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Entries in infection (13)

Friday
Dec142012

Beagle Sniffs Out Bacterial Infection

Hemera/Thinkstock (file photo)(NEW YORK) -- A 2-year-old beagle in the Netherlands has been trained to sniff out Clostridium difficile, a skill that could help doctors catch the deadly infection days before laboratory tests.

Clostridium difficile infections often occur in people who are already taking antibiotics, causing symptoms that range from mild diarrhea to severe inflammation of the colon.  And to make matters worse, the bug is particularly adept at spreading through hospitals, uncontrolled by the usual surface cleansers.

The clever canine, called Cliff, correctly identified 50 stool samples containing the bacterium, which kills 14,000 Americans each year, according to the U.S. Centers for Disease Control and Prevention.  Cliff also identified 47 of 50 stool samples that were Clostridium difficile-free (he couldn’t make up his mind about the last three).

Laboratory tests for Clostridium difficile -- dubbed C. diff -- can take up to 48 hours.  But Cliff gives his answer immediately by sitting or lying down.

“The sooner the clinician has a diagnosis, the better it is,” said Dr. William Schaffner, an expert in infectious diseases at Vanderbilt University Medical Center in Nashville, Tenn.  “You can also reduce the risk of transmission to other patients.”

Stool from patients with the C. diff has a characteristic smell, often likened to horse manure, which Cliff learned to identify over two months of training.  Now, he can smell the bug even without the stool, correctly identifying 25 of 30 patients with the infection and 265 of 270 without.

“We’ve always known that dogs make us feel good, but now we know that they’re good for us,” said veterinarian Dr. Marty Becker, who is based in Sandpoint, Idaho, and is the author of The Healing Power of Pets and a writer for VetStreet.com.

Dogs have also been trained to sniff out cancers of the lung, bowel, skin, breast and bladder with high accuracy, and petting animals can also be therapeutic.

“We use them in our institution, largely in pediatrics, and have brought in reptiles, dogs and even miniature ponies,” said Schaffner.

However, Cliff has struggled with staying focused at work, according to the study authors.  A plastic cup, urine on the floor, excited children and the strong smell of cleaners proved distracting.

“This may not work in the context of much more hectic U.S. hospitals,” said Schaffner.  “I don’t think [dogs] will replace [existing laboratory tests].”

But Becker said the healing power of pets should not be underestimated.

“There was a time when you expected to see this kind of stuff in the tabloids,” he said.  “Now the science is there to show how it works.  What are we going to find next?”

Copyright 2012 ABC News Radio

Thursday
Oct042012

Surgeons Report Progress Against Dangerous Hospital Infection

Pixland/Getty Images(CHICAGO) -- Surgeons have found a new treatment that may help put a stubborn hospital-acquired infection on the run.

Hospitalized patients are at risk for developing healthcare-related infections, and one of the most dreaded is Clostridium difficile colitis, a virulent bacteria that affects about 336,000 patients per year, causing diarrhea, fevers, and occasionally sepsis and death.  It is easily passed around the hospital, especially since it is one of very few bacteria that cannot be killed by the alcohol-based sanitizers that are fixtures in every hospital for hand hygiene.

There has never been any medical treatment available to prevent this infection.  But in findings presented Thursday at the 2012 Annual American College of Surgeons Clinical Congress in Chicago, surgeons report success using a medicine called intestinal alkaline phosphate (IAP) to prevent C. difficile infections in tests on mice.

“According to the CDC [Centers for Disease Control and Prevention], C. difficile is linked to about 14,000 U.S. deaths every year,” says Dr. Richard Hodin, a surgeon at Massachusetts General Hospital and the principal investigator of the study.  “Estimates are that we spend at least $1 billion in extra costs to the health care system due to C. difficile, and probably a lot more.”

The bacteria may live naturally in the colon and is kept in check by the rest of the natural, “good bacteria” in the gut.  But occasionally, when patients are given antibiotics, may of the “good bacteria” get killed off and the C. difficile takes over, causing symptoms like diarrhea, fever, abdominal pain and colitis.  While antibiotics typically can treat the bacteria, an unrecognized infection may progress to a dangerous disease called toxic megacolon that requires emergency surgery and a removal of the entire colon.

