Category: Photodisinfection

5 Ways to Protect Yourself from MRSA

Protect yourself at all times

As we discussed last week, Canada’s Chief Public Health Officer recently reported a 1,000% rise in Healthcare-Associated MRSA in Canada. And earlier in the year, researchers at Toronto’s Sunnybrook Hospital told us that 1 in 12 adults in Canadian hospitals are either colonized or infected with MRSA, VRE (vancomycin-resistant enterococci) , or C. difficile (Clostridium difficile) . MRSA was the major offender because 67% of the patients who tested positive were positive for it.

Infectious disease experts agree that the single most important thing healthcare workers can do to prevent the transmission of MRSA and other pathogens is to wash their hands before and after seeing patients. The problem, however, as we reported last month, is that healthcare workers aren’t doing that, with doctors being the biggest offenders with compliance somewhere between 0 and 50%.

So if healthcare workers won’t do what they should, then it falls on the patient to do what they can to protect themselves. A number of experts recently offered the following suggestions:

1. Know What to Look For

In general, fevers, if they’re accompanied by shaking chills, if they’re getting worse instead of better, that would suggest there’s a bacterial process. With community-acquired MRSA, many people first notice a skin infection or boil that becomes larger and more painful. But if you do suspect such an infection, don’t rush to the emergency room, where you might be exposed to other bugs or infect others. Call your primary-care doctor first for advice.

2. Get a Flu Shot

When people get influenza, they actually become at higher risk as they recover for complicating bacterial infections. This is because people with weakened immune systems are more vulnerable to other bugs.

3. Ask Whether You Need that Antibiotic

Don’t assume you need one — antibiotics don’t work on viral infections like colds or the flu. If your doctor does recommend one, ask whether you really need it. Using antibiotics does kill off non-resistant bacteria in your body and makes you likely to acquire antibiotic-resistant bacteria – like MRSA – in their place.

4. Ask Your Doctors to Wash Their Hands

It is every patient’s right to have every health-care provider entering the room to have clean hands.   They’re supposed to do it, they are mandated for 100 percent hand- hygiene compliance, but the reality is it doesn’t happen. And that’s where the burden falls on the patient to make sure they do.

5. Advocate for Loved Ones in the Hospital

One of the ways drug-resistant bacteria spreads in hospital is through tubes inserted in the body, such as catheters. If someone you care about is on such a device, don’t be afraid to ask doctors whether they still need it, and when the tubes can come out. Every day that decision needs to be made: Do these things need to stay in or do they need to come out?  The key, is empowering patients or their advocates to stand up for their health-care needs.

HOTEL MRSA

About two weeks ago CBC’s current affairs program Marketplace aired The Dirt on Hotelswhere it investigated the prevalence of germs in six of Canada’s largest hotel chains. They went on a bacteria hunt and discovered not just bacteria, but the more troublesome antibiotic resistant bacteria, in every hotel chain they went to. MRSA, in particular, was found growing on a faucet in Toronto’s upscale Royal York Hotel, and on telephones, counter-tops, and bed comforters in the other hotels.

Erica Johnson, the CBC reporter who investigated this, says she has  resorted to self-help when she travels. She brings alcohol wipes with her and uses them on hotel room surfaces where her investigation revealed superbugs are most commonly found: on door handles, light switches, taps, the phone, clock radio, and the toilet seat. She puts a towel down for her toiletries, brings her own cup instead of using a hotel glass, and for the biggest offender – the tv remote, she puts it in a plastic bag and uses it that way!

What this investigation uncovered is but one example of what the US Centers for Disease Control and Prevention just published in their report Antibiotic Resistant Threats in the United States, 2013.  This first-ever assessment of the threat the country faces from antibiotic-resistant organisms contained the following warnings about MRSA’s impact on human health:

  1. Of the 23,000 people who die each year as a direct result of antibiotic resistant infections, MRSA is responsible for almost half of the deaths (11,285  = 49% ).
  2. The CDC rates the threat level posed to us by MRSA as “serious.” They conclude “This bacteria is a serious concern and requires prompt and sustained action to ensure the problem does not grow.”
  3. During the past decade, rates of MRSA infections have increased rapidly among the general population.
  4. While antibiotic-resistant infections can happen anywhere, most deaths related to antibiotic resistance happen in healthcare settings such as hospitals and nursing homes.
  5. Staph bacteria, including MRSA, are one of the most common causes of healthcare-associated infections.

