India baby deaths spark Calcutta hospital negligence row
A government-run hospital in Calcutta has been accused of negligence after the deaths of 30 babies admitted to its care in the last four days. In 2011 it was cleared of negligence after the death of 18 babies in two days.
As a result of that inquiry, a new neo-natal unit was installed to provide better treatment. But critics say the state government needs to invest more money to ensure all sick children receive the best care.
'Poor hygiene' led to baby death at University Hospital of North Staffordshire
Jessica was moved to the UHNS after being born 14 weeks premature at a hospital in Nuneaton.
"Poor hand hygiene" by hospital staff may have been to blame for the death of a baby who contracted a fatal infection, an inquest has heard. Jessica Strong, who was born 14 weeks premature, got the Serratia marcescens bug at the University Hospital of North Staffordshire (UHNS) in July. She was one of two babies who died from the bug which led to a two week closure of the Neonatal Intensive Care Unit.
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The North Staffordshire coroner Ian Smith recorded a narrative verdict. Jessica was born 14 weeks early at George Eliot hospital in Nuneaton but because of her prematurity she was moved to the UHNS. The inquest heard that after she became ill, doctors took several blood samples but only identified a possible cause for her symptoms the day before her death.
The lead infection control nurse at the hospital, Emyr Phillips, told the inquest that the infection could only have been spread by direct contact. Six children in the unit were found to have traces of the bug but only two had become infected, he said.
Exact cause unclear
The court heard Mr Phillips believed general standards of cleanliness on the ward were high but the bug had been spread by "poor hand hygiene." He said: "Clearly there has been a breakdown in hand hygiene practice but we will never know exactly how the spread of infection occurred." Recording a narrative verdict, the North Staffordshire coroner, Ian Smith, said Jessica's death had been caused by "extreme prematurity and an infection spread by human contact."
The University Hospital of North Staffordshire NHS Trust said since the incident, it had started a new cleaning regime and employed three nurses to ensure standards of hygiene were maintained. The hospital trust has admitted clinical negligence over Jessica's death. Her parents, Craig and Annette Strong, said that they had appointed solicitors to take legal action against the trust.
'Disgraceful and upsetting'
Mrs Strong said: "I believe that the infection has been spread by a member of staff, there's no way one parent could've contracted it and passed it on to six other babies." "It shouldn't have taken two deaths to have the new hygiene steps put in place, it's disgraceful and upsetting." Mrs Strong said they were expecting another baby girl in June this year.
She said: "It's absolutely fantastic but Jessica will never ever in our hearts be replaced." An inquest into the death of the second baby who also died from the infection will be held later this year.
Newborn Deaths in Brazil Tied to Bacteria, Hygiene in Question at Hospitals
Health authorities in the Brazilian capital reported Tuesday the death of a baby in hospital, apparently from a bacteria suspected of causing the deaths of another five newborns in the past 12 days. The deaths have taken place since March 28 at the Regional Hospital in the Brasilia suburb of Ceilandia, and doctors suspect that all were caused by the Serratia bacteria. In every case the fatality was an infant just hours or days old, as occurred Tuesday with a child born last Sunday and who died in circumstances similar to the previous ones.
Another two babies are under observation out of concern that they might also have been infected from causes still not established. Serratia is a bacillus that grows in liquids and on damp surfaces and that can cause illnesses ranging from conjunctivitis to serious liver and urinary-tract infections. The Brasilia Health Secretariat said Tuesday that health experts have begun investigating Ceilandia Regional Hospital to check on its hygienic conditions and determine how the bacteria developed in those facilities.
Babies' deaths put spotlight on hospital hygiene
The deaths of three premature babies in a Bremen neonatal clinic has prompted renewed calls for more hygienic expertise in German hospitals.
Premature babies have been at risk from infection:
The health ministry of the German city-state of Bremen says that the three neonatal deaths since August in the city-state's Central Hospital have been traced to drug-resistant bacteria. Ministry spokeswoman Karla Götz said four surviving premature newborns remain sick.
Specialists from Germany's Robert Koch Institute (RKI) had been sent to the Bremen hospital to identify the source of the infection, she added. She rejected speculation that contaminated liquid nutrition might have led to the fatalities. "We still do not know the [exact] cause." The ward had, however, as a precaution ceased taking in further newborns.
Bremen's Central Hospital has ceased to admit premature babies:
The clinic's management, meanwhile, is facing criticism from opposition parties in the Bremen parliament for its delay in notifying the public about the outbreak. The first death occurred on August 8; the latest last Thursday, October 27. Clinic managers said they had notified authorities.
Bremen prosecutors say they have begun an investigation.
Renewed calls for better hygiene in clinics
The outbreak, reminiscent of three neonatal deaths in Mainz in central Germany in August last year, has prompted the German Association for Hospital Hygiene to demand more personnel in clinics nationwide. Association spokesman Klaus-Dieter Zastrow told German ZDF public television on Thursday that nursing staff were often overworked. Studies had shown, Zastrow said, that premature babies required especially "delicate" one-on-one supervision. "One cannot jump to-and-fro between six newborns. If there is a shortage of personnel, then the risk of infection climbs rapidly," he said.
