Many skin infections are self-induced!

Hospitals Could Stop Infections by Tackling Bacteria Patients Bring In, Studies Find

Hundreds of thousands of patients each year suffer from infections after surgery, and experts say more than half of those infections stem from bacteria the patients themselves are carrying in their nose or on their skin. Otherwise harmless bacteria can enter the body through surgical incisions and cause infections that can require expensive treatment, slow recovery or even cause death.

But two new studies suggest relatively simple ways hospitals can prevent many infections by killing the bacteria on the patient before surgery, with methods of screening, scrubbing or pretreating the patient that many hospitals do not typically use.

“This is going to be a huge help to the infection-control crowd,” said Marcia Patrick, a nurse and board member of the Association for Professionals in Infection Control and Epidemiology, who was not involved with either study. “How can we not do this? It would truly be penny-wise and pound-foolish. And it’s the right thing to do for patients.”

The studies, published Thursday in The New England Journal of Medicine, examined infections that develop at the site of surgery, often around the incision, and afflict more than 300,000 patients a year in the United States.

While experts are increasingly trying to stop hospital-acquired infections by approaches including stepped-up hand-washing by doctors and nurses, the new studies looked at the bacteria patients may be carrying before entering the hospital, especially a common bacteria, staphylococcus aureus.

“About one-third of people at any one time carry this bacterium in their nose or on their skin,” said a co-author of one study, Dr. Henri Verbrugh, a professor of medical microbiology at Erasmus University Medical Center in the Netherlands. “It does not give them any problem, but if they go to a hospital and the skin is somehow breached, they are really prone to invasion or infection by their own bacteria.”

Dr. Verbrugh and colleagues tested patients for the bacteria using nasal swabs. They treated about 500 who carried the bacteria for five days with an antibiotic ointment on their noses and showers with soap treated with chlorhexidine, an antiseptic. After surgery, which sometimes occurred during the five-day treatment, those patients were 60 percent less likely to develop infections than patients receiving a placebo of ointment and soap.

The study included only patients whose operations were extensive enough to require at least five days of hospitalization. Dr. Richard P. Wenzel, an infectious disease specialist at Virginia Commonwealth University, who wrote an editorial about the studies, said he would recommend the approach primarily for serious operations like heart surgery or joint replacements, or patients with immune system problems.

But Dr. Wenzel said the method used in the second study should be adopted across the board. That study, conducted at six United States hospitals, compared the skin disinfectant hospitals use 75 percent of the time before surgery with another one. The researchers found that patients receiving the standard disinfectant, povidone-iodine, were significantly more likely to develop infections. Those cleaned with the alternative, chlorhexidine-alcohol, got 40 percent fewer total infections, and half as many staphylococcus aureus infections.

A study author, Dr. Rabih O. Darouiche, a professor of medicine at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, said chlorhexidine-alcohol was recommended a decade ago by the Centers for Disease Control and Prevention for cleaning when catheters were inserted, but had not been extensively studied for surgical preparation.

Ms. Patrick said most hospitals still used the iodine solution largely because “we’ve always done it this way.”

Cost is a factor with both studies’ methods. Dr. Darouiche said chlorhexidine-alcohol costs about $12 per patient compared with $3.50 for povidone-iodine. His study was financed by CareFusion, which makes both products. It had no access to the data.

Dr. Verbrugh, whose study was financed by several companies, said the most expensive part of his approach was the rapid-screening test for bacteria, about $20. He said some United States cardiac departments had begun using the nasal ointment for all heart surgery patients, without screening them for bacteria.

Experts not involved in the studies said the added costs of the methods were dwarfed by the money saved preventing infections, which can run to tens of thousands of dollars per patient.

“Everybody wins on this,” Dr. Wenzel said. “Patients obviously have less morbidity, and hospitals and medical centers and insurers save a lot of money.”

 

New Model Of Skin Cancer Provides Insights On Second-Most Common Type Of Cancer

Scientists at the University of Pennsylvania School of Medicine have developed a new model of skin cancer based on the knowledge that a common cancer-related molecule called Src kinase is activated in human skin-cancer samples.

