Posts tagged: HAI

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.

Two-Time Cancer Survivor Fights Off Deadly MRSA Infection

In April 2003, while the budding and blossoming of new life surrounded the springtime air, Sally would soon be left fighting for her life. Sally, a two-time cancer survivor, was sent to the hospital to undergo reconstructive surgery on her breasts. After a few hard years of treatment for breast cancer, Sally was fortunate to have won the battle against cancer and hoped to put her struggles behind her.

The surgery was a success, but as with any surgical procedure, nothing could have prepared Sally for the pain she was about to endure. Numerous stitches held Sally’s incisions together. She was told not to move without assistance from medical personnel. One nurse entered Sally’s room to turn her and make her more comfortable, but this required further medical staff. While Sally was waiting for the medical staff to arrive, she took the initiative to attempt to turn over on her own. This caused several stitches to detach from the incision, which slowed down the healing process.

Sally subsequently developed severe, swollen blotches on her body. Such manifestations caused her more pain than the actual incisions from the procedure. Her incisions soon became infected as well, although Sally’s doctor neglected to disclose the type of infection she had acquired. According to Sally, the doctor assumed the infection was MRSA. Methicillin-resistant Staphylococcus aureus, or MRSA, is a superbug that does not get better with first-line antibiotic treatments, thus considered “resistant.”

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Healthcare-Associated Infections: Overabundant and Underreported

It’s hard to turn on the news without hearing something about new advances in cancer research, or a recent car accident that has claimed the life of an innocent victim. While these examples are serious and noteworthy issues that deserve media attention. Healthcare-associated infections (HAIs) are the reason why approximately 99,000 people die annually in the United States alone, yet this issue receives little media attention compared to other diseases and events. As the ability to control and prevent such infections increases, the occurrence of HAIs becomes more and more unacceptable.
HAIs are a major problem, causing nearly 1.7 million infections annually and up to $45 billion in additional costs in the US healthcare system alone. Emotionally and financially devastating to those involved, the majority of such infections are preventable. While progress has been made recently to combat such infections, more general awareness needs to be raised in order for patients and their families to understand the risks they face while receiving healthcare, and what can be done to protect those at risk.

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The Growing Temptation to Underreport Healthcare-associated Infections

Over the past decade, there has been much written about the rise of antibiotic resistant pathogens and the growing numbers of serious healthcare-associated infections. Some statistics have put the total cost of healthcare-associated infections at around $35-$45 billion dollars1. Infections associated with MRSA have been estimated to cost about $3-$4 billion2 and ventilator-associated pneumonia costs another $3 billion3. The truth is that we really do not know the extent of the problem or the associated costs, and this in itself is a problem. Whatever the number, we can all agree that the costs of healthcare-associated infections are an enormous drain on the economy, and this is prior to factoring in any of the socio-economic multiplier effects of HAIs due to death, loss of employment, impact on families/companies etc.

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Ondine Study Shows Reduction of Endotracheal Tube Biofilm Using Photodisinfection

Ventilator-associated pneumonia is one of the most common and deadliest forms of healthcare-associated infections.  In the U.S alone, more than one million patients in healthcare facilities require mechanical ventilation every year. Up to 1 in 4 of these patients are reported to develop ventilator-associated pneumonia and up to half of them will die.1

Antimicrobial photodynamic therapy (aPDT), commonly known as Photodisinfection, is a non-invasive technique that used to study the reduction of biofilm in the lumen of an endotracheal tube. When patients undergo mechanical ventilation, an endotracheal tube is inserted into their throat to assist with breathing. This tube has long been recognized as a major factor in a patient’s risk for developing biofilm infections. For patients that require mechanical ventilation, such as those in ICUs, the biofilm can dislodge from the endotracheal tube and enter the lungs directly, often resulting in difficult-to-treat pneumonia.

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New Application of Photodynamic Disinfection to be Funded by UK’s Medical Research Council: Catheter-Associated Infection Prevention

Today we announced a significant new opportunity for both our company and for the Photodynamic Therapy (PDT) world. By awarding our groups a £ 1 million award to develop PDT based products to prevent catheter associated infections, the UK Government has validated the need for solutions as well as endorsed the potential of Photodynamic Therapy in this role.

Together with a team of multi-disciplined experts at University College London (UCL), Ondine will collaborate on an important new initiative which leverages our combined 30 plus years of history in photodynamics to develop a new major class of medical devices based on Photodynamic disinfection. The new class of products will address the multi-billion dollar issue of catheter-associated infections, firmly placing Ondine as a leading supplier of innovative non-antibiotic products addressing  the $35-$45 billion per year healthcare-associated infection (HAI) market1. Urinary tract infections (UTIs) are considered to be the largest source of HAIs, representing about 30% of all reported cases, with catheter-associated UTIs representing 75% of this number. Read more »

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