Tag Archives: Sepsis

Antibiotic Resistance IS A Serious Global Health Concern

C.diff. Treatments

A Nevada woman has died from an infection resistant to all available antibiotics in the United States, public health officials report.

According to the Centers for Disease Control and Prevention, the woman’s condition was deemed incurable after being tested against 26 different antibiotics.

Though this isn’t the first case of pan-resistant bacteria in the U.S., at this time it is still uncommon. Still, experts note that antibiotic resistance is a growing health concern globally and call the newly reported case “a wake up call.”

“This is the latest reminder that yes, antibiotic resistance is real,” Dr. James Johnson, a professor specializing in infectious diseases at the University of Minnesota Medical School, told CBS News. “This is not some future, fantasized armageddon threat that maybe will happen after our lifetime. This is now, it’s real, and it’s here.”

According to the report, the woman from Washoe County was in her 70s and had recently returned to America after an extended trip to India. She had been hospitalized there several times before being admitted to an acute care hospital in Nevada in mid-August.

Doctors discovered the woman was infected with carbapenem-resistant Enterobacteriaceae (CRE), which is a family of germs that CDC director Dr. Tom Frieden has called “nightmare bacteria” due to the danger it poses for spreading antibiotic resistance.

The woman had a specific type of CRE, called Klebsiella pneumoniae, which can lead to a number of illnesses, including pneumonia, blood stream infections, and meningitis. In early September, she developed septic shock and died.

The authors of the report say the case highlights the need for doctors and hospitals to ask incoming patients about recent travel and if they have been hospitalized elsewhere.

Other experts say it underscores the need for the medical community, the government and the public to take antibiotic resistance more seriously.

According to the CDC, at least two million people become infected with antibiotic resistant bacteria each year, and at least 23,000 die as a direct result of these infections.

The World Health Organization calls antibiotic resistance “one of the biggest threats to global health.”

A grim report released last year suggests that if bacteria keep evolving at the current rate, by 2050, superbugs will kill 10 million people a year.

While scientists are working to develop new antibiotics, that takes time, and experts encourage doctors and the public to focus on prevention efforts.

One of the most important ways to prevent antibiotic resistance is to only take antibiotics only when they’re necessary.

“Drug resistance like this [case] generally develops from too much exposure to antibiotics,” assistant professor of pediatrics at Johns Hopkins University School of Medicine and director of the Pediatric Antimicrobial Stewardship Program at The Johns Hopkins Hospital, told CBS News. “Every time you’re placed on an antibiotic it’s important to question if it’s absolutely necessary and what’s the shortest amount of time you can take this antibiotic for it to still be effective.”

Johnson notes that medical tourism – the practice of traveling to another country to obtain medical treatment, typically at lower cost – may no longer be worth the risk. “With this [antibiotic] resistance issue, the risk/benefit of this approach really changes and I think that people really need to be aware and seriously consider if it’s a good idea given the possibility of this kind of thing,” he said.

Frequent hand washing, particularly in healthcare settings, is also extremely important in preventing the spread of germs.

To read the article in its entirety please click on the link below to be redirected:

http://www.lasvegasnow.com/news/nevada-woman-died-from-superbug-resistant-to-all-available-antibiotics-in-us/640548775

Learn More About The Signs and Symptoms Of Sepsis With The CDC; It’s A Race Against Time

SepsisCDC710

 

 

 

 

 

 

 

 

Saving patients from sepsis is a race against time

CDC calls sepsis a medical emergency; encourages prompt action for prevention, early recognition

Sepsis is caused by the body’s overwhelming and life-threatening response to an infection and requires rapid intervention. It begins outside of the hospital for nearly 80 percent of patients. According to a new Vital Signs report released by CDC, about 7 in 10 patients with sepsis had used health care services recently or had chronic diseases that required frequent medical care. These represent opportunities for healthcare providers to prevent, recognize, and treat sepsis long before it can cause life-threatening illness or death.

SepsisCDCThinkSepsis

“When sepsis occurs, it should be treated as a medical emergency,” said CDC Director Tom Frieden, M.D., M.P.H. “Doctors and nurses can prevent sepsis and also the devastating effects of sepsis, and patients and families can watch for sepsis and ask, ‘could this be sepsis?’”   

