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TWiM 6 Letters

Don writes:

I was intrigued by the comments on the antimicrobial effects of Cu, having used silver sutures in contaminated cases in the 60s. It struck me that an easy and cheap test would be to copper plate [which uses very little ] the door .faucet and toilet handles in an ICU  and see if the Hospital acquired infections changed. This is fairly low tech requiring a screwdriver, a auto battery and some CuSO4 [root killer.] or could be done by many firms who do it commercially. Thanks for the really good podcast

zowawih writes:

Hi, I am a big fan of your great education/entertaining programs. I would like to suggest Vincent to invite experts in antimicrobial resistant bacteria in his newly launched TWiM program. This problem is very serious and thus the WHO themed their day with the antibiotic resistance issue. Likewise the CDC chose a week on September last year to address the devastating health related issue. Inviting Experts and pioneers in this field will highlight and explain queries.

Chris writes:

I recall hearing about a bacterial contamination of cantaloupe years ago, which is when I started to wash them in soapy water before slicing.

Of course, I try to follow the rules. We actually cut meat products on the counter between the stove and sink, and the rest on the kitchen island to prevent cross contamination. Often I will prep for cooking by cutting the veggies on a dishwasher proof cutting board on the island, put them in bowls and set aside. Then move the cutting board to the counter, cut the meat and either put it in the bowl or the pan. Then put the cutting board in the dishwasher, set the knife to be hand washed next o the sink. Then cooking is quicker because I have everything ready, using a food safe mise a place.

The other day I was watching an old cooking show with Julia Child. I just about gagged when I saw the other chef she was working with put an herb stuffing between the breast and skin, and then reach over to pick up salt from a bowl with his fingers without washing his hands or using a spoon!

I have a TWiM idea from watching cooking shows, especially one that showed all of the varieties of salt: pink salt, which gets its color from an extremophile bacteria (a tidbit I want to share at the local upscale kitchen store when I get a chance!). Oh, cool, just checking the halophile wiki, I learned they are essential for some fermented foods like soy sauce, sauerkraut, anchovies, etc: http://en.wikipedia.org/wiki/Halophile

Frank writes:

First:  Thanks for making a career of TWI-Podcasts!  A great service and an entertaining and educational format.

In TWIM #1 you reviewed the antibacterial properties of copper and it’s potential for control of MRSA compared to other methods being pursued.  While the science of antibiotic mechanisms is fascinating, we may be blinded by the technology instead of understanding the logic of the problem.  The references below are a few of the many showing (not surprisingly) that the people who spend their days around hospitals are the reservoirs for MRSA.  Anywhere from 6% to 21% of healthcare workers (in this case anyone working in a hospital) have been shown to carry MRSA in their nares.  This is higher than the rate in incoming patients.  Remove the reservoirs and control is much easier!

While we are great at technical solutions, we are close to powerless at social, particularly politically social solutions.  It would seem that a major reduction could be achieved through regular testing of healthcare workers (<$10 & <24hrs) to identify carriers, their removal from patient care, treatment with mupirocin (I believe topically) and return to patient care.  Hospitals object to the cost of testing although as carriage rates decrease so would costs.  Unions object to the potential unpaid removal from work during treatment as well as the treatment cost.

Doctors generally refuse to be tested, even for hepatitis or HIV.   Despite the enormous monetary cost of MRSA to hospitals and to our overall healthcare system, plus the unnecessary deaths, our society insists that “magic bullet” pharmaceuticals and antibacterial hardware are the only way to solve this problem.  Pogo had it right about “the enemy”.

Thanks again for the education and entertainment.  Vincent and your TWIV, TWIP, TWIM teams are an exceptionally bright spot in scientific education!

Best regards,

Frank Shinneman,

NY, NY

 

Prevalence and Characteristics of Staphylococcus aureus Colonization among Healthcare Professionals in an Urban Teaching Hospital infection control and hospital epidemiology june 2010, vol. 31, no. 6

Prevalence of Staphylococcus aureus Nasal Colonization in Emergency Department Personnel Annals of Emergency Medicine, Volume 52, No. 5: November 2008, p.525 – 531

Incidence and Prevalence of Methicillin-Resistant Staphylococcus aureus Nasal Carriage Among Healthcare Workers in Geriatric Departments: Relevance to Preventive Measures INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY  Vol. 24 No. 6, p.456-458

How Often Do Asymptomatic Healthcare Workers Cause Methicillin-Resistant Staphylococcus aureus Outbreaks? A Systematic Evaluation infection control and hospital epidemiology october 2006, vol. 27, no. 10

Successful Control of Widespread Methicillin-Resistant Staphylococcus aureus Colonization and Infection in a Large Teaching Hospital in The Netherlands infection control and hospital epidemiology august 2007, vol. 28, no. 8

 

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