Tag Archives: Centers for Disease Control and Prevention

Centers for Medicare and Medicaid Services (CMS) Releases An Update To the “Severe Sepsis and Septic Shock: Management Bundle”

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Centers for Medicare and Medicaid Services (CMS) Issues Sepsis Measure Update

While many sepsis cases are due to unknown organisms and broad spectrum antibiotic selection is appropriate, Centers for Medicare and Medicaid Services (CMS) is releasing an update to the Severe Sepsis and Septic Shock: Management Bundle measure to allow for organism specific antibiotic administration when there is clinician documentation that indicates the causative organism and susceptibility are known.

The specification update also allows for organism specific antibiotic treatment of C. difficile suspected sepsis.

The measure update is included in version 5.2 of the Hospital Inpatient Quality Reporting (IQR) Manual in the section on sepsis.

Version 5.1 of the Hospital Inpatient Quality Reporting (IQR) Manual was posted on QualityNet in December 2015 and is available here: https://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1228775436944.

Version 5.1 becomes effective July 1, 2016, so the changes to the Sepsis measure also affect this version.

CDC and CMS believe that antibiotic stewardship and optimal sepsis management are complimentary efforts that both serve to improve patient care

 

Resource:  CDC Digest Bulletin

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Message From the Centers for Disease Control and Prevention (CDC) Clinician Alert To U.S. Healthcare Facilities RE: Multidrug-Resistant Yeast, Candida Auris

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Clinician Alert to U.S. Healthcare Facilities: Global emergence of invasive infections caused by the multidrug-resistant yeast,

Candida auris

Clinical Alert: Global Emergence of Invasive Infections Caused by the Multidrug-resistant Yeast

Candida auris

The Centers for Disease Control and Prevention (CDC) has received reports from international healthcare facilities that Candida auris, an emerging multidrug-resistant yeast, is causing invasive healthcare-associated infections with high mortality. Some strains of C. auris have elevated minimum inhibitory concentrations (MICs) to the three major classes of antifungals, severely limiting treatment options. C. auris requires specialized methods for identification and could be misidentified as another yeast when relying on traditional biochemical methods. CDC is aware of one isolate of C. auris that was detected in the United States in 2013 as part of ongoing surveillance. Experience outside the United States suggests that C. auris has high potential to cause outbreaks in healthcare facilities. Given the occurrence of C. auris in nine countries on four continents since 2009, CDC is alerting U.S. healthcare facilities to be on the lookout for C. auris in patients.

Please read CDC’s recommendations for identifying and managing patients with C. auris: http://www.cdc.gov/fungal/diseases/candidiasis/candida-auris-alert.html


CDC’s recent clinical alerts:

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Microbiome Startup uBiome Plans To Announce A Collaboration With the Centers for Disease Control and Prevention

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uBiome is a biotechnology company based in San Francisco that gives individuals and organizations access to sequencing technology to sequence their microbiomes with a sampling kit and website. The company was founded by Jessica Richman and Zachary Apte in  November 2012,

uBiome plans to announce  a collaboration with the Centers for Disease Control and Prevention to analyze over 10,000 stool samples from hospital patients.

As research into the importance of the bacteria living in people’s guts—the microbiome—has become more common, the potential in turning the genetic sequences of those intestinal critters into a useful tool for doctors is obvious—problem is, it’s only potential. No one has quite figured out how. A healthy community of gut microbes isn’t easily reduced to a single metric, like blood sugar or cholesterol levels. So uBiome and the CDC have set out to develop something a “Microbiome Disruption Index” to track how treatments, like antibiotics, alter gut microbes.

CDC will collect the samples, and uBiome will sequence them.

 

  • Sequence:   uBiome extracts the bacterial DNA out of the sample and  identify each of the bacteria that the DNA came from. It’s a little like dusting a scene for fingerprints.   *1

 

The San Francisco-based startup currently sells microbiome sampling kits directly to consumers, who mail the kits back to uBiome for analysis—much like 23andMe with its DNA sequencing kits. uBiome recently started offering grants in the form of $100,000 worth of kits to researchers. The CDC, which has microbiome on the brain (so to speak), decided to apply. “Working with companies developing expertise in this area is something we’re interested in,” says Alison Halpin, a CDC epidemiologist. “And CDC is always looking for partnerships.”