Certain people with an infection are more likely to get sepsis, including people age 65 years or older, infants less than 1 year old, people who have weakened immune systems, and people who have chronic medical conditions (such as diabetes). While much less common, even healthy children and adults can develop sepsis from an infection, especially when not recognized early. The signs and symptoms of sepsis include: shivering, fever, or feeling very cold; extreme pain or discomfort; clammy or sweaty skin; confusion or disorientation; shortness of breath and a high heart rate.

SepsisCDCBannerHealthcareMatters

According to the Vital Signs report, infections of the lung, urinary tract, skin, and gut most often led to sepsis. In most cases, the germ that caused the infection leading to sepsis was not identified. When identified, the most common germs leading to sepsis were Staphylococcus aureus, Escherichia coli (E. coli), and some types of Streptococcus.

 

Health care providers, patients and their family members can work as a team to prevent sepsis.

Health care providers play a critical role in protecting patients from infections that can lead to sepsis and recognizing sepsis early. Health care providers can:

·         Prevent infections. Follow infection control requirements (such as handwashing) and ensure patients to get recommended vaccines (e.g., flu and pneumococcal).

·         Educate patients and their families. Stress the need to prevent infections, manage chronic conditions, and, if an infection is not improving, promptly seek care. Don’t delay.

·         Think sepsis. Know the signs and symptoms to identify and treat patients earlier.

·         Act fast. If sepsis is suspected, order tests to help determine if an infection is present, where it is, and what caused it. Start antibiotics and other recommended medical care immediately.

·         Reassess patient management. Check patient progress frequently. Reassess antibiotic therapy 24-48 hours or sooner to change therapy as needed. Determine whether the type of antibiotics, dose, and duration are correct.

CDC is working on five key areas related to sepsis:

·         Increasing sepsis awareness by engaging clinical professional organizations and patient advocates.

·         Aligning infection prevention, chronic disease management, and appropriate antibiotic use to promote early recognition of sepsis.

·         Studying risk factors for sepsis that can guide focused prevention and early recognition.

·         Developing tracking for sepsis to measure impact of successful interventions.

·         Preventing infections that may lead to sepsis by promoting vaccination programs, chronic disease management, infection prevention, and appropriate antibiotic use.

To read the entire Vital Signs report visit: www.cdc.gov/vitalsigns/sepsis.

For more information on sepsis and CDC’s work visit: www.cdc.gov/sepsis.

U.S. Department of Health and Human Services

###

CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, stem from human error or deliberate attack, CDC is committed to respond to America’s most pressing health challenges.

 

SepsisCDCKnowSigns

 

 

Septic Shock; Reviewed by Dr. F. Perry Wilson, MD, MSCF on MedPage Today

Norepinephrine has long been the stable pressor agent for sepsis, but new data suggest that vasopressin might offer unique benefits. In this “150 Second Analysis”, MedPage Today clinical reviewer F. Perry Wilson discusses a study pitting the two drugs head-to-head, with an eye on renal failure as the primary outcome.

F. Perry Wilson, MD, MSCE, is an assistant professor of medicine at the Yale School of Medicine. He earned his BA from Harvard University, graduating with honors with a degree in biochemistry. He then attended Columbia College of Physicians and Surgeons in New York City. From there he moved to Philadelphia to complete his internal medicine residency and nephrology fellowship at the Hospital of the University of Pennsylvania. During his post graduate years, he also obtained a Master of Science in Clinical Epidemiology from the University of Pennsylvania. He is an accomplished author of many scientific articles and holds several NIH grants. He is a MedPage Today reviewer, and in addition to his video analyses, he authors a blog, The Methods Man. You can follow @methodsmanmd on Twitter.

