The Malaysian Insider :: Features
The Malaysian Insider :: Features |
| Germ-killing soaps cut hospital infection rates Posted: 01 Jun 2013 08:03 AM PDT  Antimicrobial cloths were found to help decrease blood infections in hospitals. — shutterstock.com picWASHINGTON, June 1 — A policy of regularly washing every patient in the intensive care unit with antimicrobial cloths helped cut down on dangerous blood infections by 44 per cent, a US study said Wednesday. The strategy was better at cutting back potentially lethal methicillin-resistant Staphylococcus aureus (MRSA) infections than screening and isolating infected patients, said the report in the New England Journal of Medicine. The randomised study compared methods at 43 hospitals, including 74 ICUs and 74,256 patients. The winning practice, known as "universal decolonisation," involves giving patients a nasal dose of the antibiotic mupirocin twice daily for five days, and bathing patients daily with cloths covered in antimicrobial chlorhexidine for the entire ICU stay. "Universal decolonisation of patients in the ICU was the most effective strategy, significantly reducing MRSA-positive clinical cultures by 37 per cent and bloodstream infections from any pathogen by 44 per cent," said the study. The method works by reducing the number of pathogens on the skin, "thus protecting patients in the ICU from their own microbiota during a period of heightened vulnerability to infection," said the study. Also, by cutting back on the number of microbes, there were fewer opportunities for patient-to-patient spread of harmful pathogens. Another key to the strategy was it began on the first day in the ICU, eliminating the waiting involved with trying to isolate patients who may be infected. The findings indicate that legislative mandates — currently on the books in nine US states — that require MRSA screening in the ICU may be misguided. "This study helps answer a long-standing debate in the medical field about whether we should tailor our efforts to prevent infection to specific pathogens, such as MRSA, or whether we should identify a high-risk patient group and give them all special treatment to prevent infection," said lead author Susan Huang. "The universal decolonisation strategy was the most effective and the easiest to implement. It eliminates the need for screening ICU patients for MRSA," said Huang, medical director of epidemiology and infection prevention at University of California Irvine Health. Washing all ICU patients this way could also cut down on unnecessary surveillance tests and do away with precautions over contacting patients who test positive, which can interfere with care, the researchers said. However, some prior research has pointed to the possibility that widespread use of chlorhexidine and mupirocin could lead to MRSA resistance, so such efforts would need to be monitored carefully. MRSA is priority target among health care associated infections because of its prevalence, virulence and multidrug resistant profile, said the study. The study, known as the REDUCE MRSA trial, was carried out by the University of California, Irvine, Harvard Pilgrim Health Care Institute, Hospital Corporation of America (HCA) and the Centers for Disease Control and Prevention. — AFP-Relaxnews |
| Vaccine hopes for hand, foot, mouth disease Posted: 01 Jun 2013 03:00 AM PDT  In the final testing phase, a trial foot and mouth vaccine proved 90 per cent effective, providing protection for at least 12 months against HFMD caused by the enterovirus 71 (EV71), said a study published in The Lancet. — shutterstock.com picPARIS, 1 June — Researchers in China said Wednesday a trial vaccine provided "significant" protection against a virus that can cause potentially deadly hand, foot and mouth disease (HFMD) in children. In the final testing phase, the vaccine proved 90 percent effective, providing protection for at least 12 months against HFMD caused by the enterovirus 71 (EV71), said a study published in The Lancet. Since it was discovered in 1969, EV71 has caused major outbreaks of HFMD around the world, affecting mostly children and mainly in Asia. HFMD caused by EV71 has caused more than 2,000 deaths out of about six million infections, mainly of children, in the past decade, said the study's authors. It can also cause other, more severe diseases in young children, such as meningitis and encephalitis. The candidate vaccine was tested in a trial with more than 10,000 healthy children from six to 35 months of age at four sites across China. Half of the children were given the vaccine and half a placebo. "The vaccine was well tolerated," said a statement, and no serious side-effects were noted. HFMD starts with fever, painful sores in the mouth, and a rash of blisters on the hands, feet and buttocks, followed in some cases by more serious neurological, cardiovascular and breathing problems. Not to be confused with foot-and-mouth disease in cattle, sheep and pigs, HFMD is spread from person to person through direct contact. No vaccine yet exists against the EV71 virus. The study authors said there was no evidence their trial drug would work on coxsackievirus A16 -- a virus that often circulates with EV71 and is the main cause of HFMD, though in a milder form. In a comment published with the study, The Lancet described the results as a "notable advance" but said it was limited in dealing exclusively with the C4 strain of EV71 which is predominant in mainland China. It is thus not known whether the trial vaccine would also work on regionally specific strains. "This shortcoming affects how the findings can be applied to other countries in Asia," said the journal. "Future studies should assess serum immune responses across different genogroups." The comment pointed out that the youngest participants in the study were vaccinated at the age of six months, leaving younger infants vulnerable to EV71 infection. It also said that given the relatively low mortality rate from EV71 infections, the vaccine's major contribution would be to reduce hospital admissions. "The next step is to assess the appropriateness of including an EV71 vaccine in China's national immunisation programme, including a cost-effectiveness analysis," the journal stated. — AFP-Relaxnews |
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