The collaboration, which will begin early next year, is still fairly open-ended. The CDC has only just started thinking about the Microbiome Disruption Index and how to use it to predict things like whether a patient might be at risk for infections that hang out in hospitals. But if sequencing costs continue to fall says Halpin, “It’s possible for [microbiome sequencing] to become a standard tool. We’re trying to anticipate that by understanding how you interpret that information.”

How to interpret sequencing information is a challenge for uBiome, too, which is expanding its business from direct-to-consumer kits to clinical tests ordered by doctors. “We’re moving into the clinical space in a number of ways,” says cofounder and CEO Jessica Richman. “This collaboration helps us figure out what the problems are.” In other words, this is all very early-days. Richman says that uBiome plans to announce its first clinical test next year, but she declined to give details.

Researchers have linked the makeup of the gut microbiome—with varying degree of certainty—to big things like obesity, cancer, and mental illness. But uBiome is more likely to start smaller, with clearer-cut tests like looking for the presence of nasty bugs such as the Clostridium difficile bacteria. (It causes all sorts of nasty gut problems, and can turn pathogenic when a person’s normal, healthy gut flora get wiped out by a course of antibiotics.) The advantage of microbiome sequencing is that uBiome could look test for several different pathogens at once without having to grow any of them in a petri dish first.

uBiome’s lab is currently certified under the Clinical Laboratory Improvement Amendments, which allows approved labs to develop new tests without getting individual approval for each one. That could feel like a red flag. Recent controversy over the blood testing company Theranos has highlighted the sometimes loose regulations, and the Food and Drug Administration has it wants to regulate lab tests more strictly.

For now, says Daniel Almonacid, a senior scientist at uBiome, “We assume we’re in good standing because the CLIA requirements are already met.”1

23andMe famously had a big battle with the FDA over the medical information it offered as results for its genetic tests. If uBiome wants to go in that direction, it may end up running into regulation, too. But in the meantime, 10,000 plus samples could be a significant conversion of poop into data.
1 UPDATE: Correction 8:50pm ET 11/30/2015 This quote has been corrected to more accurately reflect uBiome’s CLIA status.

 

*1 http://ubiome.com/

 

To review the article in its entirety click on the following link:

http://www.wired.com/2015/11/ubiome-cdc-collaboration/?utm_source=dlvr.it&utm_medium=twitter

Two leading CDC Physicians discuss current issues focused on C. difficile infections (CDI) and Antibiotic usage, Tuesday, May 5th on C. diff. Spores and More, C diff Radio

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C. diff. Spores and More”

UPCOMING SHOW:  Tuesday, May 5th: 

Two leading CDC Physicians discuss current issues focused on C. diff.Infections and Antibiotic usage.

 

Join us as we learn from our guests;

Dr. Clifford McDonald, MD, Senior Advisor for Science and Integrity, Division of Healthcare Quality Promotion at the CDC with main interests in epidemiology and prevention of Healthcare-Associated Infections, especially Clostridium difficile infections, and the prevention of antimicrobial resistance,

AND
Dr. Arjun Srinivasan, MD, Associate Director for Healthcare-Associated Infection prevention programs in the Division of Healthcare Quality Promotion at CDC’s National Center for Emerging and Zoonotic Infectious Disease. Listen in as these two stellar Physicians discuss the topics of Clostridium difficile infections and Antibiotic usage, two important issues with potential solutions facing the citizens on a global level.

