections each year, almost 10 times more than previous estimates, based on findings from a major new study in 2007. And about 48,000 to 119,000 hospital patients a year may be dying from Methicillin-Resistant Staphylococcus Aureus (MRSA) infections, far more than previously thought, the study reveals.

Dr. William Jarvis at 2008 CQI Conference

Obtained results are from the Association for Professionals in Infection Control & Epidemiology (APIC), which is releasing the report publicly on August 2007. The author is Dr. William Jarvis, former acting director of the hospital infections program at the Centers for Disease Control and Prevention. The findings come amid raising public concern about the spread of antibiotic-resistant bacteria in health-care facilities and community settings. Medical experts consider the rise of so-called superbugs such as MRSA, a leading cause of deadly blood infections, and pneumonias, one of the most alarming public health threats in the nation.

Kathy Warye, the association’s executive officer, said she hope that this survey will be a wake-up call to all health-care workers around United States. It is the largest, most comprehensive survey of MRSA in health-carefacilities to date. It is based on surveys in 2005 sent to 10,000 infection-control practitioners, including doctors and nurses in hospitals, nursing homes and rehabilitation facilities. Health-care professionals were asked to select one day between Oct. 1 and Nov. 10, 2005,  and to report all known MRSA cases in their institutions. More than 1, 200 hospitals and 100 nursing homes and rehabilitation facilities responded, supplying data about patients with MRSA infections and patients colonized with the bacteria. People colonized with MRSA typically carry it in their nose without being symptomatic. They are at risk of passing the superbug to others unknowingly by wiping their nose and then touching a table that a doctor or nurse later touches,  for instance. MRSA can live on surfaces for days or even weeks.

The new survey confirms what is been observed for years – MRSA is rampant in health-care facilities. It found that 34 of 1,000 patients in the survey had active MRSA infections and that 12 were colonized with the superbug, for a total MRSA prevalence rate of 46 per 1,000 patients. (In Illinois, the prevalence rate was 37 per 1,000 patients, based on responses from 74 hospitals and other acute-carefacilities.) The most widely cited previous study, published by CDC researchers in June 2005, had estimated that the MRSA infection rate at in-patient hospitals was 3.9 per 1,000 patients. Based on that rate,  about 126,000 patients  were infected with the superbug each year. The new report did not translate its findings into actual numbers, but Jarvis outlined a means of doing so. He said it was important for the public to see the ballpark figures. The calculation involves 35.2 million people hospitalized in the U.S. in2005, the latest year for which information is available.

Applying the prevalence rates in the new study, the data suggest that 1.2 million hospital patients are afflicted with MRSA each year and that an additional 423,000 patients are colonized with the superbug. This is only an estimate,  subject to the accuracy of the numbers reporting by infection-control practitioners and the limitations of a “single point intime” snapshot of the data, Jarvis said. Many hospitals do not routinely test patients to see whether they are colonized with MRSA, he said. Also, the findings have not been peer-reviewed, which is standard in scientific publications.  Nancy Foster, vice president of Quality and Patient-safety policy at the American Hospital Association, after reviewing an advance copy of the APIC report said :

“Most hospital leaders are paying very close attention to infections within their institutions. … But I think this tells us that MRSA is an even bigger problem than we thought it was,”

Dr. John Jernigan, a medical epidemiologist at the CDC and the agency’slead expert on MRSA, said he “applauded the study” even though he had not examined its results or methodology. He has co-written articles on MRSA with Jarvis that appeared in leading infection-control publications. Jernigan said that :

“Everything we’re finding is telling us the same thing: MRSA is an enormous problem in health-care facilities, more needs to be done to prevent it, andhospitals need to make infection control more of a priority,”

The CDC has said at least 5,000 patients die after being infected by MRSAat surgical sites, in their blood or in their lungs. That’s a mortality rateof 4 percent, assuming a base of 126,000 patients. Using new prevalence estimates of 1.2 million MRSA patients a year, it suggests 48,000 patients a year may die of MRSA. There is considerable uncertainty about the mortality rate associated with MRSA, however, and it may be as high as 10 percent, said Dr. Lance Peterson, director of infectious disease research at Evanston Northwestern Healthcare. Using the new estimates, that suggests as many as 119,000 hospital patients a year may be felled by the superbug. To put that figure in context, the Institute of Medicine has estimated that nearly 100,000 patients die of 2 million infections acquired in hospitals  every year.

MRSA constituted only a portion of those infections and deaths. The new numbers suggest the actual number of hospital-related infections and deaths could be far larger. An important finding in the new study suggests that hospitals may not befocusing infection-control strategies on the right locations in their institutions. Though earlier research has indicated intensive-care units, which often treat patients with compromised immune systems, are hot spots of infection, this report shows that 67 percent of patients with MRSA infections were on medical wards. As Jarvis said said:

“This suggests that MRSA has become a problem throughout the institutionand that [hospital staff] may need to look for it beyond the ICU,”

The study shows that 77 percent of patients with MRSA were identified within two days of entering a hospital, making it likely they were colonized or infected before being admitted. The vast majority of these patients picked-up MRSA during an earlier stay at a hospital or nursing home, Jarvis said.

On the positive side, there is strong consensus about the steps hospitals need to take to control MRSA, said Dr. Don Goldmann, a senior vice president at the Institute for Healthcare Improvement in Boston. All health-care workers should practice rigorous hand-washing, and all institutions should have robust programs for disinfecting medical equipment and patients’ rooms, he said. When patients are known to have MRSA, hospital staff should wear gowns and gloves to prevent MRSA transmission. And patients deemed at risk of carrying MRSA should be screened to determine where bacterial hot spots are festering.

“Now that the true extent of this scandalously tragic epidemic is known, I hope that health-care leadership will finally confront it with the effectivemeans that have always been available,”

As said by Michael Bennett, president of the Coalition for Patients’ Rights in Maryland.

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