“The paradox is that it is caused by antibiotics, but antibiotics don’t always work to cure it,” says Dr. Angela Moss, a surgery resident at Massachusetts General Hospital and one of the co-authors on the study.  “Then it becomes a life-threatening problem.”

Unfortunately, because C. diff may be lying dormant in any person’s colon, almost every patient on antibiotics can be at risk for C. difficile colitis.  Researchers therefore have been searching for a way to prevent this infection before it starts.

In the study, Hodin and colleagues found that giving IAP to mice on antibiotics resulted in a 10-fold decrease in C. difficile bacteria in their stool, as well as a 10-fold decrease in an inflammatory marker called IL-1.

“We were surprised to find that this naturally occurring enzyme was a regulator of the gut flora,” says Hodin.  “If this works in humans, like it does in mice, then we think it could be used as an oral supplement in almost all patients who are taking antibiotics.”

Fortunately, IAP is a naturally occurring gut enzyme, so it is likely completely safe to take.  A previous study using IAP in patients showed no side effects.  Researchers are hopeful that clinical trials in humans can soon begin, allowing progress to be made on preventing this dangerous infection.

Copyright 2012 ABC News Radio

Wednesday
Aug012012

Woman Fights Infection From Dog Saliva

WSBTV(DECATUR, Ga.) -- At 32 years old, nursing student Hannah Rinehart is hooked to a ventilator, her body healing after an amputation of her hands and feet.

The Decatur, Ga., woman, who is also a three-time cancer survivor, is fighting a rare bacterial infection, called capnocytophaga, which is found in the saliva of dogs but rarely affects people, her father, Doug Johnson, said.

During a weekend of yard work, Rinehart contracted a high fever, but held out seeking medical attention until her appointment that Monday, July 2, with her oncologist.

The married nursing student, who also has a business degree, changed careers after she successfully battled Hodgkin's lymphoma three times. The cancer first appeared when she was 18, Johnson said.

After the cancer re-appeared for the third time when she was she was in her mid-20s, Rinehart had a stem-cell transplant from her brother that has so far been successful, her father said.

Rinehart left the hospital seven years ago in July, hoping she'd only be back as a nurse.

But on July 2, on the recommendation of her oncologist, she was wheeled into Northside Hospital in Atlanta with a high fever. That evening, her father said, she went into septic shock.

"Her blood pressure was low and her kidneys and lungs were weakened," he said.

Doctors sent a sample of the bacteria attacking Rinehart's body to the Mayo Clinic, where it was identified as capnocytophaga, a common bacteria found in dog saliva that rarely harms the health of humans.

There's no way to directly tie the infection to Rinehart's 1-year-old puppy, her father said, but the family has its theories.

"Hannah would throw the ball for the dog and it would mouth her hand and forearm and she'd get scratches," Johnson said. "What we suppose is the fact she has had two bone-marrow transplants, her immune system is probably not that strong as a regular adult."

The infection continued to cut off circulation to Rinehart's extremities, leaving her parents and husband Mark a difficult decision to make.

"To not respond to the situation as it stands now would not be a display of faith, but rather a crude act of negligence," Mark Rinehart wrote on his wife's Facebook page before the surgery.

On July 26, doctors amputated Hannah Rinehart's hands and feet. "It was very obvious it needed to be done at that point," her father said. "We had been praying and just watching it get worse."

Rinehart has been sedated since the surgery, but has continued to make improvements.

Her 103.7-degree fever went down to 98.6 degrees Tuesday night, Mark Rinehart said.

And despite having another health obstacle thrown in her path, Rinehart and her family, who are devout Christians, are confident she'll be able to live a normal life.

"She is very strong. I don't even really remember her complaining about [the cancer] at all," her father said.

"We get the news and then you'd find out what to do and she kind of plugged away and kept going. After this, she'll be able to carry on and have a great life."

Copyright 2012 ABC News Radio

Friday
Jul202012

Sepsis: How Doctors Miss Signs of Dangerous Infection

iStockphoto/Thinkstock(NEW YORK) -- A child gets a minor scrape while playing sports at school.  The child and parents ignore it, but the next day he is vomiting and has pain in his leg.  The parents take their child to the emergency room.

