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Healthcare Associated Infections, MRSA Surveillance & Research Integrity

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Comment CDC HICPAC Meeting.
Kevin Kavanagh, MD, MS from Health Watch USA expresses concern regarding the efficacy of enhanced barrier precautions in preventing the spread of dangerous pathogens in nursing homes. Public , Nov. 14, 2019.  View YouTube Video:  https://youtu.be/Gijk606uY9E     Download Written Comment

Comment on Draft Guideline for Prevention and Control of Infections in Neonatal Intensive Care Unit Patients: Draft Recommendations for the Prevention and Control of Staphylococcus aureus in Neonatal Intensive Care Unit Patients
HW USA's comment stresses the importance of defining an outbreak and not to have optional recommendations with the use of "may."  Recommendations should be either made or not made.  In addition, if an outbreak is defined as greater than a single case, then a baseline infection rate is deemed acceptable and MRSA should be considered endemic.  In this case, facility wide screeing of patients and staff should be enacted.  Sept. 19, 2019.  View Comment

Health Watch USA Submitts Comments on PACCARB Goals of Combating Antibiotic Resistant Organisms.
"The committee should expand its focus on prevention to include patients and healthcare workers to undergo routine active surveillance for carriage of endemic MDROs. A reporting system of healthcare workers carriage and infections along with an economic safety net for those affected also needs to be implemented."     View Full Comment
  

Advocating for National Healthcare Reporting System for Healthcare Worker Acquisition of Dangerous Pathogens, Periodic Testing of Healthcare Workers for Dangerous Pathogens and Job Protection of Healthcare Workers Including an Economic Safety Net..

  • 2019, June 19,  CDDEP Blog Posting:  "But of utmost importance, we need to protect our healthcare workers who may well be acting as reservoirs to spread these pathogens to patients and their families. An economic safety net needs to be established and medical screening needs to take place. Until these reforms are universally enacted in the United States Healthcare facilities, I have grave reservations that the epidemic of drug resistant bacteria will be brought under control."   http://blogs.biomedcentral.com/on-health/2019/06/19/the-changing-narrative-of-mrsa-infection-control-in-the-united-states/  

  • 2019, May 16, CDC HICPAC Comment: Call for for a national public reporting system for healthcare acquisitions of dangerous reporting systems and facilities required to keep a log of healthcare worker infections and acquisitions of dangerous pathogens (timeline 2:12 to 2:36).   YouTube Video:  https://youtu.be/zFGjj4D42x4

  • 2018, Nov 16, CDC HICPAC Comment:  Call for a National Reporting System of Healthcare Worker Acquisitions and healthcare worker economic safty net (timeline 3:14 to 5:15).  YouTube Video:   https://youtu.be/HOFCJxV2Rek

  • 2018, Oct 31.  View Comment Letter Submitted to Regulations.Gov Regarding the Proposed CDC Recommendations  “Infection Control in Healthcare Personnel: Infrastructure and Routine Practices for Occupational Infection Prevention and Control Services.”  View Letter

  • 2018, Sept. 18.  ARIC Article:  "In addition, the United States does not have a national surveillance system for the tracking of healthcare worker acquisition and infections with dangerous pathogens. This results in cases not being recorded and classified as work related. Healthcare staff will often use sick leave or work while ill. Additionally, there is a concern regarding healthcare workers bringing antibiotic resistant pathogens home to their families. "   https://aricjournal.biomedcentral.com/articles/10.1186/s13756-018-0407-0 

  • 2018, Jan 1  CDC Drafts New Guidelines for Occupational Health Conduct assessments of infectious risks to HCWs
    "Kuhar says. There are likely to be continuing points of contention and clarification on achieving this balance. For example, a comment on the CDC draft guidelines submitted to the docket by Kevin T. Kavanagh, MD, MS, of Health Watch USA, said the document does not sufficiently address the risk of healthcare workers becoming carriers of MRSA and other drug-resistant pathogens. “Some of the resistant organisms such as MRSA have become endemic, and different methodologies for prevention of spread need to be instituted, such as routine periodic screening for carriers,” Kavanagh noted in the comments. " https://www.reliasmedia.com/articles/143702-cdc-drafts-new-guidelines-for-occupational-health

    2017, July 13.  - View Comment Letter to CDC HICPAC Regarding Testing of Healthcare Workers for MRSA.  View Letter.

Comments and analysis of two underpowered studies where intervention groups have effective intervention less than 50% of the time. These studies appear to have prevented standards being set regarding MRSA Surveillance.

Transparency of Healthcare Associated Infections   

  • Public reporting of HAI is a major initiative of Health Watch USAsm. Information regarding Hospital Acquired Infections and Healthcare Acquired Conditions can be found at: www.neverevents.org 

  • Public reporting of HAI is a major initiative of Health Watch USAsm. Information regarding Hospital Acquired Infections and Healthcare Acquired Conditions can be found at: www.neverevents.org  View Document

  • HW USA Legislative Testimony on public disclosure of HAI can be view at:
    http://www.healthwatchusa.org/HWUSA-Presentations-Testimony/HWUSA-Testimony.htm 

Below are the most recent legislative initiatives to pass public reporting of HAI.