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In July the German parliament passed new hygiene legislation requiring standardized hygiene practices nationwide to overcome a patchwork of regulations across 16 federal states.
Deaths through preventable infections At the time, the federal health ministry confirmed estimates that each year between 10,000 and 15,000 patients of all ages die from hospital infections.
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The Robert Koch Institute was asked to draw up recommendations for doctors in dealing with multiply resistant pathogens and how to efficiently use antibiotics long known to mutate.
Experts at a surgeons' conference in Munich in May said the key remedy was prevention through more stringent hygiene in clinics. As a result, clinic infection could be lowered by up to 30 percent, they said. The babies who died in Bremen were infected with stomach bacteria which emit an enzyme that deactivates common antibiotics. The bacterial behavior - not a form of mutation - is known as Extended-Spectrum-Beta Laktamasen (ESBL).
Author: Ian Johnson (dpa, AFP, Reuters, dapd)Editor: Michael Lawton
Hygiene standards in German hospitals are questioned after babies’ deaths
BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c4731 (Published 27 August 2010)
Ned Stafford, Hamburg
The deaths of three babies after apparently being infected from intravenous drip infusions at the University of Mainz Medical Centre in Germany has sparked a debate among politicians and doctors over hygiene standards at German hospitals.
On 20 August 11 premature or seriously ill babies being treated in the hospital’s intensive care unit received the contaminated infusions, the university said. Two babies with congenital heart defects died the next day, and a third baby, born prematurely, died on 23 August. Four other babies also became seriously ill from the infusions, but their conditions had improved significantly by 27 August. It is not yet clear how the drips became contaminated.
New way to steer clear of the most infection prone public hospitals
- by: Sue Dunlevy National Health Reporter
- From: News Limited Network July 06, 2013 6:33PM
Hospitals are full of sick people, so they are also full of germs and bacteria, but some are cleaner than others. AUSTRALIANS can now avoid the nation's dirtiest or infection prone public hospitals and find the best performers using a new internet tool.
Health fund HCF has developed a web based search engine - www.hcf.com.au/hospitalsafetyandquality - that allows patients to compare the superbug infection rate and handwashing records of up to ten hospitals at a time.
A search through hospitals in Sydney reveals that Westmead and Blacktown hospitals have rates of superbug and golden staph infections that exceed national benchmarks of two cases per 10,000 patients treated. Meanwhile, the Royal Prince Alfred, the Royal Hospital for women and St Vincent's Hospital have lower infection rates.
In Melbourne, the Peter MacCallum Cancer Centre has rates of superbug and golden staph infections that exceed national benchmarks or two cases per 10,000 patients treated, but the Royal Women's Hospital and St Vincent's Hospital have much lower infection rates. A Brisbane search shows none have golden staph infection rates that exceed the national benchmark. In fact, The Prince Charles Hospital in Brisbane has the lowest rate of such infections in the country at 0.47 cases per 10,000 patients treated, well below the national benchmark of two cases per 10,000 patients.
A search through hospitals in Adelaide shows the Royal Adelaide Hospital has rates of superbug infections that exceed the national benchmark. The search engine shows all the major hospitals in Perth performed well, with low rates of superbug infections. King Edward Hospital had the lowest golden staph infection rates and Armadale public hospital also rated well. In Tasmania, the Royal Hobart Hospital is a good performer with superbug infection rates below the benchmark.
Golden staph is a bloodstream infection that proves fatal in 20-35 percent of cases and it is used as a key measure of hospital quality and safety. Each year, around 35,000 Australians treated in public and private hospitals develop an infection following a procedure.
In 2011-12, 1725 of these infections in public hospitals were golden staph infections.
CONCLUSION:
In the invisible, parallel world of Earth's they kill half the bacteria in the ocean every day, and invade a microbe host 10 trillion times a second around the world. There are 10 billion trillion, trillion viruses inhabiting Planet Earth, which is more stars than are in the Universe -- stacked end to end, they would reach out 100 million light years.
Over tens, hundreds and millions years, our ancestors have been picking up retroviruses (HIV is a retrovirus) that reproduce by taking their genetic material and inserting it into our own chromosomes. There are probably about 100,000 elements in the human genome that you can trace to a virus ancestor. They make up about 8 percent of our genome, and genes that encode proteins only make up 1.2 percent of our genome making us more virus than human.
Occasionally, a retrovirus will end up in a sperm cell or an egg and insert its genes there, which then may give rise to a new organism, a new animal, a new person where every cell in that body has got that virus.
In 2009, MIT researchers have explained why two mutations in the H1N1 avian flu virus were critical for viral transmission in humans during the 1918 pandemic outbreak that killed at least 50 million people -- believed more than that taken by the Black Death, and higher than the number killed in World War I.