The CDC emphasized that their numbers of infection and death are purposefully conservative. So for example, by way of contrast, the Journal of the American Medical Association reported in 2007 that 18,650 deaths each year in the US are associated with 94,360 invasive MRSA infections.

This is why, for example, the American Academy of Orthopedic Surgeons describe  MRSA as a “silent epidemic.”

How does Photodisinfection Work?

Photodisinfection is a topical, non-antibiotic antimicrobial therapy that destroys a broad spectrum of pathogens including fungi, bacteria and virus without damaging human tissue. Unlike antibiotics, Photodisinfection selectively kills virulence factors such as the endotoxins and exotoxins produced by pathogens, leading to a clinically observable anti-inflammatory effect. The treatment process takes only minutes, making it over 1,000 times more effective at biofilm killing than antibiotics.

Photodisinfection is a minimally invasive non-thermal therapy involving the light activation of a photosensitizer to eliminate topical infections in a highly targeted approach. Photodisinfection has been proven to be safe and effective in other applications such as for the dental, sinusitis and hospital acquired infection prevention markets. In dentistry, Photodisinfection has been proven to be highly effective for the treatment of caries, endodontics, restorative dentistry, periodontitis, peri-implantitis and halitosis. Many new applications of Photodisinfection are now under development.

The Photodisinfection Process: Instant Antimicrobial Therapy

Apply Photosensitizer to Infection Site & Illuminate with Appropriate Wavelength for Several Minutes

A photosensitizing solution is applied to the treatment site where the photosensitizer molecules preferentially bind to the targeted microbes.  The photosensitizer molecules are inactive at this stage.  A light of a specific wavelength and intensity illuminates the treatment site and a photocatalytic reaction occurs.  The wavelength is carefully chosen to maximize absorption of light energy by the photosensitizer.

This 2 step procedure results in the destruction of the targeted microbes and their virulence factors without damaging host cells.  This reaction involves the formation of short-lived, highly reactive free-radical oxygen species.  These radicals cause a physical disruption of the microbial cell membrane through oxidative reactions, resulting in immediate rupture and destruction of the cell.  This process occurs in seconds with total kills completed in minutes.

The Photodisinfection process has also been shown to eliminate a multitude of virulence factors, unlike antibiotics. When the light isremoved, the photocatalytic reaction ceases along with all antimicrobial action. Photodisinfection does not promote the development of resistance.

The Photodisinfection process is both pain-free and stress-free due to lack of side-effects or damage to human tissue.

Source: Eastman Dental Institute, UK

Nelson Mandela- In Critical Condition Suffering from Lung Infection

Our heart goes out to the family of Nelson Mandela and to the people of South Africa.  While prayers and well wishes flood in from around the world, we would like to add our own in the hopes that good intentions and earnest positive thoughts can make a difference to this special man in such critical condition.

http://bclc.uschamber.com/sites/default/files/Nelson_Mandela,_2000_(5).jpg

At a time like this, we are reminded that Nelson Mandela was an inspirational leader and remains a true international treasure.  His guiding principals were way ahead of his time.  I cannot of think of the Mandela legacy without immediately thinking of the backdrop of the severe human rights abuses currently raging in the Middle East and around the world. The world needs more Mandela’s, not one less. I will pray hard tonight.

Ondine CEO to Represent Photodisinfection at the World Congress of the IPA in Seoul, Korea

The World Congress of the International Photodynamic Association (IPA) is a biannual conference highlighting the advances in scientific and clinical research around the world. This year’s Congress is being held May 28th to May 31st, 2013 at the Ritz-Carlton Hotel, Seoul, Republic of Korea.  All of the leaders in the field of PDT and their work will be represented during this event. Clinicians, scientists, researchers, hospital administrators, and students are welcome to participate at this year’s conference. Registration details are available here.

About the International Photodynamic Association

The IPA was founded in 1986 and its membership consists of the most prominent international clinicians and scientists involved in performing and researching photodynamic therapy (PDT) and photodiagnosis (PD). The purpose of the IPA is to promote the study of diagnosis and treatment using light and photosensitisers, to disseminate such information to the members of the IPA, the medical community and to the general public.