Remarkably, decisions made by doctors at this point could mean the difference between life and death.  And right now, the case of Rory Staunton, a 12-year-old boy who died after showing symptoms exactly as described above, has hospitals all over the country focusing on ways to make sure these cases don't end tragically.

In an episode first reported by The New York Times last week, Staunton died at NYU Langone Medical Center of a deadly condition known as sepsis.  Such cases are rare, but not unheard of.

Sepsis, which affects at least 750,000 adults a year, can and does affect children.  In 2007, a 13-year-old in Chicago named Tony Love almost died after experiencing nearly the same symptoms.  Love's story is told at the beginning of Maryn McKenna's 2010 book Superbug about the dangers of antibiotic-resistant bacteria.

For doctors, the problem is recognizing what's wrong before it's too late.

Sepsis is the result of a body's overwhelming response to an infection.  When bacteria get into the bloodstream, the body's immune system mobilizes to fight them.  But if the infection is left unchecked, the body's own defenses can rage out of control.

"The body says, 'Hey, we have some attackers here, let's go fight them,'" says Dr. Nathan Shapiro, an emergency medicine physician at Beth Israel Deaconess Medical Center.  "It makes chemicals called cytokines and other factors as part of the inflammatory response."

But as Shapiro explains it, if the underlying infection is not treated, the response itself can cause organ damage and death.

The problem is that, in its early stages, sepsis causes symptoms that aren't much different from those of a viral infection that will go away on its own.  Consequently, sorting out who can go home from the emergency department and who needs quick hospitalization can be tough.

"The thing that people are always looking for is the crystal ball that will tell whether this kid who doesn't look all that sick really is," says Dr. David Gaieski, assistant professor of emergency medicine at the Hospital of the University of Pennsylvania.  "Right now there's nothing that is 100 percent able to do that."

Shapiro agrees: "The tricky part is discriminating between someone who has an infection and is going to recover by themselves, and someone who is going to become really sick."

The stakes involved in this decision could not be higher, since treating septic patients early is the single most important element in their care.

"When the person shows up, the clock starts ticking," says Gaieski.  "Those first six hours mean a lot."

Complicating matters further is the fact that guidelines developed to tip off physicians when they should suspect sepsis and start early treatment are most often geared toward adults.  In children, these same rules may not apply.

"It's hard to apply sepsis criteria mentioned in there to pediatric patients," says Dr. Abhi Mehrotra of the University of North Carolina at Chapel Hill.  "Vital sign criteria are age-appropriate.  It's difficult to take criteria out of the clinical population in which they were developed and apply them to another."

Copyright 2012 ABC News Radio

Wednesday
Jul112012

Superbug Dangers in Chicken Linked to Eight Million At-Risk Women

iStockphoto/Thinkstock(NEW YORK) -- A growing number of medical researchers say more than eight million women are at risk of difficult-to-treat bladder infections because so-called superbugs -- organisms resistant to antibiotics and that grow in chickens -- are being transmitted to humans in the form of E. coli.

“We’re finding the same or related E. coli in human infections and in retail meat sources, specifically chicken,” says Amee Manges, epidemiologist at McGill University in Montreal.

If the medical researchers are right, this is compelling new evidence of a direct link between the pervasive, difficult-to-cure human disease and the antibiotic-fed chicken people buy at the grocery store.

“What this new research shows is, we may in fact know where it’s coming from.  It may be coming from antibiotics used in agriculture,” says Maryn McKenna, reporter for the Food & Environment Reporting Network.

The research is part of a joint investigation by ABC News and Food and the Environment Reporting Network.

The Food and Drug Administration says 80 percent of all antibiotics sold in the United States are fed to livestock and even healthy chickens to protect them from disease in cramped quarters.  It also helps the chickens grow bigger and faster.

“We’re particularly interested in chickens.  They, in many cases, are getting drugs from the time that they were in an egg all the way up to the time they are slaughtered,” Manges says.

The chicken industry says there could be other factors, such as overuse of antibiotics by humans, contribuing to the superbugs.  The industry further cautions that there’s no study that has proven a superbug from poultry transfers directly to humans.

Researchers note that a study to prove the latter would be unethical because it would require intentionally exposing women to the bacteria.  They add that there's persuasive evidence that chickens carry bacteria with the highest levels of resistance to medicine.