Also visit the link to view the video:

http://www.medpagetoday.com/Nephrology/GeneralNephrology/59463

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

 cms.gov-footer

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

cdc.gov

CDC Launches Clean Hands Count Campaign May 5, 2016 On World Hand Hygiene Day

In The News:   #CleanHandsCount

CDCCleanHands

 

CDC Launches Clean Hands Count Campaign

Today, May 5, 2016 –   World Hand Hygiene Day, CDC has launched a new hand hygiene campaign for healthcare providers, patients, and their loved ones called Clean Hands Count. The campaign aims to:

  • Improve healthcare provider adherence to CDC hand hygiene recommendations.
  • Address the myths and misperceptions about hand hygiene.
  • Empower patients to play a role in their care by asking or reminding healthcare providers to clean their hands

 

Hand Hygiene Is Everyone’s Responsibility
Everyone CAN Do Their Part At Preventing Infections Worldwide.

 

  • Did you know?
    • On average, healthcare providers clean their hands less than half of the times they should.
    • Alcohol-based hand sanitizer is more effective and less drying to the skin than using soap and water.
    • Using alcohol-based hand sanitizer does NOT cause antibiotic resistance.

    Patients may be at risk of getting an infection while they are being treated for something else.

    The science is clear: Clean hands protect patients and healthcare providers from dangerous and deadly infections.

    Check out today’s Public Health Matters blog to learn other things you may not know about hand hygiene. Visit: http://blogs.cdc.gov/publichealthmatters/2016/05/what-you-may-not-know-about-hand-hygiene/

    Join the CDC  today – May 5, 2016 – at 2 pm ET

    for a Twitter chat on hand hygiene.

    Follow #CleanHandsCount and @CDCgov and be sure to let us know

    who your #CleanHandsCount for

    To learn more about the CDC hand hygiene  Clean Hands Count campaign please visit:

    http://www.cdc.gov/handhygiene/

A Note From Prof. Konrad Reinhart, MD, ML — Global Sepsis Alliance For the World Sepsis Day

worldSepsisDay

 

 

 

Dear Supporters and Friends of World Sepsis Day,

Today, we are glad to inform you that Achim Steiner, Under-Secretary-General of the United Nations, Executive Director of the United Nations Environment Programme and designated new director of the Oxford Martin School, made his very inspiring keynote lecture held at the German National Academy of Sciences meeting “Sepsis – The Challenges of Science, Politics and Society” available to all of us.

In his keynote address,  he clearly states that tackling sepsis is crucial to more than half of the 17 goals of the 2030 agenda for sustainable development!
This agenda was adopted by the UN Sustainable Development Summit in September 2015 and aims to end poverty and hunger, improve health and education, make cities more sustainable, combat climate change and protect oceans and forests.

You can access Achim Steiner’s full keynote lecture here:
www.unep.org/KeynoteSteiner

We highly encourage you to share this link with your families, friends, and co-workers!

Thank you for your continued support and warm regards from Germany,

Prof. Konrad Reinhart, MD, ML

######

World Sepsis Day is a concept developed by the Global Sepsis Alliance, and operated as a collaborative effort with other relevant parties
Global Sepsis Alliance The Global Sepsis Alliance is a charity registered in England and Wales number 1142803 and a company limited by guarantee, registered in England and Wales number 7476120

Head office:
Global Sepsis Alliance for the World Sepsis Day:
Center for Sepsis Control and Care
Prof. Konrad Reinhart, MD, ML
Erlanger Allee 101
07747 Jena
Germany
Fon: +49 3641 / 9323101
Fax: +49 3641 / 9323102
Email:        office@world-sepsis-day.org

 

C. diff. Infection (CDI) and Sepsis

What is Sepsis?

Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail.  If sepsis progresses to septic shock, blood pressure drops dramatically, which may lead to death.

Anyone can develop sepsis, but it’s most common and most dangerous in older adults or those with weakened immune systems. Early treatment of sepsis, usually with antibiotics and large amounts of intravenous fluids, improves chances for survival.

Definition of Sepsis:  sep•sis (ˈsep-səs) n. Sometimes called blood poisoning, sepsis is the body’s often deadly response to infection.

Patients are given a diagnosis of sepsis when they develop clinical signs of infections or systemic inflammation; sepsis is not diagnosed based on the location of the infection or by the name of the causative micro-organism. Physicians draw from a list of signs and symptoms in order to make a diagnosis of sepsis, including abnormalities of body temperature, heart rate, respiratory rate, and white blood cell count. Sepsis may be diagnosed in a 72-year-old man with pneumonia,, fever, and a high white blood cell count, and in a 3-month-old with appendicitis, low body temperature, and a low white blood cell count.