The IPA organizes an International Congress every two years which is a unique opportunity to sum up research activities in the clinical and basic research aspects of PDT. The IPA Secretary General is Dr Alison Curnow, Peninsula Medical School. Inquiries, comments and contributions can be sent to ipa@pms.ac.uk. To become a member, visit our webpage here to register.

Ondine Biomedical CEO Carolyn Cross has been selected to be a Plenary Speaker at this conference. She has been noted for translating research from the labs into usable products for patients. There are twelve Plenary Speakers representing countries and research facilities from across the world, Carolyn being one of the two Canadian plenary speakers. We look forward to hearing what she and the other speakers have to say about the latest advances in photodynamics!

Ventilator Acquired Pneumonia: A Large Problem for Hospitals

Although hospitals are centers of refuge for those who need care, an unfortunate reality is that the number of people coming in and leaving these facilities inevitably results with the spread of disease and infections between patients, doctors, and other health care workers. These unintentionally transmitted diseases, born in hospital settings, are collectively known as Hospital Acquired Infections (nosocomial infections in medical literature). This class of disease results in over  99,000 deaths each year in the United States alone.

One significant form of nosocomial infection is Ventilator Acquired Pneumonia (VAP) which, as the name suggests, is pneumonia (an inflammatory condition of the lung) transmitted to patients while they are on mechanical ventilator breathing support. The incidence of this disease is between 8% and 20%, and mortality rates are between 20% and 50%. As a result, VAP has a critical impact on morbidity, length of stay, and cost of ICU care.

A significant contributor to such high rates of incidence and morbidity is the fact that patients on mechanical ventilation systems are often sedated and are rarely able to communicate or cough up the biofilm that grows in the tubes and drains down into the lungs. Typical symptoms of pneumonia may be absent or unobservable, leading to delays in detection and therefore treatment.  Under these conditions, the medical signs that a patient has acquired pneumonia are increased number of white blood cells on blood testing and new shadows (infiltrates) on chest x-rays. Other important signs are fever, low body temperature, purulent sputum, and hypoxemia (decreasing amount of oxygen in the blood).

If any of these symptoms are suspected by care takers, two conventional methods of diagnosis are deployed. The first is to collect cultures from the trachea while also scanning the chest with an x-ray to detect new or enlarging infiltrates. The other method is more invasive and involves a bronchoalveolar (where fluid is squired out small areas of the lung and recollected for examination), as well as a chest x ray.

Treatment regimens depend on the specific bacteria causing the inflammation, although a widely used first step is the prescription of empiric therapy (broad spectrum antibiotics) until the particular bacterium and its sensitivities are determined. Once the specific microorganisms implicated in generating pneumonia are known, more antibiotics are prescribed. The use of antibiotics raises the issue of resistance from the bacteria, and the related decrease of efficacy of the antibiotic in the years to come.

Photodisinfection is a non antibiotic approach under development by the research and development teams at Ondine Biomedical Inc., for the decolonization of the tubes of long term intubated patients. Pre-clinical studies have demonstrated proven effects of Photodisinfection directed toward the inner surface of the endotracheal tubes. The Exelume™ Photodisinfection system is currently being tested in NIH funded clinical trials in the US. Other Photodisinfection applications under development by Ondine include:  periodontitis, chronic sinusitis, burns & wounds, UTI, vertical transmission of HIV, nasal decolonization to reduce SSI, GI infection protection, etc.

Food For Thought: Antibiotic Resistance Generated in Food Production

The expression “food for thought” is often used proverbially more than literally, although results from FDA reports make it necessary to consider how our food and livestock are processed and put serious thought into the food we eat. To make the case immediately apparent, consider that four fifths of all antibiotic consumption in the USA is not human consumption; it’s consumed by farm animals. To quantify this statement, in 2011, 7.7 million pounds of antibiotics were consumed by American people, while 29.9 million pounds went into meat and poultry production.

Ondine

Antibiotics Sold to Livestock Industry vs. Sold for Human Consumption.

The proportion of antibiotics fed to livestock is not a recent issue, it has been growing and the problems that arise from it have accumulated for over 50 years. An alarming development of bacteria that had grown drug resistant due to antibiotics in the livestock industry is MRSA (short for methicillin-resistant Staphylococcus aureus) which is a persistent threat to human health. Estimates indicate that MRSA kills 19,000 Americans each year, hospitalizes 370,000, and results in billions of dollars of additional health care spending. The intent of these statistics is not to frighten, but to raise awareness concerning administering millions of pounds of antibiotics annually to artificially boost animal growth. Maryn McKenna wrote a book chronicling the rise and danger of these superbugs (http://superbugthebook.com/).