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Copyright 2012 ABC News Radio

Thursday
May172012

Diabetic Sues Doctor After Penis Amputation

Jupiterimages/Thinkstock(MIAMI) -- A man who elected to have a penile implant in a Florida hospital is now suing his doctor after a post-surgical infection resulted in the amputation of his organ.

Enrique Milla, 65, who was reportedly deported from the United States last year back to his native Peru, has been testifying in court via Skype that the medical procedure robbed him of his dignity and manhood.

In a medical malpractice trial that began this week, Milla claims that his doctors should have known that he was not a good candidate for the procedure because of his diabetes and high blood pressure.

"This has been devastating, painful and embarrassing," said Milla's attorney, Spencer Aronfeld of Coral Gables, according to ABC's affiliate WPLG.

Milla alleges that his anesthesiologist Dr. Laurentiu Boeru "failed to evaluate properly the risks of this procedure." He first filed the lawsuit in 2009, naming Boeru and Dr. Paul Perito, the urologist who performed the surgery.

According to the Miami Herald, which obtained records that are not publicly available, Perito settled the case out of court.

Penile implant surgery is most commonly performed after all other treatments for erectile dysfunction have failed. It is also used to treat some cases of Peyronie's disease, a condition that causes scarring inside the penis, leading to bent, painful erections.

Implant surgery comes with a risk of infection, which can occur at any time after surgery -- in rare cases, even years later, according to the Mayo Clinic.

Milla suffered from a number of medical conditions, including erectile dysfunction, according to court records. Milla, who had lived in Miami for 40 years working in a medical supply business, received the surgery in 2007 at Coral Gables Hospital. But two weeks after the operation, Milla developed an infection that eventually turned to gangrene. Amputation of his penis was necessary to save his life, according to his lawyer, who alleges Boeru didn't exercise proper care after the surgery.

"Post-operative period is about anywhere between six to 24 hours after surgery. It does not include either days or months," testified Boeru.

"This is an infection that occurred in this gentleman because he didn't do what he was supposed to do post-operatively nine days after the surgery," Boeru's lawyer Jay Chimpoulis, told WPLG.

He suggested that Milla ignored medical instructions to avoid sex and developed a fecal infection.

"There are any number of ways he could've gotten that. None of them had anything to do with [Boeru]," Chimpoulis said.

Dr. Pravin Rao, director of reproductive medicine and surgery at the Johns Hopkins Brady Urological Institute, said penile implants, called prostheses, are safe for patients who are in good health -- even those with diabetes, as long as the disease is "controlled." The risk rate is lower than three percent, according to Rao, who did not treat Milla.

Penile implants are among a "long algorithm of options" for those with erectile dysfunction, according to Rao. Urologists start with pills like Viagra -- the least invasive approach -- to vacuum erection devices and injection therapy. But sometimes those treatments fail because of the quality of the tissue in the penis or poor blood flow. The most common reason for ED is chronic disease that affects the vessels in the penis -- most often diabetes, hypertension, smoking or high cholesterol. Nerve damage, caused by spinal cord injuries, diabetes or radical prostate cancer surgery, can also trigger ED.

A poor candidate for a prosthesis is someone who is not in overall good health and may be at risk under anesthesia or not be able to withstand the blood loss of surgery.

"The number-one concern is infection, and that's why we make sure their overall health and immune status are good and their diabetes is under control," said Rao.

When infection does occur, the prosthesis must be immediately removed to clear the infection.

The prosthesis is an inflatable device that is inserted in the two tubes of the penis. The balloons can be filled up with fluid, creating an erection. A small pump is placed in the scrotum with a reservoir of fluid that connects to the tubing.

"When we first place it, we don't have it activated to create a full erection," said Rao. "Then after letting it heal for six weeks, [the patient] comes in and we teach them how to use the pump by squeezing it."

Patients are told not to have sex during that recuperative period.

Rao said that penile implants are "very successful and infection is not the norm."

Some studies of patients with diabetes and those without the disease had the same rate of infection. "But," he said, "we have to be prudent about picking the patient."
 