"Our previous work demonstrated that Src kinases are activated in human squamous cell carcinomas of the skin. We modeled these observations by increasing the expression of the gene Fyn, a member of Src family of proteins, in mouse skin," explains senior author John T. Seykora M.D., Ph.D, assistant professor of Dermatology. In addition, prior work by the Seykora lab on a related protein called Srcasm, discovered by him in 2002, suggested that Srcasm may function as an anti-oncogene, a molecule that keeps others in check in order to control cell growth.

In this proof-of-principle study, published this month in Cancer Research, the authors found that genetically engineered mice expressing a K14-Fyn transgene develop precancerous lesions and invasive squamous cell carcinomas (SCCs) spontaneously in 5 to 8 weeks. Skin SCCs are the second most common form of cancer, with greater than 250,000 cases annually in the US, leading to approximately 2,500 deaths.

Last Updated (Saturday, 02 January 2010 18:37)

 

Your genes can play a role in skin cancer

NEW YORK (Reuters Health) – Want to reduce your risk of skin cancer? Wear sun screen, of course. But two new studies suggest that choosing your relatives carefully could also be helpful.

One found that having an identical twin with melanoma increased a person's own risk of developing the disease much more than having a fraternal twin with this type of skin cancer. The other found that having a sibling or parent with one of several different types of non-melanoma skin cancer increased risk as well.

Several studies have suggested melanoma and other skin cancers run in families, but it can be difficult to tease out the difference between the influence of genes and environment. In the Australian study, Dr. Sri N. Shekar of the University of Queensland in Brisbane and his colleagues attempted to do so by looking at twin pairs in which at least one sibling had been diagnosed with melanoma.

They searched through thousands of cases of melanoma reported in Queensland and New South Wales and found 125 twin pairs. In four of the 27 identical twin pairs, both had melanoma, while three of the 98 fraternal twin pairs had both been diagnosed with the deadly skin cancer.

Based on these numbers, having an identical twin with melanoma increased a person's own risk of the disease nearly 10-fold, while melanoma associated with having a non-identical twin with the disease was roughly doubled.

This suggests, the researchers say, that some of the increased melanoma risk can be attributed to genes, in particular interactions between genes. They estimate that genes account for about half of the differences in risk between two people.

In the second study, Dr. Shehnaz K. Hussain of the University of California Los Angeles and colleagues looked at the Swedish Family-Cancer Database to gauge the risk for several types of skin cancer among siblings and children of people diagnosed with these diseases.

They found that people with a sibling or parent diagnosed with some types of skin cancer were more likely to develop skin cancers of various types, not just the ones their relatives had. When tumors occurred at parts of the body more likely to have been exposed to the sun (such as the face, compared to the torso), the familial risk was stronger.

Based on the findings, Hussain and colleagues conclude, a person's family history can be used to gauge their own skin cancer risk, and genetic studies could be a useful way to identify potential targets for treating or preventing the disease.

SOURCE: Journal of Investigative Dermatology, September 2009.

 

 

Cranberry, Pumpkin & Jell-O Can Work Miracles On Body

Kristine Johnson

NEW YORK (CBS) ?

Last Updated (Saturday, 02 January 2010 18:39)

 

Is there such a thing as a 'healthy tan'? .....No!

Tanning Beds Classified as Carcinogenic

Tanning BedA new report issued in July places tanning beds in the “highest cancer risk” category. The agency also reclassified all UV radiation as carcinogenic to humans, including UVA, UVB and UVC.

A review by the International Agency for Research on Cancer concluded that the risk of melanoma, the most deadly form of skin cancer, increases by 75 percent when use of tanning beds and sunlamps begins before 30 years of age. This high-risk tanning behavior, seen primarily in females, could explain the increasing melanoma rates for females 15-29 years old. 

Last Updated (Thursday, 08 October 2009 01:11)

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