Paper Money and Coins as Potential Vectors of Transmissible Disease

Paper currency and coins may be a public health risk when associated with the simultaneous handling of food and could lead to the spread of nosocomial infections. Banknotes recovered from hospitals may be highly contaminated byStaphylococcus aureus. Salmonellaspecies, Escherichia coli and S. aureus are commonly isolated from banknotes from food outlets. Laboratory simulations revealed that methicillin-resistant S. aureus can easily survive on coins, whereas E. coli, Salmonella species and viruses, including human influenza virus, Norovirus, Rhinovirus, hepatitis A virus, and Rotavirus, can be transmitted through hand contact. Large-scale, 16S rRNA, metagenomic studies and culturomics have the capacity to dramatically expand the known diversity of bacteria and viruses on money and fomites. This review summarizes the latest research on the potential of paper currency and coins to serve as sources of pathogenic agents.

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Old Antibiotic for Uncomplicated Urinary Tract Infection

CAPE TOWN, South Africa — In hospitalized patients with uncomplicated urinary tract infections (UTIs), cure rates with oral fosfomycin, an old antibiotic, are excellent, even in those colonized with resistant organisms, a new study shows.

"Results from this project showed an 83% cure rate. Even in patients who did not achieve a clinical cure, only about 3% overtly failed therapy," said investigator Shauna Jacobson, PharmD, from the Orlando Regional Medical Center in Florida.

"We recently restricted fluoroquinolones at our hospital, and then we went on to restrict meropenem," she told Medscape Medical News. Although "fosfomycin has been studied pretty well in community patients, especially in patients with uncomplicated cystitis, it hasn't been well studied in hospitalized patients," she said. "We wanted to see how our patients did on it."

The study results were presented here at the 16th International Congress on Infectious Diseases.

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Will Medicine Ever Become Safer?

Hello and welcome. I am Dr. George Lundberg and this is At Large at Medscape.

Hospitals are dangerous places. I no longer work in a hospital, and I try never to go to hospitals even to visit, unless, of course, I or my family were to become really sick and would obviously stand to benefit from hospitalization. I feel almost the same about surgicenters, free-standing emergency rooms, and urgent care facilities.

...

In 1999, the Institute of Medicine published the sentinel report To Err is Human, ^[2] still a best-seller. They pegged the annual number of American hospital deaths secondary to errors and adverse effects of treatment to be 44,000 to 98,000. In an interview earlier this year, I asked Lucian Leape whether that number still held. He said no, it was much larger. I asked whether we had made any progress. He said yes, but only in narrow fields.

In 2013, a new report^[3] in the Journal of Patient Safetyestimated American hospital deaths following adverse events at 210,000 to 440,000 per year. Medicare patients are reported to die at a rate of 180,000 per year from or with nosocomial infections and other medical care-related problems

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Universal Flu Vaccination: Are We Paying Attention?

Despite recommendations for universal vaccination of all individuals older than 6 months, influenza vaccine uptake in the United States remains dismal. Although there are clear benefits of large-scale vaccination in terms of both use of healthcare resources and improved work productivity, the issue of whether the influenza vaccine may prevent cardiovascular (CV) events has been controversial.

However, a new meta-analysis finds that the influenza vaccine may reduce the risk for CV events by more than one third among adults, and even more among adults at high risk for CV disease (CVD).^[1] These findings could have important implications for public health policy, as well as the way in which physicians counsel individual patients regarding the use of the influenza vaccine.

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Infection Control Certification May Lower MRSA Rates

April 10, 2012 — California hospitals appear to have significantly lower rates of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection if their infection control directors are board-certified, according to a study published in the March issue of the American Journal of Infection Control.

via Infection Control Certification May Lower MRSA Rates.

Hospitals Cut Central-Line Infections 40% With Safety Plan

September 10, 2012 — More than 1000 hospitals in 44 states lowered their rate of central line-associated bloodstream infections (CLABSIs) by 40% over 4 years through a program that features a checklist of precautions such as hand washing and donning sterile apparel, the federal Agency for Healthcare Research and Quality (AHRQ) announced today.

AHRQ estimates that the program prevented more than 2000 CLABSIs, saved more than 500 lives, and avoided more than $34 million in healthcare costs.

The AHRQ-funded program, called Comprehensive Unit-based Safety Program (CUSP), was developed by Peter Pronovost, MD, PhD, senior vice president for patient safety and quality at Johns Hopkins Medicine in Baltimore, Maryland.

Participating hospitals in a national rollout of CUSP reduced the CLABSI rate in their adult intensive care units on average from 1.903 infections per 1000 central-line days to 1.137 infections, according to AHRQ preliminary findings. At some hospitals already excelling at infection control, the CLABSI rate fell to zero. AHRQ funded the use of CUSP nationally through the research arm of the American Hospital Association.

via Hospitals Cut Central-Line Infections 40% With Safety Plan.