Copyright 2012 ABC News Radio

Friday
Sep022011

Man Dies From Toothache, Couldn't Afford Meds

Stockbyte/Thinkstock(CINCINNATI) -- A 24-year-old Cincinnati father died from a tooth infection this week because he couldn't afford his medication, offering a sobering reminder of the importance of oral health and the number of people without access to dental or health care.

According to NBC affiliate WLWT, Kyle Willis' wisdom tooth started hurting two weeks ago. When dentists told him it needed to be pulled, he decided to forgo the procedure, because he was unemployed and had no health insurance.

When his face started swelling and his head began to ache, Willis went to the emergency room, where he received prescriptions for antibiotics and pain medications. Willis couldn't afford both, so he chose the pain medications.

The tooth infection spread, causing his brain to swell. He died Tuesday.

Calls to Willis' family were not immediately returned. University Hospital in Cincinnati, where Willis was admitted, did not comment, citing federal privacy laws.

"People don't realize that dental disease can cause serious illness," said Dr. Irvin Silverstein, a dentist at the University of California at San Diego. "The problems are not just cosmetic. Many people die from dental disease."

Willis' story is not unique. In 2007, 12-year-old Deamonte Driver also died when a tooth infection spread to his brain. The Maryland boy underwent two operations and six weeks of hospital care, totaling $250,000. Doctors said a routine $80 tooth extraction could have saved his life. His family was uninsured and had recently lost its Medicaid benefits, keeping Deamonte from having dental surgery.

Getting access to dental care is particularly tough for low-income adults and children, and it's getting tougher as the economy worsens. In April, the Kaiser Family Foundation reported that 33 percent of people surveyed skipped dental care or dental checkups because they couldn't afford them. A 2003 report by the U.S. Surgeon General found that 108 million Americans had no dental insurance, nearly 2.5 times the number who had no health insurance.

Trips to the dentist aren't the only expenses hard-up Americans are skipping. An August report by the Commonwealth Fund found that 72 percent of people who lost their health insurance when they lost their jobs said they skipped needed health care or did not fill prescriptions because of cost.

Dr. Jim Jirjis, director of general internal medicine at Vanderbilt University, said people, like Willis, without access to care often die of conditions that were much more common decades ago.

"He [Willis] might as well have been living in 1927," Jirjis said. "All of the advances we've made in medicine today and are proud of, for people who don't have coverage, you might as well never have developed those."

There are a number of free dental clinics in operation around the country, where dentists volunteer to provide care to those without health insurance. But even if Willis had access to a free dental clinic, Stream said he still may not have been able to get the care he needed for his infection. "The wait is often months at these clinics, and this young man died within two weeks of his problem," Stream said.

Silverstein operates three free dental clinics in the San Diego area. "We're overwhelmed right now," he said. "We can't take any new patients."

Copyright 2011 ABC News Radio

Wednesday
Jun152011

Teen May Lose Hand to Rare, Flesh-Eating Fish Tank Bacteria

Courtesy Amy Cox(OAK HILLS, Calif.) -- What started as a small scrape from the corner of the family's fish tank five years ago may end in the amputation of a champion teen gynmast's hand.

Hannele Cox, 13, from Oak Hills, California has battled a rare, flesh-eating infection she contracted from the tank when she was 8 and doctors have been unable to stop it from spreading.  The bacteria has now spread to the bones of her right hand.

"I can't use that hand at all.  I'm in pain all the time," says Cox.

Over the years, the infection has forced Cox to quit sports like volleyball and gymnastics, despite having won an American Athletic Union gymnastics championship.  The infection has become so severe that the eighth grader has been unable to write or do school work because her dominant hand is constantly shaking with pain.

Mycobacterium marinum, sometimes referred to as fish tank granuloma, usually eats away at only the surface of the skin.  But in Cox's case it has infected several bones in her right hand, a development which could mean amputation of her right hand.

Doctors at the Loma Linda Medical Center and UCLA Medical Center have tried multiple types of antibiotics and two surgeries to remove infected tissue, but the bacteria seems to have become drug-resistant.  Fearing she may be infected with a "superbug" strain of the bacteria, the Cox family is seeking further treatment for her with infectious disease experts at Denver, Colorado's National Jewish Health medical center next week.

