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Doctors’ Garments And Bacterial Contamination

This colorized 2005 scanning electron micrograph depicts numerous clumps of methicillin-resistant Staphylococcus aureus bacteria, magnified 2,390 times. Content provided by CDC/Jeff Hageman, MHS, via the CDC's Public Health Image Library (PHIL)Bacterial contamination of physicians’ newly laundered uniforms occurs within three hours of putting them on, making them no more or less dirty than the traditional white coats, researchers reported.

Researchers sought to compare bacterial and methicillin-resistant Staphylococcus aureus contamination of physicians’ white coats to freshly laundered short-sleeved uniforms, and to determine the rate at which bacterial contamination happens. They reported results in the Journal of Hospital Medicine.

ACP Internist‘s blog recently took up the debate as well. The issue has cropped up over the years, assessing not only the cleanliness but the professionalism inherent in the white lab coat.

Researchers conducted a prospective, randomized, controlled trial among 100 residents and hospitalists on an internal medicine service at Denver Health, a university-affiliated public safety-net hospital. Subjects wore a white coat or a laundered, short-sleeved uniform.

At the end of an eight-hour workday, no significant differences were found between the extent of bacterial or MRSA contamination of infrequently-washed white coats compared to the laundered uniforms. Sleeve cuffs of white coats were slightly but significantly more contaminated than the pockets or the midsleeves, “but interestingly, we found no difference in colony count from cultures taken from the skin at the wrists of the subjects wearing either garment,” researchers wrote.

And, there was no association found between the extent of bacterial or MRSA contamination and the frequency with which white coats were washed or changed. Colony counts of newly laundered uniforms were essentially zero, but after three hours they were nearly 50 percent of those counted at eight hours.

*This blog post was originally published at ACP Internist*

How To Prevent An Infection From Your Pet

Can your dog give you MRSA? Sharing with your dog is wonderful — unless you’re sharing bacteria. Pets can harbor harmful germs to pass on to you.

Staphylococcus bacteria is a common cause for skin infections in people and animals. A virulent strain of staph, called MRSA, has made headlines for school outbreaks and fatal infections. MRSA infections are usually blamed on dirty locker rooms and contaminated gym clothes, but the source for an infection might be in your lap right now.

Here are five ways to avoid catching an infection from your pet:

1. Your pet’s mouth is not clean. It’s teeming with bacteria. Don’t let your pet lick your wounds. A dialysis patient once contracted a life-threatening pasturella bacteria infection from his beautiful golden retriever this way.

2. Keep open wounds covered. Contact between your wound and your pet could spread bacteria such as MRSA. Read more »

*This blog post was originally published at The Dermatology Blog*

Developing New Antibiotics: Thinking Beyond Bacteria Resistance

44s3uqhhro.jpgBacteria may be having a renaissance. Back in the days of the discovery of penicillin, doctors gleefully handed out antibiotics like they were candy and patients were more than happy to munch them down. They were quite effective too, but bacteria rapidly became resistant.

Doctors and scientists worry that we are approaching a time where if we don’t come up with novel antibiotic mechanisms, we will face an epidemic of untreatable bacterial infections. MRSA, methicillin-resistant staphylcoccal auerus, is probably one of the biggest fears.

John Rennie wrote about this issue in the PLoS blog The Gleaming Retort. He describes two strategies scientists are using to try to come up with new weapons in the great antibacterial war. So, naturally one of the first things they turned to was cockroach brains. Read more »

*This blog post was originally published at Medgadget*

Watch Out For MRSA In Your Community

“Community acquired” (that is, not acquired in the hospital, which would be “hospital acquired”) methicillin-resistant Staphylococcus aureus (MRSA) infections have not likely come about because germs that have evolved bacterial resistance by residing within hospitals have spread into the community. Rather, this bacterial resistance to methicillin appears to have arisen independently. The “community” now absolutely needs to be considered to include the outdoor community. Hikers, kayakers, divers, climbers and all other outdoors persons who share equipment or mingle with the general population are susceptible. From a reference entitled “Diagnosis MRSA – The Clinical Challenge of Multidrug-Resistant Infections,” authored by Peter DeBlieux and colleagues and published as a supplement to ACEP NEWS, comes some useful observations.

Skin and soft tissue infections are among the most common infections caused by bacteria that can develop resistance to bacteria. Persons at particular risk for such infections include males, certain geographies, time of year (during warmer months), and affliction with diabetes. Many of the infections are abscesses, in which there is a pus pocket that can be drained by making an incision. Such treatment is in fact important to help control the spread of MRSA infections, presumably by helping to cure the abscess(es).

The current thinking is that in the setting of an “uncomplicated” skin and soft tissue infection (e.g., no involvement of deep tissues, minor clinically: simple abscess, impetigo, pimple, or superficial cellulitis), incision and drainage of small, localized abscesses can be curative. However, this is not an absolute, so many physicians are of the opinion that adding an effective antibiotic is useful. Until we have more information, it remains the clinical judgment of the treating physician about whether or not to prescribe an effective antibiotic, such as trimethoprim-sulfamethoxazole.

In complicated infections, which involve deeper skin structures (such as infected tissue ulcers, rapidly progressive infections, diabetic foot infections involving MRSA), antibiotics are deemed to be essential. The oral antibiotics that are felt to be effective against MRSA are clindamycin, trimethoprim-sulfamethoxazole, doxycycline, minocycline, linezolid, and rifampin. The injectable antibiotics that are felt to be effective against MRSA are vancomycin, clindamycin, daptomycin, tigecycline, linezolid, and quinupristin-dalfopristin. Notably, the fluroquinolone category of drugs, which includes ciprofloxacin, is not recommended as an effective treatment for community acquired MRSA infection. The same holds true for the macrolide category, which includes erythromycin, as well as cephalexin, penicillin, and dicloxacillin.

To prevent the spread of MRSA, wounds should be kept covered with clean, dry bandages; hands washed with soap and water or an effective hand sanitizer after each dressing change; close contacts instructed to bathe regularly; no sharing be allowed of bedding, towels, washcloths, bar soap, razors, and so forth.

image courtesy of www.mrsatreatments.com

This post, Watch Out For MRSA In Your Community, was originally published on Healthine.com by Paul Auerbach, M.D..

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