antibiotic use often due to misdiagnosis
Misdiagnosis often leads to improper antibiotic use in hospitals, new
research finds. Incorrect antibiotic use can cause patient harm, reduce the
effectiveness of antibiotics and increase healthcare costs, the researchers
"Antibiotic therapies are used for approximately 56 percent of inpatients in
U.S. hospitals, but are found to be inappropriate in nearly half of these
cases, and many of these failures are connected with inaccurate diagnoses,"
study author Dr. Greg Filice said in a news release from the Society for
Healthcare Epidemiology of America.
Filice, an internist with the Minneapolis Veterans Affairs Health Care
System, and his colleagues analyzed 500 inpatient cases at the Minneapolis
VA Medical Center. They found that inappropriate use of antibiotics occurred
with 95 percent of patients who received an incorrect or indeterminate
diagnosis, or those with an identified symptom but no diagnosis.
By comparison, incorrect use of antibiotics occurred in 38 percent of
patients who received a correct diagnosis. Overall, only 58 percent of
patients received a correct diagnosis, researchers found. The most common
misdiagnoses were pneumonia, cystitis, urinary tract infections, kidney
infections and urosepsis (when an infection starts in the urinary tract and
spreads to the bloodstream).
The findings suggest that programs overseeing antibiotic use in hospitals
would be more effective if designed to help providers make accurate initial
diagnoses and to know when antibiotics can be safely withheld, Filice said.
The researchers said relying on intuition rather than proper analysis
contributed to incorrect diagnoses and inappropriate use of antibiotics at
hospitals. Other contributing factors on the part of staff: fatigue, sleep
deprivation, mental overload, dealing with patients with a previous
diagnosis from another healthcare provider, lack of clinical experience, and
lack of experience with drug side effects.
The study was published online May 18 in Infection Control & Hospital
Epidemiology, the journal of the Society for Healthcare Epidemiology of
Visit NIH for the study.
genetically 'barcode' tens of thousands of cells at once, potentially
unlocking secrets of disease
If someone handed you a smoothie and asked you to determine every ingredient
that went into it the feat would be difficult because all of the ingredients
would be combined to create on flavor, Harvard Medical School reported. To
continue the example (in a bit of a gross way), imagine the smoothie was
made up of 20,000 ground up brain cells. Tests could be run to determine
what cells were present in the smoothie, but their origins would be more
difficult to determine, leaving you with only a general cell profile of the
sample. A similar scenario is true for human tissue because he cell averages
of these samples don't paint the whole picture.â€¨
"If you take a hunk of tissue and grind it up and analyze the RNA, you have
no idea if it represents what every cell in that population is doing or what
no cell in the population is doing," said Marc Kirschner, the John Franklin
Enders University Professor of Systems Biology and chair of the Department
of Systems Biology at Harvard Medical School. "Imagine if you had a
population of men and women. If you assume everyone is an average of men and
women, you [probably] wouldn't represent a single person in that
These tissues now must be characterized cell-by-cell, or at least by cell
type, which is time consuming and often costly. To remedy this, scientists
have developed high-throughput techniques that give each cell an
individualized "genetic barcode," this allows them to analyze complex tissue
by profiling each cell instead of averaging the entire population.â€¨
The researchers hope these new innovations will allow researchers to
discover new cell types, and even create maps of cell diversity in tissues
like the brain, leading to a better understanding of genetic disease.
The findings were published in a recent edition of the journal Cell. â€¨
Visit Harvard for the study.
reports on antibiotic resistance
Many of the world's diseases are caused by microorganisms such as bacteria,
fungi, viruses, and parasites. While there are a number of drugs designed to
treat these infections, resistant strains are emerging at a rate that is
currently outpacing the development of effective new drugs. Methicillin-resistant
Staphylococcus aureus (MRSA) alone kills more than 19,000 Americans
every year--more than emphysema, HIV/AIDS, Parkinson's disease, and homicide
combined. Despite this public health need, pharmaceutical companies do not
have strong economic incentives to develop new antibiotic drugs.
