By Melissa Patrick
Kentucky Health News
If the United States really wants to figure out the best way to fight infections that are resistant to antibiotics, a big problem in Kentucky, researchers say it first needs to create a better system for tracking the infections.
The study, published on BioMed Central, looked at the incidence rate of Methicillin-resistant Staphylococcus aureus (MRSA) by analyzing data from five different reports and determined the data varied so widely between them that any sort of real comparison would be difficult.
The variances included the types of populations studied (general population, military facilities, medical centers, pediatric patients and different geographic areas); the types of infections measured (total MRSA infections versus bloodstream infections only) as well as variances in how baseline data was gathered. In addition, it said the terminology used to describe the results also varied.
Taking all this into account, the researchers said they did not find any "definitive evidence" that MRSA rates had decreased significantly in health-care facilities or in communities since 2010-2011, and found they had increased between 2014 and 2015. However, the U.S. Veterans Health Administration had over an 80 percent reduction in MRSA.
Why does this matter?
The U.S. Department of Health and Human Services has set a goal of reducing MRSA infections by half by 2020, but lead researcher Dr. Kevin Kavanagh of Somerset, an infection-control activist who leads Health Watch USA, said in a separate opinion piece about the study that the nation "is nowhere near on track to meet this target."
The researchers note that health-care facilities use two main strategies to fight these infections, and one seems to have better results than the other, but they say that until all of the tracking measures are equal, a "best practice" cannot conclusively be determined.
The strategy used by VA hospitals is based on identification and isolation, along with strict hand-washing rules. The other, used by more than 60 percent of U.S. hospitals, is based on the "Reduce MRSA" study and involves a protocol of daily bathing with chlorhexidine along with intranasal mupirocin, an antibiotic.
The researchers note that new antibiotics are being developed to combat these infections, but say a comprehensive tracking system must come first, to accurately prioritize development and then to be able to better track resistance to it. It also adds that all types of health-care facilities, not just hospitals, should be involved in reporting.
About the same time this study was released, the Reuters news service published an in-depth investigative story that said many health experts have concerns about the "Reduce MRSA" study because Sage Products, the maker of the chlorhexidine wipes, provided "funding and millions of dollars in wipes for studies" to Rush University Medical Center in Chicago to test the efficacy of the product, and that Rush has since "published 11 articles on six trials that endorse daily washing of patients with Sage's patented wipes, which is an "off label" use." The U.S. Food and Drug Administration has only approved them for cleaning patients before surgery,
"The industry money funding chlorhexidine research muddies the message of the results, in the view of many health experts," Deborah J. Nelson and Ryan McNeill report for Reuters.
They also report that experts have voiced concerns about routine use of such a "potent biocide," and the FDA recently issued warnings about increased "reports of allergic reactions, including a couple of deaths, and other adverse events linked to the chemical." In addition, Sage has also recalled the product twice because the chlorhexidine cloths have been "tied, ironically, to dozens of infections by Burkholderia cepacia, a pathogen that wreaks havoc on hospital patients," they write.
Dr. Robert A. Weinstein, an infectious-disease specialist at Rush and senior researcher on the chlorhexidine wipe studies, told Reuters that the maker funding his research has not influenced his findings. He has published one negative report on the product.
In its analysis, Reuters looked at health-department records and compared them to death certificates during the same time period and found that while health departments reported about 3,300 deaths from antibiotic-resistant infections in 2003-2014, death certificates reported 180,000 such deaths. In the same time frame, Kentucky's health departments reported nine such deaths, but the Reuters investigation found 3,027.
Kentucky Health News
If the United States really wants to figure out the best way to fight infections that are resistant to antibiotics, a big problem in Kentucky, researchers say it first needs to create a better system for tracking the infections.
The study, published on BioMed Central, looked at the incidence rate of Methicillin-resistant Staphylococcus aureus (MRSA) by analyzing data from five different reports and determined the data varied so widely between them that any sort of real comparison would be difficult.
 |
| Report notes that this MRSA infection might not be reported, depending on the data-reporting guidelines. (CDC) |
Taking all this into account, the researchers said they did not find any "definitive evidence" that MRSA rates had decreased significantly in health-care facilities or in communities since 2010-2011, and found they had increased between 2014 and 2015. However, the U.S. Veterans Health Administration had over an 80 percent reduction in MRSA.
 |
| Dr. Kevin Kavanagh |
The U.S. Department of Health and Human Services has set a goal of reducing MRSA infections by half by 2020, but lead researcher Dr. Kevin Kavanagh of Somerset, an infection-control activist who leads Health Watch USA, said in a separate opinion piece about the study that the nation "is nowhere near on track to meet this target."
The researchers note that health-care facilities use two main strategies to fight these infections, and one seems to have better results than the other, but they say that until all of the tracking measures are equal, a "best practice" cannot conclusively be determined.
The strategy used by VA hospitals is based on identification and isolation, along with strict hand-washing rules. The other, used by more than 60 percent of U.S. hospitals, is based on the "Reduce MRSA" study and involves a protocol of daily bathing with chlorhexidine along with intranasal mupirocin, an antibiotic.
The researchers note that new antibiotics are being developed to combat these infections, but say a comprehensive tracking system must come first, to accurately prioritize development and then to be able to better track resistance to it. It also adds that all types of health-care facilities, not just hospitals, should be involved in reporting.
About the same time this study was released, the Reuters news service published an in-depth investigative story that said many health experts have concerns about the "Reduce MRSA" study because Sage Products, the maker of the chlorhexidine wipes, provided "funding and millions of dollars in wipes for studies" to Rush University Medical Center in Chicago to test the efficacy of the product, and that Rush has since "published 11 articles on six trials that endorse daily washing of patients with Sage's patented wipes, which is an "off label" use." The U.S. Food and Drug Administration has only approved them for cleaning patients before surgery,
"The industry money funding chlorhexidine research muddies the message of the results, in the view of many health experts," Deborah J. Nelson and Ryan McNeill report for Reuters.
Dr. Robert A. Weinstein, an infectious-disease specialist at Rush and senior researcher on the chlorhexidine wipe studies, told Reuters that the maker funding his research has not influenced his findings. He has published one negative report on the product.
Reuters, in another investigative story, also found that infections and deaths from antibiotic-resistant infections are not reported or tracked routinely, saying that the federal Centers for Disease Control and Prevention estimate that 23,000 Americans die each year from an antibiotic-resistant infection is "mostly guesswork" and that the real number is likely much higher.
In its analysis, Reuters looked at health-department records and compared them to death certificates during the same time period and found that while health departments reported about 3,300 deaths from antibiotic-resistant infections in 2003-2014, death certificates reported 180,000 such deaths. In the same time frame, Kentucky's health departments reported nine such deaths, but the Reuters investigation found 3,027.
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