An aggressive effort to reduce the spread of deadly bacterial infections at veterans' hospitals is showing impressive results and may have broad implications at medical centers across the country, according to the first comprehensive assessment of the program, released Wednesday.
ATLANTA — An aggressive effort to reduce the spread of deadly bacterial infections at veterans hospitals is showing impressive results and may have broad implications at medical centers across the country, according to the first comprehensive assessment of the program, released Wednesday.
The study of 153 Veterans Affairs (VA) hospitals found a 62 percent drop in the rate of infections caused by methicillin-resistant Staphylococcus aureus, or MRSA, in intensive-care units over 32 months. There was a 45 percent drop in MRSA prevalence in other hospital wards, such as surgical and rehabilitation units.
The Veterans Affairs strategy employs a “bundle” of measures that include screening all patients with nasal swabs, isolating those who test positive for MRSA, requiring that staff treating those patients wear gloves and gowns and take other contact precautions and encouraging rigorous hand washing.
The results may not be easily replicated in the private sector, but they are likely to step up pressure by further undercutting the notion that infections are an unavoidable cost of doing business.
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“I think our study has shown that it is possible to make this large-scale change, even in a large system,” said Dr. Rajiv Jain, an official with the Veterans Health Administration and the study’s primary author.
A second large study of intensive-care cases, also published Wednesday, raises doubts about whether a key component of the veterans approach — testing every patient upon admission and discharge — is necessary or cost-effective. Taken together, the studies are likely to stoke a raging debate among infection-control specialists about the wisdom of universal testing, which can be expensive and time-consuming.
The studies were published in tandem in The New England Journal of Medicine.
Treatment makes organs more viable
For decades, heart- and lung-transplant surgeons have followed a strict directive: Get the donor organ into the recipient as soon as possible.
That may change. In a study published Wednesday, researchers said the number of donor lungs and successful transplants may be dramatically increased by treating the organs on a perfusion machine for several hours before transplant. The technique pumps a liquid consisting of oxygen, proteins and nutrients into the donor lungs after they’ve been removed and transported to the recipient’s hospital.
About 85 percent of lungs made available for donation are not used because of tissue damage that potentially could be repaired with perfusion or other techniques.
“We won’t just transplant an organ,” said Dr. Shaf Keshavjee, senior author of the study in The New England Journal of Medicine and director of the Toronto Lung Transplant Program at Toronto General Hospital. “We will diagnose it, fix it, make it OK and then transplant it.”
“This is the most exciting advance in lung transplantation since we first started 25 years ago,” said John Dark, a professor of cardiothoracic surgery at Newcastle University, U.K., and president of the International Society for Heart & Lung Transplantation. He was not involved in the study. “It’s converting lungs you can’t use into lungs you can use.”
More U.S. adults taking vitamins
Vitamins and other dietary supplements continue to gain in popularity in the United States, according to a new government survey released Wednesday.
The percentage of U.S. adults who take supplements increased from 42 percent when the last National Health and Examination Survey was conducted in 1988 to 1994, to 50 percent when the most recent survey was performed in 2003 to 2006, according to a new report from the National Center for Health Statistics, which conducted the survey.
The survey involved detailed interviews with 18,504 adults between 1988 and 1994, and 9,432 adults between 2003 and 2006.
Vitamins and minerals are the most commonly used supplements, with about 40 percent of men and women saying they take them, the analysis showed.
Calcium, which protects bones, increased from 28 percent to 61 percent between the two surveys among women aged 60 and older.
Despite efforts to get more young women to take folic acid, which can prevent birth defects known as neural-tube defects, the intake of that nutrient did not increase, with only 34 percent of women ages 20 to 39 taking a supplement containing folic acid.
Vitamin D, however, increased for men and women and most age groups.
Seattle Times news services