Unless new drugs are developed--together with measures taken to slow the
emergence of new drug-resistant microbes--previously treatable infections
will become major public health concerns, posing grave threats to infected
individuals and increasing the risk of spreading to others. In recent years,
several global and national public health organizations have highlighted the
growing number of multidrug-resistant microbes as a major public health
The commonly used term "antimicrobial resistance" applies to any
microbe--bacteria, fungus, or virus--against which drugs have declining,
limited, or zero effectiveness. This policy brief primarily focuses on the
diminishing effectiveness of many drugs specifically in fighting bacteria,
referred to here as "antibiotic resistance."
With so many agencies involved in the regulation and use of antibiotics,
comprehensive solutions must focus on creating a coordinated plan that
touches on aspects of research and development as well as enhanced infection
prevention and control, and stewardship to ensure the proper use of these
drugs across different settings.
This brief provides an overview of antibiotic resistance, including a
summary of its current impact, the factors that contribute to its spread,
and the policy recommendations put in place by federal and global public
health agencies. It also reviews the debate around the regulation of
antibiotic use in agriculture and examines new developments in policy and
research associated with multidrug-resistant bacterial diseases and their
There are several potential directions for new antimicrobial drug research
and development. Better diagnostic tools could affect the way antibiotic
resistance is detected, diagnosed, and reported. More rapid tests could help
to prevent overprescription of antibiotics and assist with global
surveillance measures already emerging as a result of policy goals.
There are also potential developments for new drugs. Researchers at
Northeastern University recently published a paper in Nature about a
potential new antibiotic called teixobactin that targets polymers that build
the bacterial cell wall. The drug's pathway--examined in mice but not yet in
humans--is similar to vancomycin, another antibiotic often used as a
last-resort treatment for resistant strains of bacteria such as MRSA. In
their paper, the researchers highlighted how the technology used for this
discovery might help lead to additional drug discoveries.
While it is tempting to assume that a potential new human antibiotic means
that the pharmaceutical industry's interest in developing new antibacterial
drugs will spring back into gear, it's important to consider that the
failure rate for antibiotics from early discovery stage to actual drug
approval is 97 percent. In general, new antibiotics are less profitable
compared to other types of drugs, as their use is tightly controlled by
hospitals trying to prevent the emergence of new resistant strains, and yet
drug companies are not able to compensate for slow adoption by charging more
because they'd have to compete with inexpensive generic antibiotics. In
2011, for example, Pfizer, one of the few drug companies to work on
developing new antibiotics, closed its research lab in Connecticut.
For healthcare facilities, life science researchers, federal agencies, and
local health officials to meet many of the specific goals outlined in the
Obama administration's recent National Action Plan, they will require
additional resources. To that end, President Obama's fiscal year 2016 budget
proposes to nearly double the amount of federal funding for combating and
preventing antibiotic resistance to more than $1.2 billion. Congress,
however, is unlikely to support and enact the president's full budget
Visit Health Affairs for the full report.
standards document available on website
Healthcare Laundry Accreditation Council (HLAC) document, "Accreditation
Standards for Processing Reusable Textiles for Use in Healthcare Facilities
- 2016 Edition," is now available for viewing and downloading at
www.hlacnet.org. The new Standards go into effect January 1, 2016.
The 60+ page document comes after a lengthy and thorough review by HLAC's
board of directors and public comment from professionals who serve the
healthcare industry or use or process healthcare textiles, according to HLAC
board president Gregory Gicewicz.
"With the 2016 revision, HLAC continues to promote a heightened awareness
and increased understanding of the infection prevention and safety culture
among healthcare laundry personnel," Gicewicz said.
The newly revised Standards document recently received the Association of
periOperative Registered Nurses (AORN) AORN Seal of Recognition. The AORN
Seal of Recognition confirms that the content of the document has undergone
thorough review by AORN and meets the guidelines of the "AORN Perioperative
Standards and Recommended Practices."