Guest Bio’s:

Dr. Clifford McDonald, MD, graduated from Northwestern University Medical School, completed his Internal Medicine Residency at Michigan State University and an Infectious Diseases Fellowship at the University of South Alabama, following which he completed a fellowship in Medical Microbiology at Duke University.  Past positions have included Associate Investigator at the National Health Research Institutes in Taiwan and Assistant Professor in the Division of Infectious Diseases at the University of Louisville. Dr. McDonald is a former Epidemic Intelligence Service officer and former Chief of the Prevention and Response Branch in the Division of Healthcare Quality Promotion at the Center for Disease Control and Prevention (CDC), where he currently serves as the Senior Advisor for Science and Integrity.  He is the author or co-author of over 100 peer-reviewed publications with his main interests in the epidemiology and prevention of healthcare-associated infections, especially Clostridium difficile infections, and the prevention of antimicrobial resistance.

Dr. Arjun Srinivasan, MD, is Associate Director for healthcare-associated infection prevention programs in the Division of Healthcare Quality Promotion at the Center for Disease Control and Prevention’s National Center for Emerging and Zoonotic Infectious Diseases. Dr. Srinivasan is also a captain in the US Public Health Service. An infectious disease doctor, Dr. Srinivasan oversees several CDC programs aimed at eliminating healthcare-associated infections and improving antibiotic use. For much of his CDC career, Dr. Srinivasan ran the healthcare outbreak investigation unit, helping hospitals and other healthcare facilities track down bacteria and stop them from infecting other patients. Today, Dr. Srinivasan leads CDC’s work to improve antibiotic prescribing and works with a team of CDC experts researching new strategies to eliminate healthcare-associated infections.

 

http://www.voiceamerica.com/show/2441/c-diff-spores-and-more

 

Antibiotic Resistant Bacteria and CDC warns of possible catastrophic consequences

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The CDC has been discussing this matter and publishing information over time in hopes to raise Antibiotic and antibiotic-resistant bacteria awareness in the healthcare industry, and patients/individuals used to depending on Antibiotic therapy for many symptoms that are caused by a virus.

Today the press has released yet one more article with stern headlines regarding “Drug resistant bacteria”  and the possibility of catastrophic consequences combating them.

CDC Director Thomas R. Frieden told reports on Monday that “Without urgent action now, more patients will be thrust back to a time before we had effective drugs.”

The new report has revealed that there are at least two dozen antibiotic resistant bacteria known to harm humans.  Should this path continue some infections will not be able to be treated.

An excerpt from the latest article:

One bacteria atop the agency’s “urgent” list of infections is carbapenem-resistant Enterobacteriaceae (CRE), which typically strike patients in medical facilities and has become resistant to nearly all existing antibiotics. Known as the “nightmare bacteria,” CRE causes life-threatening diarrhea. It has continued to proliferate and has been confirmed in medical facilities in nearly every state.

Clostridium difficile, or C. diff. infections, which cause about 14,000 deaths per year, also made the agency’s urgent list Monday. While resistance to the antibiotics used to treat         C. difficile infections has not yet become a problem, the agency said the bacteria spreads rapidly because it is naturally resistant to many drugs that are used to treat other infections.

Neisseria gonorrhoeae — the drug-resistant form of this bacteria causes gonorrhea, the second most commonly reported infection in the United States. Gonorrhea can cause a variety of illnesses in men and women, including infertility. The CDC estimates there are 820,000 infections each year. In nearly a third of the cases, treatment of the sexually-transmitted disease, is hampered by growing antibiotic resistance.

#1 Prevention remains good hand washing (hand hygiene) before/after eating, before exiting restrooms, before/after diaper changes, before/after patient care, before/after using exam gloves, and as often as necessary.

Speak to your healthcare professional when combating a cold and utilize recommended over-the-counter cold symptom relievers, natural interventions vs antibiotics.  Antibiotics do not combat viruses.   When in doubt, please visit a Physician and healthcare provider, as they will assess and treat symptoms accordingly.

To learn more about this topic, please click on the following link which will redirect you to the article in its entirety.

http://www.washingtonpost.com/national/health-science/drug-resistant-bacteria-pose-potential-catastrophe-cdc-warns/2013/09/16/4cd2d482-1ed6-11e3-b7d1-7153ad47b549_story.html