Too much of a good thing?

A hospital in the UK is removing alcohol gel dispensers at entrances to the building because of instances of homeless persons drinking the gel. The article reports that two deaths in London have been attributed to this. Gel dispensers will remain in other parts of the hospital.

New MRSA bill in Congress

The MRSA Infection Prevention and Patient Protection Act was recently introduced into both the US House of Representatives and Senate. The bill mandates testing for MRSA on admission and discharge from the ICU and other high risk units. We can only hope that CDC is able to influence the lawmakers by bringing MRSA into perspective. If not, the winners will be the companies who make the MRSA testing products. The losers will be hospital infection control programs, which are already overworked and underresourced, and the patients these programs serve.

More on clothing and infection control

Today's Cleveland Plain Dealer has an article on public reaction to a photo that recently appeared in the paper. The photo showed two women in scrubs and hair covers at a farmers market. I suspect that a few years ago the photo would have attracted little attention, but some readers were concerned that produce could become contaminated by hospital pathogens and others were concerned about carriage of organisms into the hospital. Both are low probability events, but the importance of this article is the public's awareness of hospital acquired infections.

Religion vs. infection control, part 2

Last month I blogged about a phlebotomist in the UK who was facing disciplinary action because she wore a crucifix while working. Today, British newspapers are reporting that she has resigned her position because she refused to comply with an order to remove it. She reports that she wore it under her clothes. If this is true, the claim that the crucifix represents an infection control risk is baseless, and such heavy handed treatment only serves to undermines infection control efforts.

WSJ Health Blog Goofs!

The Wall Street Journal Health Blog has now corrected its previous post on the AMA House of Delegates voting in favor of a ban on white coats. The official AMA response (on p. 15 of this document) was to refer the resolution to another committee for further study. As I stated in a previous posting, it would have been surprising for the AMA to pass the resolution given the AMA's generally conservative approach, coupled with the iconic status of the white coat for the profession. Nonetheless, I still believe it makes sense to hang up those germ-laden coats for good.

Wear a mask when performing lumbar punctures!

An Ohio newspaper reports that two women developed meningitis recently due to Streptococcus salivarius after undergoing spinal anesthesia by the same anesthesiologist. It was noted that the anesthesiologist did not wear a mask during the procedures. One of the women died. Such cases have been increasingly recognized over the last several years, and occur when the saliva of a healthcare worker performing a lumbar puncture for diagnostic or therapeutic purposes contaminates the spinal needle which is in direct communication with the CSF. This can easily occur if the operator is talking when performing the procedure. For this reason, CDC specifically recommended that masks be worn during such procedures in its latest guideline on isolation precautions (p. 69 of this document).

Potential new option for treating C. difficile

A small case series in Clinical Infectious Diseases describes four patients with severe refractory Clostridium difficile infection successfully treated with IV tigecycline. Three of the patients had failed standard therapy with metronidazole and vancomycin. This is potentially important given the rising incidence in C. difficile. Unfortunately, my experience with this antibiotic for other indications has been poor since most of my patients could not tolerate the severe nausea it causes.