28 March 2008

MRSA and animals and hospitals

I am at the annual meeting of the Association of Health Care Journalists, where last night we heard actor Dennis Quaid discuss the severe medical error that led to his infant twins being given 1000x the appropriate dose of heparin - twice. (Interesting tidbit: The twins were in the hospital because of a staph infection.) Quaid and his wife have set up a foundation that will work to reduce medical errors and is soliciting stories from victims and families.

Later today I'll be moderating a panel on mandatory reporting of hospital infections that we hope will provoke an, ahem, free and frank exchange of views. More on that to come.

Meanwhile, though, a wrinkle in the possibility that companion animals might spread MRSA: What if they are therapy animals?

An international collaborative group has contemplated that question and come out with a thoughtful set of guidelines that are published in this month's issue of the American Journal of Infection Control. The guidelines address both official therapy animals and also pets who live in long-term care facilities or are brought to visit patients.

Key considerations: Animals could not only spread disease to patients because they are colonized; they may also become colonized because they are handled by patients. Because transmission and colonization may be so dynamic, the most important preventive measure will be hand hygiene rather than attempting to evaluate the animal's bacterial carriage at any single point. And key points: To minimize opportunities for transmission, exclude animals that have come directly from a shelter or pound; animals that eat a raw-food diet; animals that haven't been or can't be housebroken or litter-trained.

The guidelines are here, and there's a good MSM summary by Helen Branswell of the Canadian Press here.


robyn said...

Our prayers go out to parents everywhere that must be vigilant and protect their children from both superbugs but also a recalcitrant medical system.

The more I read about resistance mechanisms in bacteria the more I understand the role of modern medicine and animal husbandry in creating these superbugs.

I am convinced that doctors require quick methods of identifying specific bacterial strains. Otherwise, it is simply Russian roulette. This is because a particular antibiotic may actually make the bacteria MORE virulent because the drug stimulates its protective mechanisms, honed over 3 billion years. The bacteria learn like the borg. They adapt.

The wrong drug may CREATE a superbug. Is this not true?

So how often do doctors guess right? Is there anything on the market or in the pipeline to assist doctors in ascertaining the particular bug and its strain, and thus prescribe the appropriate drug?

Or will we maintain our Dark Ages technology and barbaric warring behavior that pits us against 3 billion years of practice?

Maryn McKenna said...

Rapid diagnostics are a major business area. Here's an earlier post on Cepheid, which has one, and there is another on the market by a different company and about five more in development. But can they subtype? Not that I know of.

Hey, Robyn, there's new research coming soon that you'll be interested in — I'll blog it as soon as the embargo expires.