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MRSA Is More Prevalent In Paediatric Healthcare Than Previously Thought - Birmingham Children's Hospital, UK
Birmingham Children's Hospital has introduced a new way of detecting the
MRSA superbug amongst its most critically ill young patients.
The test, developed by molecular diagnostics company Cepheid, has so far
proven to be 100% accurate and is allowing doctors at the hospital to
identify if a patient to be admitted to the ICU has MRSA within an hour. The
only other testing method that offers the same level of accuracy as the
GeneXpert(R) test is the traditional culture-based test, where the bacteria
is grown in a petri dish in a micro-biology lab. However, it takes up to
three days to verify if the MRSA culture can be grown from the patient's
sample.
At the moment the project is focusing on screening all patients being
admitted to the Intensive Care Unit. Every result obtained using the Cepheid
GeneXpert(R) System has so far been verified as accurate by a further culture
test and the hospital has already identified two cases of MRSA that they
wouldn't normally have picked up on.
"Something else that is becoming apparent as we roll out a wider
screening programme of our patients is that levels of MRSA amongst children
are actually higher than is commonly believed," says Dr Jim Gray, Consultant
Microbiologist at Birmingham Children's Hospital. "It is a generally accepted
belief in the medical profession that children are not really carriers of the
MRSA bacterium, however we are increasingly finding that this is not the
case."
Obtaining an accurate and rapid result for MRSA is absolutely key at the
emergency admission point in hospitals. For example, if a patient is
critically ill and needs to be admitted to the ICU (Intensive Care Unit)
without delay, clinicians simply cannot afford to wait two to three days for
a culture result to see whether the patient has MRSA. By then the patient
will certainly have undergone several medical procedures that carry a risk of
introducing MRSA into sites of the body where it can cause serious harm, such
as the lungs and the bloodstream. Also, if the child is carrying the
superbug, by the time the results of MRSA cultures arrive back from the lab
it may have spread to other children on the unit.
"It made sense to start the screening with ICU patients as they are the
most susceptible to contracting the MRSA infection due to the bacteria most
commonly gaining access to the body through open wounds, injections,
catheters and IV sites," says Dr Gray. "It is vital to prevent MRSA from
entering the ICU as it is extremely serious and potentially fatal for
children who are already critically ill."
Paediatric hospitals are not currently required to comply with the
Department of Health guidelines issued to UK hospitals regarding the
introduction of MRSA screening for all elective admissions to hospitals by
March 2009. Although Birmingham Children's Hospital has comparatively low
levels of the superbug, it was concerned to realise that approximately half
of the MRSA cases at the hospital were going undetected until the child had
actually developed symptoms and fallen ill with the infection. They are
therefore rolling out a policy of screening all patients who fall into one of
the deemed 'high risk' categories at admittance stage, starting with the ICU.
The hospital will then expand the screening programme to include all elective
surgical patients who require overnight admission, as well as elective and
emergency admissions to the liver and renal units, and haematology and
oncology ward.
Dr Gray believes that the surveillance work the hospital is carrying out
on MRSA is very important in building a better picture of the levels of MRSA
colonisation within children. "We are learning a lot and asking ourselves a
great many questions. For example, because of the nature of their condition,
some of our haematology patients may be admitted as often as three or four
times per month. Is it necessary and helpful to screen them every time they
come back? Hopefully the answers that we obtain will assist other UK health
trusts in developing a best practice policy regarding MRSA in child
patients."
About Birmingham Children's Hospital
Birmingham Children's Hospital is the foremost specialist Children's
Hospital for Birmingham and the Midlands, offering a wide range of paediatric
services for children and young people throughout the Midlands and beyond.
Some of its services cater for children and young people on a national or
supra-regional basis, for example our Burn Centre and Liver Unit. But it also
offers many local services for children and young people, including one of
the country's largest Child and Mental Health Services (CAMHS).
About the GeneXpert(R) System Molecular Diagnostic Platform
Cepheid's GeneXpert System is a closed, self-contained,
fully-integrated and automated platform that represents a paradigm shift in
the automation of molecular analysis, producing accurate results in a timely
manner with minimal risk of contamination. The GeneXpert System is the only
system to combine on-board sample preparation with real-time PCR (polymerase
chain reaction) amplification and detection functions for fully integrated
and automated nucleic acid analysis. The system is designed to purify,
concentrate, detect and identify targeted nucleic acid sequences thereby
delivering answers directly from unprocessed samples. Modular in design, the
GeneXpert System has a variety of configurations to meet the broad range of
testing demands of any clinical environment. http://www.cepheid.com
Source
Nigel Smith/Laura Warner/Victoria Harvey
Schwartz Communications
Cepheid
MRSA este mai rãspânditã În pediatric Healthcare decat se credea anterior - Birmingham Children's Hospital, Marea Britanie - MRSA Is More Prevalent In Paediatric Healthcare Than Previously Thought - Birmingham Children's Hospital, UK - articole medicale engleza - startsanatate