The 1918 flu pandemic -- commonly known as the Spanish flu -- was an influenza pandemic that started in the United States, appeared in West Africa and France and then spread to nearly every part of the globe in three waves lasting from March 1918 to June 1920, spreading to the Arctic and remote Pacific islands. It was caused by an unusually severe and deadly Influenza A virus strain of subtype H1N1.
Scientists have found a half dozen other strains that cause similar illnesses, but E. coli O157:H7 has been responsible for the lion’s share of E. coli food poisoning, striking again in 1993 in contaminated hamburgers in Washington state, for example, sickening 732 people and killing four of them. But it has not used just hamburger to infect its victims. Along with the spinach outbreak of 2006, E. coli O157:H7 has turned up in lettuce, bean sprouts, and even cookie dough.
A deadly new strain of E. coli has spread fear across Europe about meat and vegatables.The sudden debut of E. coli O157:H7 in the 1980s made many people wonder how it had come to be. Was it the monstrous product of the modern food industry? Tarr and his colleagues analyzed the genome of the bacteria to estimate its time of origin.
“These organisms have been around for 7,000 years,” says Tarr. It’s possible that E. coli O157:H7 and other pathogenic strains caused outbreaks for centuries before microbiologists could identify them as the cause.
A look at the genetic makeup of E. coli O157:H7 is cause for even more concern. It evolved into a deadly pathogen by picking up genes from other bacteria through a process called recombination. Viruses, for example, can move from one E. coli to another and insert genes from their old host into a new one. “E. coli are a cauldron of recombination,” says Tarr.
Microbes have evolved with us over the millennia, shaping human civilization through infection, disease, and deadly pandemic. Beginning with a dramatic account of the SARS pandemic at the start of the 21st century, As our move from hunter-gatherer to farmer to city-dweller accelerated, we became ever more vulnerable to microbe attack. With increased crowding and air travel putting us at risk, Crawford wonders whether we might ever conquer microbes completely, and whether we need a more microbe-centric view of the world.
The Daily Galaxy via Newsweek.com, npr.org and carlzimmer.com
Image credit Spanish Flu Virus: Courtesy, Yoshihiro Kawaoka, University of Wisconsin-Madison
Meet Your New Symbionts: Trillions of Viruses
by Carl Zimmer
With deadly new viruses emerging these days in Saudi Arabia and China, it can be hard to imagine that viruses can be good for anything. It’s easy to forget that we are home to trillions–perhaps quadrillions–of viruses on our healthiest days. And, according to a team of California scientists, those viruses are our symbiotic partners, creating a second immune system. These viruses serve as a defensive front-line, keeping bacteria from invading our gut lining and causing deadly infections.
The viruses in question are far less familiar than, say, influenza viruses or Ebola viruses. They are known as bacteriophages, which means “eater of bacteria.” And yet bacteriophages (or phages for short) are vastly more common than viruses that infect humans. They’re more common than all the viruses that infect every animal on Earth. The reason is simple arithmetic: there are far more hosts for phages to multiply in than there are for viruses that infect our own cells. They’re in the ground, in the oceans, under ice, and in the air. By some estimates, there are 1031 phages on Earth. That makes phages the most abundant life form, period.
Consider the bacteria that line the delicate walls of our large intestines. If they multiplied with abandon, they would end up pushing down into the intestinal wall, pressing against our cells and wedging between them. If they broke through, they’d get swept away into the bloodstream where they could cause dangerous infections.
Our intestinal walls are also loaded with immune cells, and they can make this kind of a breach even more damaging. They may overreact, causing dangerous levels of inflammation in the intestines–creating a new environment that can foster the growth of disease-causing bacteria.
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To avoid this disaster, our bodies hold back the microbiome. One strategy that intestinal cells use for their defense is secreting a dense layer of mucus. While the surface of the mucus provides lots of tasty food for bacteria, the lower levels are so dense they’re hard for the microbes to invade. Our intestines also defense themselves from the microbiome by secreting microbe-killing molecules to knock off any bacteria that get too close to breaching the wall. And when pathogens invade, our intestines can ramp up these defenses–making more antimicrobials and even thicker layers of mucus.
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Scientists have found viruses in other species, such as fungi, plants, and insects, that help out their hosts. It’s possible that we can add ourselves to the list of hosts that depend on their own virome. If this new research holds up, it will be fascinating to see how far evolution has taken this partnership. Many species that host symbiotic microbes go to great lengths to care for their residents. Some insects even grow special organs to house them. Do we tailor our intestines to grow as many phages as possible?
Answers to these questions might eventually provide us with a new way to approach the enduring dream of phage therapy. Rather than unleashing an invasion of shock troops on infections, maybe we should learn how to help our phages keep up their quiet defenses.
(For more on bacteriophages, see my book A Planet of Viruses.)
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