The HLAC Accreditation Standards are established as the minimum acceptable
practice for the preparation of hygienically clean, reusable healthcare
textiles for patient care, implemented and executed by accredited laundry
facilities processing reusable healthcare textiles. The document covers the
complete textile processing cycle: from handling and transporting to
laundering and finishing to customer service. Special attention has been
directed to laundry processes directly related to patient safety and OSHA
required practices, including Bloodborne Pathogen Exposure Control
Visit HLAC for the new standards.
linked to risk of liver disease death, study shows
Suffering from anxiety or depression could carry an increased risk of death
from liver disease, a study suggests. The study is the first to identify a
possible link between high levels of psychological distress and deaths
resulting from a variety of liver diseases.
Reasons for this are unclear as the biological links between psychological
distress and liver disease are not well understood, researchers say.
Previous research suggests mental distress can put people at increased risk
of cardiovascular disease. At the same time, risk factors for cardiovascular
disease - such as obesity and raised blood pressure - have been linked to a
common form of liver disease, known as non-alcoholic fatty liver disease.
In a similar way, suffering from anxiety and depression may be indirectly
linked to an increased risk of death from liver disease, the team says.
Dr Tom Russ, of the University of Edinburgh's Centre for Clinical Brain
Sciences, who led the research, said: "This study provides further evidence
for the important links between mind and body, and of the damaging effects
psychological distress can have on physical wellbeing. While we are not able
to confirm direct cause and effect, this study does provide evidence that
requires further consideration in future studies."
Adapted by MNT from original media release.
Men should be
screened for osteoporosis, too
Men are far less likely than women to be screened for osteoporosis, even
though they are more likely to suffer worse consequences from the
bone-thinning condition, a new study finds.
Up to 2 million American men have osteoporosis, and another 8 million to 13
million men have low bone density, a precursor to osteoporosis, the
While most women in the study said they would accept osteoporosis screening
if it was offered, only 25 percent of men said they would get screened.
Women were also over four times more likely than men to take measures to
prevent osteoporosis, such as taking calcium and vitamin D supplements to
strengthen their bones.
"We were surprised at how big a difference we found between men and women
regarding osteoporosis," study author Dr. Irina Dashkova, a geriatric fellow
at North Shore-LIJ Health System in New Hyde Park, NY, said in a health
system news release.
"The fact that longevity is increasing in our population is wonderful. But
we know from research that when men suffer fractures, their mortality is
higher than in women and that severe medical consequences and loss of
independence are much more prevalent in men," she said.
"In our environment, you just get this perception that osteoporosis is a
women's problem. This has to be changed, and the sooner the better,"
Dashkova said in the news release.
The findings were to be presented Friday at the American Geriatrics Society
annual meeting in Washington, D.C. Research presented at medical meetings
should be viewed as preliminary until published in a peer-reviewed journal.
More than 10 million Americans have osteoporosis, and another 43 million
have low bone density, according to the National Osteoporosis Foundation.
Research suggests that 13 percent of white American men older than 50 will
have at least one osteoporosis-related fracture in their lifetime.
Certain health problems and drugs that boost osteoporosis risk are specific
to men, including some prostate cancer drugs, the researchers pointed out.
Dr. Gisele Wolf-Klein, program director for the geriatric fellowship at
North Shore-LIJ, was a mentoring author and collaborated with Dashkova on
the research. "Our survey clearly establishes that physicians are just not
thinking of screening men. It's only when older men fall and break their hip
that someone thinks maybe we should do something to prevent them breaking
the other hip," Wolf-Klein said in the news release.
Visit Web MD for the report.
look for permanent end to Ebola virus
The U.S. Army Edgewood Chemical Biological Center, or ECBC, and the U.S.
Army Medical Research Institute of Infectious Diseases, or USAMRIID, are
partnering to help expedite progress in the global fight against Ebola.
