Hightlights from SHEA/Becker’s, Thurs, 10/30: Fecal Tx/MRSA precaut./EBOV waste/Clostridium strain helps   Leave a comment

10/30/14

Dear Colleagues:

SHEA Spotlight this week has the following highlights:

l.  Fecal transplants for recurrent C. difficile are excellent for these patients.  Fresh transplants (require 4 d prep) and frozen transplants have similar cure rates of >90%.  This cure rate occurs in patients with toxin and w/o toxin.  The transplants change the GI microbiotome to resemble the donor microbiotome.  Multiple transplants can be done.

2.  Fecal transplants can be used in critically ill patients with C. difficile scheduled for colectomy.  Cure rate is 88%.  Vancomycin is given concurrently.

3.  Contact precautions (gloves, gowns, masks) prevent MRSA spread in hospitals, but note that only 20% of MRSA is transmitted patient to patient in hospital.  80% of MRSA comes from the outside.  See JAMA article.

4.  Needle sticks may be prevented by sharp-protection needles, double gloving, and blunt sutures in surgery.

5.  Only 1/3 hospital patients wash their hands after using the toilet.  Remember 1/2 of hospital patients are on antibiotics at any given time.  Not hard to see why antibiotic resistance has developed in hospitals.

6.  EBOV waste should stay in the ‘hot area’; autoclaved or otherwise sterilized with DEDICATED autoclave or sterilizer; no shared autoclave or sterilizer.

See: https://col128.mail.live.com/?tid=cmOftTEDxg5BGSeQAiZMHTgA2&fid=flinbox for full stories on these highlights.

7.  Becker’s reports that a gut Clostridium strain named C. scindens produces resistance to C. difficile.  See:  http://www.nature.com/nature/journal/vaop/ncurrent/full/nature13828.html#affil-auth in Nature.

RGL, MD

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Posted October 30, 2014 by levittrg in HAI

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