Year

2008

2009

2011

2014 2015
KY Bill SB 118 HB 67 SB 72, HB 291 HB 460 KAR 902_2_020
Comment KY DPH CHFS Financial
Analysis
Financial
Analysis

 
Op-Eds Calling for Public Reporting of Healthcare Associated Infections

  • Jan. 31, 2012. 'Hospital Infections are Underreported.  Courier Journal, Louisville, KY, The case is made for Public Reporting and Full Disclosure of Adverse Events and Not to Charge Patients for These Events.
     View Op-Ed References    Linked to Archived Abstract    Link to Article Text

  • Jan. 21, 2011.  State Reporting on Hospital Infections - Lax, Dangerous   Lexington Herald Leader, Lexington, KY, As other states are issuing infection reports to the public. Kentuckians are endangered buy the lack of reporting and inhibited health department oversight.  View Op-Ed References   Link to Article Text

  • July. 25, 2010.  Hospital Acquired Infections Reporting and Kentucky's HAI Health Plan  Lexington Herald Leader, Lexington, KY, The State of Kentucky Needs to require hospitals to report all Hospital Acquired Infections.    Link to Article Text

  • Oct. 4, 2009. Keep Public Reporting in Reform Plan - Lexington Herald Leader, Lexington, KY, Public reporting of healthcare acquired infections is now supported by major national medical organizations.   Link to Article Text

  • July 9, 2009. Stop Hospital Borne Infections  Courier Journal, Louisville, KY, Public reporting of healthcare acquired infections is now in the process of implementation in 27 states. View CJ Editor's Comment on HAI        View CJ Editor's Comment on HAI    Link to Article Text

  • Jul 26, 2009  You should learn the ABSs of HAI and MRSA.  Courier Journal. 
    http://www.healthwatchusa.org/downloads/20090727-CJ-MRSA.pdf 
     

Comments on Research Integrity and Use of Chlorhexidine to Prevent MRSA

  • 2016, Dec. - Patient Advocate Letter Sent to NEJM Regarding Evaluation for Retraction of the REDUCE MRSA Study.   View Letter   NEJM's Response:  View Response

  • 2016, Nov. - Health Watch USA Presentation on Research Integrity:  Kevin Kavanagh, MD, MS, discusses the impact that problems in research integrity has had in formulating healthcare policy in controlling infectious disease. The example of daily bathing with the antiseptic chlorhexidine verses surveillance and contact precautions for the control of MRSA is presented.  https://youtu.be/m9UxOOzSA_8

  • 2015, Jun. - FDA Comment on Rule for Additional Data on Antiseptics: HW USA, Consumers Union and patient advocates have sent a comment to the FDA requesting that they include the antiseptic chlorhexidine in their regulations calling for additional data on antiseptics.  Chlorhexidine is an antiseptic which some institutions are using for the prevention of MRSA (the deadly staph infections).  However, there have been questions regarding the integrity of some the research advocating for its use.    Read Comment and References:   http://www.healthwatchusa.org/downloads/20150610-CommentToFDA.pdf 

  • 2014, Dec. - Peer Reviewed Publication:  Conflict of Interest, Dr Charles Denham and the Journal of Patient Safety. J Patient Saf. 2014 Dec;10(4):181-185. PubMed PMID: 25408235.  http://journals.lww.com/journalpatientsafety/Fulltext/2014/12000/
    Conflict_of_Interest,_Dr_Charles_Denham_and_the.1.aspx 

  • 2014, Apr. - Peer Reviewed Publication:  Reply to ''Planned Analyses of the REDUCE MRSA Trial'' Kevin T. Kavanagh, Daniel M. Saman and Yanling Yu Antimicrob. Agents Chemother. 2014, 58(4):2486. DOI: 10.1128/AAC.02821-13.  http://www.healthwatchusa.org/HWUSA-Publications/PDF-Downloads/20140318-Antimicrob_Agents_Chemother-2014-Kavanagh-2486-7.pdf 
       

Congressional Enquiries on Control and Prevention of Methicillin resistant Staphylococcus aureus (MRSA). 

  • 2008, Feb. - Senator McConnell's Letter in Response to Lexington Herald Leader Op Ed: View Letter  View Op-Ed

  • 2010, Jun. - Congressional Inquiry by Senator McConnell to obtain the results of the Veterans Administration Protocol to control MRSA.   View Letter

  • 2010, May - Results of Congressional Inquiry which obtained the National Veterans Administration protocol results for control of MRSA.   View Document  

  • 2012, Aug. - Funding of the Star*ICU Study - Senator McConnell's Office.   View Document
     

HW USA - Presentations on MRSA Surveillance

HW USA - In House Publications on MRSA Surveillance and Policy Reports

  • Comment on: Docket No. CDC-2018-0099. “Infection Control in Healthcare Personnel: Infrastructure and Routine Practices for Occupational Infection Prevention and Control Services.”  Oct. 31, 2018.  Download Comment

  • Health Watch USA and Patient Advocates Public Comment to CDC HICPAC Calling For Periodic Screening of Healthcare Workers for MRSA,  Nov. 8, 2017.  Download Comment

  • The Role of Surveillance Cultures in the Prevention of Methicillin-resistant Staphylococcus aureus in Acute Care Facilities, Nov. 22, 2010.    Download PDF 557 K

  • Hospital Acquired Infections: The Necessity of Prevention and Mandatory Surveillance. Word Count 1464, Feb. 4, 2008 Download PDF 504 K