"I'm afraid they won't be able to fix it," the teen girl says of her upcoming trip to Denver.  "I'm afraid they'll mess up again and I'll go through something I didn't have to, like with the past treatments."

Her mother is also looking ahead to the Denver trip with concern.

"When I found out that it had spread to her bones, I think that's the hardest I've cried in this whole thing.  I just lost it," says the teen's mom, Amy Cox.  "After years of doctors not taking this seriously, this trip [to Denver] is our last hope."

Copyright 2011 ABC News Radio

Monday
Jun132011

California Girl Survives Rabies Without Receiving Vaccine

Creatas Images/Thinkstock(SACRAMENTO, Calif.) -- An eight-year-old girl from California is said to be the third person in the U.S. to have recovered from a rabies infection without ever receiving the vaccine, according to the University of California Davis Children's Hospital.

Health officials believe Precious Reynolds may have become infected by a feral cat she encountered near her elementary school in Willow Creek, California.  However, because this was never confirmed and the date on which she contracted rabies is not known, Reynolds never received the antiviral inoculations that are usually given after being exposed to the infection.

After being admitted to UC Davis Children's Hospital, a team of hospital staff along with help from state, local and federal officials at the U.S. Centers for Disease Control and Prevention, worked diligently to treat Reynolds.

"Precious received superb care from everyone at UC Davis Children's Hospital," said Jean Wiedeman, associate professor of pediatric infectious diseases.  "And we were enveloped with support from the CDC and the state encephalitis group from the moment we learned she was infected."

"From the very beginning, Precious had a very rapid, robust immune response to her infection, which is a significant contributor to why she survived," Wiedeman added.  "She is truly a fighter."

Copyright 2011 ABC News Radio

Thursday
Jun022011

HIV/AIDS: 30 Years Since First Report, CDC Vows to Continue Fight

Photodisc/Thinkstock(WASHINGTON) -- Thirty years ago Sunday, the U.S. Centers for Disease Control and Prevention published a report documenting a mysterious and deadly new syndrome that today affects the lives of more than 1.1 million people in the United States.

On Thursday, CDC director Dr. Thomas Frieden said that at the time, "no one could have predicted the enormous toll" that HIV/AIDS would take, "claiming the lives of more than 500,000 Americans and many millions worldwide."

The number of Americans living with HIV increased by more than 71,000 people between 2006 and 2008, according to new numbers from the CDC, and as long as that number continues to increase, as does the risk of transmission.

In a CDC-issued report Thursday, the agency said the number of people newly diagnosed with AIDS grew rapidly from 318 in 1981 to over 75,000 in 1992, and is now estimated at 50,000 new cases each year. By 2008, an estimated 1,178,350 persons in the U.S. were living with HIV and 20 percent were unaware of their condition.

Today, most infections are among people under the age of 30, the CDC said. Gay and bisexual men remain the group most affected by the disease, while gay men account for more than half of all new infections.

"Over the last three decades, prevention efforts have helped reduce new infections and treatment advances have allowed people with HIV to live longer, healthier lives," Frieden says in a statement released by the CDC. "But as these improvements have taken place, our nation's collective sense of crisis has waned. Far too many Americans underestimate their risk of infection or believe HIV is no longer a serious health threat, but they must understand that HIV remains an incurable infection."

New cases of the infection were about 6 times higher in African-American men than in white men and about 3 times that of Hispanic men. New cases in black women were 15 times higher than those reported in white women and almost 4 times that of Hispanic women. In Hispanics, new HIV infections among men is more than double that of white men and; the rate among women is close to 4 times that of white women.

Frieden says that while the CDC remains committed to stopping the spread of HIV through increased prevention education, "government alone cannot end this epidemic."

"It's up to all of us to get the facts about HIV, get tested, and take control to protect ourselves and our loved ones."

Frieden calls it "imperative" that experts work to reduce HIV rates in the U.S., and points to a recent analysis showing it could cost more than $200 billion over the next decade to treat those newly infected.

"On this 30th commemoration of AIDS, our resolve to end the epidemic cannot falter. It is possible to greatly reduce new HIV infections. Working together, we can break through complacency, save lives, and end HIV as a threat to the health and well-being of all Americans."

Copyright 2011 ABC News Radio







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