"The groundwork of all happiness is health." - Leigh Hunt

Statewide prevalence data on two newly emerging pathogens in health care settings

Researchers on the University of Maryland School of Medicine (UMSOM) conducted a statewide survey of all patients on ventilators in hospitals and long-term care facilities and located that a major percentage of them harbored two pathogens. Those with a compromised immune system might be fatal. A pathogen was identified in about 31 percent of all patients on ventilators for respiratory support. According to the study, published this week, it was identified in about 7 percent of patients on ventilators.

They conducted the study with colleagues from the Maryland Department of Health and presented their findings at this week's annual meeting of the Infectious Disease Society of America in Boston.

“We found patients in long-term care facilities, such as skilled nursing homes, were more likely than those treated in hospitals,” said study leader Anthony Harris, MD, MPH, professor of epidemiology and public health. were more more likely to be colonized with pathogens.” An infectious disease specialist at UMSOM and the University of Maryland Medical Center. “We were the first in the nation to do a statewide survey of all ventilated patients, and I think that speaks to the strength of the infection control programs in the state of Maryland and the excellent collaboration between the University of Maryland and the state. Department of Health.”

And each have been highlighted by the federal Centers for Disease Control and Prevention (CDC) as emerging pathogens that pose a worldwide health threat. Spread — often in hospitalized people and on respiratory machines (ventilators). Elderly individuals with weakened immune systems are particularly at risk of this infection, with bacteria immune to common antifungal drugs, posing a risk to the identical forms of patients and most antibiotic treatments. have been very immune to over time.

To conduct the study, Dr. Harris and colleagues obtained culture swabs from all 482 patients receiving mechanical ventilation in Maryland health care facilities between March and June of this yr. All eligible health facilities, 51 in total, participated within the survey. They identified no less than one patient in one-third of acute care hospitals and 94 percent of long-term care facilities. They identified about 5 percent of hospitalized patients and 9 percent of patients in long-term care facilities.

“However, a positive test does not necessarily mean that patients have symptoms or an active infection that is potentially infectious,” said study co-author J. Christie Johnson, PhD, professor of pathology at UMSOM, whose lab performed the tests for the study. are life-threatening.” But knowing which patients are colonized with these pathogens can help prevent their spread to other patients.”

During 2022, state and native health departments nationwide reported 2,377 clinical cases, nearly five times the variety of infections in 2019, which were fewer than 500 cases, based on the CDC. Maryland alone had 46 cases in 2022. Although these infections don't often pose a significant health risk to hospital staff, they pose a major risk of death in patients with weakened immune systems. Infections can often spread from patient to patient, with health care staff carrying the germs on their hands, equipment, or clothing.

“More health care facilities around the country need to be aware of the extent of the problem through surveillance testing,” Dr. Harris said. Some measures might be implemented to assist reduce the spread of those pathogens, including more stringent use of disposable gloves and gowns. Between using chlorhexidine to wash the critically sick to disinfect patients and their skin.

“Emerging pathogens that are resistant to available treatments present a growing challenge in our country, especially with the expected increase in our aging population entering long-term care facilities,” said UMSOM's Dan Mark. Gladwin, MD, who can also be executive vp of medical. Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor at UMSOM. “According to the CDC, about half of patients who develop C. aureus infection die within 90 days, and the pathogen is now found in nearly 50 states. That's why these surveillance studies are nationwide. Holdings are important across the board, not just Maryland.”

UMSOM faculty members Lisa Pineles, MA, Lyndsay O'Hara, PhD, Leigh Smith, MD, and Indira French, MS, were co-authors of the study. The study was funded by a grant from the CDC (1U54CK000450-01).