Becker's Clinical Quality & Infection Control

18 Sign up for the Free Becker's Infection Control and Clinical Quality E-Weekly at www.beckersasc.com/clinicalquality. T he University of Iowa Hospitals and Clin- ics is on the forefront of biomedical re- search that could change the future of in- fection control and clinical quality in hospitals and healthcare systems. Researchers there have devel- oped a vaccine combating Staphylococcus bacteria, even methicillin-resistant strains, which may be available on the market in just a handful of years. News of such a vaccine is a boon for healthcare pro- viders across the country as antibiotic resistance, climbing healthcare costs and changing payment models transform how the industry is approaching managing healthcare-associated infections. The new vaccine targets toxins produced and secreted by Staphylococcus bacteria. What's more, the vaccination has been found to com- pletely protect against Staphylococcus bacteria and eliminate any traces of the bacteria in the host. Instead of targeting Staphylococcus cell sur- face molecules like most vaccines, the Iowa re- searchers' vaccine directly targets three common Staphylococcus toxins: toxic shock syndrome tox- in, Staphylococcus enterotoxins, and a cytotoxin called alpha toxin. These three toxins have been mutated to have no toxicity. "Instead of immunizing against [Staphylococcus causing bacteria], we prevented the organism from being able to set up the disease," says Patrick Schlievert, PhD, professor and chair of microbiol- ogy at the University of Iowa Carver College of Medicine and lead researcher of the study. In animal model trials trials, the vaccine provided sterilizing immunity, meaning it produced an im- mune response completely eliminating the infec- tion. In one trial, Dr. Schlievert and researchers introduced Staphylococcus bacteria into rabbits at extremely high doses, up to four million times more bacteria than normal. When the researchers injected their vaccine and then administered the Staphylococ- cus bacteria into the rabbits' lungs, 86 of the 88 rab- bits had sterilizing immunity after seven days. The next step for the Iowa researchers is conduct- ing safety studies, which Dr. Schlievert says could be complete as early as in the next couple of years, pending FDA approval. If all goes well, the impli- cations of this vaccine could be greatly effective and potentially eliminate the threat of certain Staphylococcus infections for good. "The bad thing is Staphylococcus aureus varieties come and go. They emerge and they disappear and new strains come and they disappear," Dr. Schlievert says. "The thing we've seen consistently over the years is these three targets that we have are maintained over the long term, so we think by protecting against them, we will have a vaccine that will work against any variety of Staphylococ- cus aureus and would extend into the future." n university of Iowa Hospitals and Clinics: Vaccinating Away MRSA By Akanksha Dr. Patrick Schlievert T he Centers for Disease Control and Prevention has released its most up-to-date report on healthcare-associated infection estimates from 2011, the latest data available. The report was published in the New England Journal of Medicine. The report shows the incidence of HAIs has slightly decreased, with the 2011 data estimating 721,800 infections and the National Nosocomial Infections Surveillance system data from 1990 to 2002 estimating 1.7 million infections. Here are 17 findings and statistics from the CDC's "Multistate Point-Preva- lence Survey of Health Care-Associated Infections." 1. In 2011, 4 percent of inpatients at acute-care hospitals had at least one HAI, totaling approximately 648,000 patients with 721,800 infections. 2. One in 25 patients will contract at least one infection during a hospital stay. 3. Approximately 75,000 patients with HAIs died during hospitalization. 4. Pneumonia and surgical site infections were the most common HAIs, each accounting for 21.8 percent of all infections. 5. Gastrointestinal infections accounted for 17.1 percent of all HAIs. 6. Urinary tract infections totaled 12.9 percent of all infections. 7. Primary bloodstream infections totaled 9.9 percent of all infections. 8. Approximately a quarter of all HAIs, 25.6 percent, were associated with medical devices, such as catheter-associated urinary tract infec- tion, ventilator-associated pneumonia and central-catheter associated blood stream infection. 9. Approximately 43 percent of non-surgical site infections developed within 48 hours of a stay in the critical care unit. 10. Colon surgeries experienced the highest number of SSIs, at 14.5 per- cent, followed by hip arthroplasties (10 percent) and small bowel sur- geries (6.4 percent). 11. The median interval from hospital admission to HAI symptoms was six days. 12. One in five HAIs was present on admission and was related to a previ- ous admission to the same hospital. 13. The most common pathogen was Clostridium difficile, accounting for 12.1 percent of infections. 14. The majority of gastrointestinal infections, 70.9 percent, were due to C. diff. 15. Staphylococcus aureus accounted for 10.7 percent of infections. 16. Klebsiella pneumoniae and K. oxytoca accounted for 9.9 percent of infections. 17. Escherichia coli accounted for 9.3 percent of infections. n How Common Are HAIs? 17 Latest Statistics on HAI Rates By Akanksha Jayanthi

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