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Underscoring the importance of its new infection control standards for 2005, the Joint Commission on Accreditation of Healthcare Organizations has decided to roll out the new requirements on a consultative basis for hospitals being surveyed from July to December of this year.
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A third case of vancomycin-resistant Staphylo-coccus aureus (VRSA) has occurred in the United States, opening up the distinct possibility that the much-feared superbug will continue to emerge. Though little was known about the case as this issue went to press, Hospital Infection Control was able to confirm that it occurred in a patient in New York.
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In February, the FDA approved a new monoclonal antibody for the treatment of metastatic colorectal cancer.
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Long-term treatment with aspirin is associated with a progressive diminution in platelet sensitivity to the drug.
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The common and increasing practice of opioid treatment for chronic pain is reviewed. Randomized trials support this therapy, however the risk benefit decision is complicated by new evidence of hazards making this practice more difficult.
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The use of serum procalcitonin helps to differentiate bacterial from viral lower respiratory infections and may reduce the use of unnecessary antibiotics.
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Influenza had a major impact on the nations hospitals this season, filling up intensive care units and leading to staff shortages. Currently, there is no standard that requires immunization of health care workers, but the Joint Commission requires hospitals to be in compliance with applicable laws and regulations. A vaccine against the H5N1 virus could be in clinical trials by this summer.
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Receipt of vancomycin antedated isolation of MRSA with reduced susceptibility to vancomycin in 25 patients. Fortunately, there are several alternatives to vancomycin for many of these isolates. There are, in addition, a large number of antibiotics in the pipeline with activity against Gram-positive organisms.
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A formulary switch from levofloxacin to gatifloxacin as the preferred quinolone in a long-term care facility was associated with a significant increase in the incidence of Clostridium difficile-associated diarrhea (CDAD). A case-control study showed that duration of gatifloxacin was independently associated with illness. Switching back to levofloxacin was followed by a decrease in incidence of CDAD to prior levels.
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An antibiotic preparation meant for addition to animal feed was found to be contaminated with antibiotic resistance genes. Fortunately, the genes being used generally encode for resistance mechanisms that are already highly prevalent in gastrointestinal bacteria.