What causes Sepsis?

Sepsis is a response to an infection. When you get an infection, your immune system releases chemicals into your blood to fight the infection. The chemicals sometimes cause body-wide inflammation, which can lead to blood clots and leaky blood vessels. This impairs blood flow, which damages the body’s organs by depriving them of nutrients and oxygen.

Different types of infections can lead to sepsis, including infections of the skin, lungs, urinary tract, abdomen (such as appendicitis), or other part of the body. Healthcare-associated infections (HAI’s), including pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and surgical site infections can sometimes lead to sepsis. MRSA infections of the skin and soft tissue can also lead to sepsis.

Sepsis infected blood cell

 TO DOWNLOAD A “SEPSIS AND C. difficile” Information guide, courtesy of Sepsis Alliance, CLICK ON THE FOLLOWING LINK:

http://www.sepsis.org/files/sig_sepsisandcdifficile.pdf

 

Who gets Sepsis?

Anyone can get sepsis, but the risk is higher in:

  • people with weakened immune systems
  • infants and children
  • elderly people
  • people with chronic illnesses, such as diabetes, AIDS, cancer, and kidney or liver disease
  • people suffering from a severe burn or physical trauma

How many people are diagnosed with Sepsis?

According to the CDC’s National Center for Health Statistics estimates that, based upon information collected for billing purposes, the number of times people were in the hospital with sepsis or septicemia (another word for sepsis) increased from 621,000 in the year 2000 to 1,141,000 in 2008.1  Between 28 and 50 percent of people who get sepsis die.2

The number of cases of sepsis each year has been going up in the United States.  This could be because of the following reasons:   the population is aging, people have more chronic illnesses, people are getting more invasive procedures, immunosuppressive drugs, chemotherapy, and organ transplants;  increasing antibiotic resistance,  increasing awareness and tracking of sepsis

—————————————

For Healthcare Professionals: Use this optional tool to screen patients for severe sepsis in the emergency department, on the medical/surgical floors, or in the ICU http://survivingsepsis.org/SiteCollectionDocuments/ScreeningTool.pdf

 

Recommendations: Special Considerations in Pediatrics*

 

 http://survivingsepsis.org/Guidelines/Documents/Pediatric%20table.pdf

 

4. Clostridium difficile colitis should be treated with enteral antibiotics if tolerated. Oral
vancomycin is preferred for severe disease (grade1A).
Sepsis Pocket Card for Healthcare Professionals:
Surviving Sepsis Campaign Bundle
Initial Resuscitation Bundle
To Be Completed in 3 hours:
1)Measure lactate level
2)Obtain cultures prior to administration of antibiotics
3)Administer broad spectrum antibiotics
4)Administer 30ml/kg crystalloid for hypotension or lactate greater
than or equal to 4mmol/kg
Septic Shock Bundle
To be Completed Within 6 Hours:
1)Apply vasopressors (for hypotension that does not respond to
initial fluid resuscitation) to maintain a mean arterial pressure
(MAP) greater than or equal to 65mmHg
2)In the event of persistent arterial hypotension despite volume
resuscitation (septic shock) or initial lactate greater than or equal
to 4mmol/L
a.Measure central venous pressure (CVP)*
b.Measure central venous oxygen saturation (ScvO2)*
3)Remeasure lactate if initial lactate was elevated*
*Targets for quantitative resuscitation included in the guidelines are CVP
greater than or equal to 8mmHg, ScvO2 greater than or equal to 70% and
normalization of lactate
> To print a pocket card please access the following link
References:
*International guidelines for management
of severe sepsis and septic shock: 2012.Crit Care Med. 2013; 41:580
*Mayclinic
*Survivingsepsis.org
1. NCHS Data Brief No. 62 June 2011 – Inpatient Care for Septicemia or Sepsis: A Challenge for Patients and Hospitals 2. Wood KA, Angus DC. Pharmacoeconomic implications of new therapies in sepsis. PharmacoEconomics. 2004;22(14):895-906
* Sepsis Alliance  http://www.sepsisalliance.org
637