ECBC is working with USAMRIID on two critical studies - a vaccine study and
a biomarker study - that will advance the global fight against Ebola. This
disease has a high death rate - to date, there have been 22,000 cases and
9,000 deaths attributed to the most recent outbreak - with no known cure or
effective vaccine. ECBC and USAMRIID are trying to change that.
USAMRIID, the Department of Defense's lead laboratory for medical biological
defense research, called upon the ECBC-US Army Medical Research Institute of
Chemical Defense Mass Spectrometry Core Facility to assist with two of its
ongoing Ebola research programs - characterizing a potential vaccine and
identifying biomarkers of infection.
For the vaccine work, ECBC is analyzing several different vaccine
preparations provided by USAMRIID to quantify VP40 and glycoprotein
concentrations expressed in virus-like particles generated from Ebola
(strains Zaire and Sudan). The aim is to monitor quality control of the
vaccine production process and to determine if a correlation can be made
between protective immunity and the amount of Ebola-specific structural
proteins, GP and VP40, that are present. This type of research is
foundational in creating a long-term solution to a devastating disease.
"Our role was to blindly and independently quantitate the amount of protein
present in each vaccine combination. With this information, we hope to
better understand the varying degrees of protection observed during the
vaccine study," said Trevor Glaros, an ECBC mass spectrometry core facility
manager leading the ECBC/USAMRIID Ebola collaboration.
In addition to vaccine research, ECBC is also supporting USAMRIID to
discover Ebola-specific biomarkers in serum. The scientists will analyze
Ebola-infected serum to discover a protein-based panel of biomarkers.
"The hope is that this panel of biomarkers will constitute a unique
fingerprint for Ebola infection, which can be used to diagnose patients
before symptoms develop," stated Lisa Cazares, the USAMRIID researcher
leading the project. A tool like this would give first responders the
ability to administer the appropriate care and the unprecedented ability to
track the disease outbreak in real time. Biological analysis of this scope
required additional instrumentation, which ECBC was able to secure from its
partner, Thermo Fisher Scientific.
Thermo Fisher Scientific generously loaned ECBC a complete Q Exactive Plus
mass spectrometry system with a Dynex nanoflow liquid chromatography pump
and autosampler. This new equipment relieves the burden on existing
instrumentation and, given its technological advancements, allows for a more
rapid and thorough analysis.
Visit the U.S. Army for the report.
bolster hospital, medical research
A stretch of the Upper East Side of Manhattan will be transformed into even
more of an international hub for hospitals and medical research with a total
of $250 million in separate donations from the industrialist David H.
Koch and the financier Henry R. Kravis and his wife, Marie-JosÃ©e Kravis.
Memorial Sloan Kettering Cancer Center will announce a $150 million gift
from Koch, the billionaire executive vice president of Wichita, KS, based
Koch Industries. His donation will fund the construction of a $1.3 billion,
750,000-square-foot, 23-story outpatient cancer center to be built on East
74th Street and FDR Drive. The center, which will be named for Koch, is
expected to serve some 1,300 patients daily.
Also, Rockefeller University plans to announce a $100 million gift from the
Kravis foundation to build a laboratory research building that will be the
centerpiece of a 2-acre campus extension over FDR Drive from East 64th to
East 68th. That building, which is to be named for the couple, will be two
stories high and span three city blocks.
Though Koch, 75 years old, has given away some $1.3 billion to charity, the
gift to Memorial Sloan Kettering is his largest single donation. When asked
in an interview if he was worried about having to outdo himself in the
future, he laughed.
The new facility will provide radiology, chemotherapy and outpatient
bone-marrow transplants, and concentrate on lung, skin, head and neck, and
hematological cancers. Each one of those cancers types will have its own
mini-center within the Koch building, but those individual areas have yet to
be named with gifts.
The new laboratory facilities, which will be used for a variety of
biological sciences, will replace current labs that date back to the 1950s,
said Marc Tessier-Lavigne, the president of Rockefeller University.
Visit the Wall Street Journal for the story.