A team of University of Cincinnati (UC) researchers is exploring a “zinc zipper” that holds bacterial cells together and plays a key role in such infections. It is hoped that these studies will lead to new ways to prevent this growing public health danger.
Researchers in UC’s department of molecular genetics, biochemistry and microbiology have found that the presence of zinc is crucial to the formation of infection-causing biofilms. Their findings appeared in the December 1st 2008 online edition of Proceedings of the National Academy of Sciences.
UC researchers working with Andrew Herr, PhD, an assistant professor and Ohio Eminent Scholar in structural biology, found that zinc causes a protein on the bacterial surface to act like molecular Velcro, allowing the bacterial cells in the biofilm to stick to one another. Zinc chelation, or removal, prevented biofilm formation by Staphylococcus epidermidis and Staphylococcus aureus. The researchers used a chelation agent called DTPA (diethylenetriamine pentaacetic acid) to remove the zinc from a sample biofilm.
Herr explains, “We’ve shown that if you remove the zinc, you prevent the biofilm from forming, and if you add zinc back, the biofilm can grow. So we’re hopeful that we can use this sort of approach to prevent these biofilms from ever taking hold in the first place.”
The Evolution Of Medical Device Coatings
Staphylococci are remarkably adhesive and can grow on many surfaces, including implanted medical devices. These new findings could be used to develop new coatings for implanted medical devices, or rinses that a surgeon could use to clear the area around the implant.
Because DTPA is approved by the U.S. Food and Drug Administration only for people with radio isotope poisoning, systemic removal of zinc, such as through an intravenous injection, is currently impractical.
Read more about zinc removal fighting MRSA.
Medical malpractice lawsuits over hospital acquired infections that include MRSA are increasing in the US.
In July, a Missouri couple was awarded $2.58 million after the husband contracted a MRSA infection when doctors inserted a pacemaker. As a result of the infection, the patient lost a kidney and a leg and a foot had to be amputated.
Medical-malpractice defense attorney Neal M. Brown said of the threat of hospital-acquired infections, “What we’re dealing with here is a national phenomenon”. Hospitals are “well-aware” of the danger to patients and are taking strong steps to prevent it, added Brown. These steps include the screening of patients for MRSA on admission to the hospital and frequent hand washing by medical and support staff.
Mary Coffey, an attorney at Coffey Nichols in St. Louis, won the $2.58 million verdict on behalf of the 69-year-old Missouri man who contracted MRSA through an IV that was administered in the ambulance following a heart attack. When doctors later inserted a pacemaker, the infection spread. Although the traditional stance maintained by people in the medical community was that hospital acquired infections are a just part of the risk of being in a hospital, she asserts that the rate of patient infection is “close to zero” when health care personnel comply with strict hygiene protocols.
McCaughy, founder and chair of the Committee to Reduce Infection Deaths, a nonprofit patient safety organization in New York says, “Now that the evidence is overwhelming that nearly all infections are preventable, hospitals that don’t follow the proven protocols are inviting lawsuits.”
Read more about increasing MRSA Infection Lawsuits.
New research has found a direct correlation between the amount of alcohol handwash supplied to a ward and reductions in the rate of hospital acuqired MRSA infections.
A study by University College London (UCL), in collaboration with the Health Protection Agency, London School of Hygiene and Tropical Medicine, and the Hand-Hygiene Liaison Group, discovered that rates of MRSA infection are cut by 1% with each extra millilitre of alcohol hand rub supplied per patient per day.
These findings are the results of an independent evaluation of the cleanyourhands campaign to boost hygiene on hospital wards and were presented at this year’s Federation of Infection Societies conference in Cardiff.
The National Patient Safety Agency started co-ordinating this campaign in 2004 and rolled it out to 187 acute NHS trusts in England and Wales.
Dr Sheldon Stone, lead author of the evaluation at UCL, said: “Our study shows that hand hygiene lowers hospital superbugs, and our message to healthcare workers is: ‘one ml. one percent’.
He added, “The findings also serve as a reminder that we should be washing our hands in the home and workplace. Winter is the season when colds and flus abound, and people can protect themselves and stop germs from spreading by frequently washing their hands.”
So, this research tells us what we knew already. Greater levels of hygiene reduce infection. Common sense really, isn’t it?
UNC Asheville basketball player, Kenny George, has returned to Chicago after spending 3 months in hospital. Kenny developed a MRSA infection in his right foot and consequently had to undergo surgery to amputate part of it.
The basketball player was released from a hospital in Des Moines, Iowa, on 20th November 2008 and is back in Chicago. He hopes to return to school in January to continue working on his degree.
According to Asheville coach Eddie Biedenbach: “To my knowledge, the infection is completely gone”.
You can read more about Kenny George’s recovery after his MRSA infection.
Hospitals in Lincolnshire, UK are fighting infections by screening patients for MRSA on admission. At the moment, Lincolnshire hospitals perform MRSA screenings on patients admitted as emergencies and other groups of patients depending on the procedures to be undertaken. They aim to screen all elective patients for MRSA on admission by March 2009.
The transmission of MRSA and the risk of MRSA infection can be minimised by taking measures to identify MRSA carriers as soon as they enter a hospital. When identified, they are treated immediately.
Screening of patients takes place on or before admission to hospital and patients identified as MRSA carriers start decolonisation procedures involving the use of antibacterial shampoo, body wash and nasal cream.
Senior Infection Control Nurse at ULHT, Charmian Hutson, says “We find that detecting and treating those who are carrying infections as early as possible is an effective way of cutting MRSA rates- and it’s working. In the last year, rates of MRSA in our hospital have been cut by 37%.”