What is important to note is that a vast majority of the provided antibiotics is not to target infections or better animal health. It is administered at a herd or flock wide basis through the animals water source or feed to promote growth and weight gain, as well as to preventatively help livestock survive harsh farm and living conditions. This is one reason why antibiotics are used, another is for therapy. Therapy is used when farm animals exhibit clinical diseases, and drugs can be an effective way to prevent catastrophic health risks that could be detrimental to the agricultural sector.

Administering antibiotics to animals is not an inherently bad thing to do, although it can become detrimental if done without caution and concern. The FDA’s report on the application of antimicrobial drugs in industry warns that “the development of resistance to this important class of drugs, and the resulting loss of their effectiveness as antimicrobial therapies, poses a serious public health threat”. In this article, the main point is not to suggest entirely eliminating antibiotic consumption in the livestock industry, but to manage it judiciously by targeting specific diseases. Another significant argument is that farmers and food corporations should “voluntarily” withdraw from using drugs which have a functional similarity to drugs used in humans, since this would reduce the concern for transmitting resistive bacteria on to humans through our food. Use of antibiotics for livestock growth promotion has been banned by many European countries, as they have determined that similar investment in more food resulted in the same growth yields without the additional antibiotic resistance generation.

It is evident that we can no longer take how our food is produced for granted. The expression food for thought is no longer some overused metaphor, it is a reality.

Photodisinfection Kills MRSA Superbug Quickly and Safely

It is fair to say there are no microorganisms that cannot be killed by PDT (photodisinfection). It is a relatively non-specific formation of reactive oxidant species which, by and large, will kill anything. The way to optimize is to target the {‘photosensitizer’} to the species you want to kill – Richard Hamblin, Harvard Medical School.

One important application of photodisinfection is “nasal decolonization”, the elimination of all or almost all of the MRSA (Methicillin-resistant Staphylococcus aureus , one of the superbugs) that thrive inside of the nose. This is an important application because a number of studies have demonstrated that removing the harmful bacteria in the nose (called ‘decolonization’) results in a significantly lower incidence of surgical site infections. Patients who are colonized with bacteria are at risk of self contamination after surgeries when their bodies are weakened. By reducing all or substantially all of the harmful bugs in the nose prior to surgery, fewer patients will die and fewer patients will become infected with resistant and susceptible forms of staphylococcus (‘Staph’).

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Study Shows Increased Effectiveness Of Light-Activated Antimicrobial Agents Against MRSA

Many bacteria capable of causing life-threatening infections are now resistant to a wide range of antibiotics.  It is essential, therefore, that alternatives to antibiotics are developed for use in the prevention and treatment of such infections. Light-activated antimicrobial agents (LAAAs) are one possible new approach to this problem. LAAAs are compounds that display no antimicrobial activity in the dark but, when exposed to light of a certain wavelength, can kill microbes in the vicinity.  One of the essential attributes of any antimicrobial agent, including a LAAA, is that it be effective at low concentrations so as to reduce the risks of any toxicity to the patient.

The new LAAAs as seen through a very powerful electron microscope. The diameter of each particle is approximately 0.000000005 metre.

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The Three Myths About Photodisinfection

I’ve talked before about how photodisinfection works, but I want to take a moment to clarify what I think are the three most common myths about the technology we’re working on here at Ondine.

It’s Not That New

Our products are often met with scepticism because people are unfamiliar with photodisinfection as a treatment, or even as a science.  Truth be told, photodisinfection has existed for over 100 years[i], and the research behind it has a solid foundation in the literature extending back well over 20 years.  Check out this short reference list if you don’t believe me. So why, with all this research, is photodisinfection only creeping into the marketplace now?  The simple answer is that, until Ondine, most companies have been a little hesitant to put the work in to make it a success.  Photodisinfection requires a lot from a company: an engineering team for a light source, a microbiology team for the preclinical tests, a chemistry team for the careful formulation of the photosensitizer and a regulatory team to get the product cleared for use in trials and approved clinical use.  When you add in quality control, finance, administration, and sales and marketing, you can see the inherent challenges facing a company. You can trust me that the science is there (and growing), and Ondine has proven that it has what it takes to make these products a reality.

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