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Medscape
3 hours ago
- Health
- Medscape
ICU Skin Decolonisation May Raise Resistant Infections
Universal skin decolonisation of patients admitted to intensive care units (ICU) may not improve infection control. New research led by the University of Aberdeen indicated that it might increase meticillin-resistant Staphylococcus epidermidis (MRSE) bloodstream infections in vulnerable patients. Hospital-associated infections cause significant morbidity and mortality, with critically ill patients in ICUs at particularly high risk. Surveillance figures from English ICUs show an ICU-associated bloodstream infection rate of 3.5 per 1000 bed-days for stays of two nights or more in the year to March 2024. Over 25% of patients with these infections die within 30 days. Reasons for the increased infection rate in ICUs include high antibiotic use leading to significant skin flora colonisation by resistant bacteria. Invasive procedures including indwelling catheters and the insertion of intravascular devices are independently associated with meticillin-resistant Staphylococcus aureus (MRSA) colonisation and infection. Need for a New Infection Control Approach Decolonisation protocols were introduced in the 1990s to curb rising nosocomial MRSA infections due to MRSA. Nationwide infection control programmes since the mid-2000s led to sharp declines in MRSA rates in NHS hospitals over the next decade. One UK-wide study in ICU patients between 2007 and 2016 showed a 78% decrease in bloodstream infections overall and a 97% reduction in MRSA bloodstream infections. However, data from the National Institute for Health and Care Research show this decline plateaued after 2012. Rates have subsequently been largely static, suggesting the need for a new approach. Routine ICU decolonisation typically involves chlorhexidine skin disinfection combined with nasal mupirocin. The Aberdeen team noted conflicting evidence on chlorhexidine's effectiveness. They also raised concerns that biocide skin and mucous membrane decolonisation might lead to reduced susceptibility to chlorhexidine and selection for multidrug-resistant pathogens. Study Compares Universal and Targeted Decolonisation The researchers compared universal versus targeted skin and nasal decolonisation in ICU patients at two Scottish hospitals in adjacent health boards with different protocols. The study included patients aged 16 years and over admitted between 1 July 2009 and 28 Feb 2022. One hospital switched from universal decolonisation of all admissions to targeting only MRSA carriers from 1 February 2019. The other hospital used targeted decolonisation throughout. The researchers analysed rates of S. epidermidis bloodstream infections and tested MRSE and chlorhexidine susceptibility. Results Show Benefits in Reducing Resistant Infections The results, published in The Lancet Microbe , showed that S epidermidis was identified in 334 (45%) of 735 bloodstream infections in the hospital that de-escalated decolonisation. Of these, 197 occurred before de-escalation. Overall, bloodstream infection rates did not increase after de-escalation. However, MRSE infections declined significantly after the switch – from 10.4 to 4.3 cases per 1000 occupied bed days. The probability of MRSE among infections fell from 89.2% to 56.7%. By contrast, the control hospital reported 167 (60%) S. epidermidis bloodstream infections among 278 total, with no significant changes in infection rates or MRSE incidence. Genetic analyses revealed de-escalation was linked to fewer bloodstream infections caused by multidrug-resistant S. epidermidis strains. There was reduced carriage of mobile genetic elements and genes related to multidrug resistance and biofilm production. Balancing Benefits and Risks "In ICU settings with low MRSA incidence, the benefits of universal decolonisation should be balanced against the risks of selecting MRSE sequence types adapted for invasive and device-associated infection," the researchers concluded. Professor Karolin Hijazi, chair in oral and maxillofacial medicine at the University of Aberdeen and study lead, commented in a press release: "This research essentially demonstrates that the excess use of disinfectants in universal decolonisation offered no advantage in terms of control of serious blood infections in a low MRSA ICU setting, but instead caused the unintended rise of MRSE bloodstream infections." Implications for Infection Control Policy The authors recommended that hospitals consider the "unintended harms of universal decolonisation", especially given the global rise of antimicrobial resistance. Hijazi added that such practices increase resistance risks and costs without added benefit in low-MRSA settings. The findings should inform standardised national guidelines for effective and safe patient decolonisation, in line with the government's 5-year action plan for antimicrobial resistance, the researchers said. They described the emergence and spread of antimicrobial resistance as a 'silent pandemic' and stressed that reducing unnecessary decolonisation could help contain resistance and reduce costs.
Sky News
a day ago
- Health
- Sky News
'Pioneering' new scanner used for brain tumour patients trialled in world-first
A "pioneering" new scanner derived from MRI technology could be used to track brain cancer spread and lead to improved treatment for patients, scientists have said. Researchers at the University of Aberdeen and NHS Grampian have been awarded £350,000 funding by the Scottish government to generate never-before-seen images of glioblastoma brain tumours. It is hoped the technology will improve treatment and quality of life for patients by investigating a new way to scan the tumours. Glioblastoma is the most common and aggressive type of brain tumour with more than 3,000 new patients in the UK diagnosed each year. The University of Aberdeen said half of all patients die within 15 months of diagnosis even after extensive surgery, radiotherapy and chemotherapy. Field cycling imaging (FCI) is a new and specialist type of low-field MRI scan pioneered in Aberdeen and has already been found to be effective in detecting tumours in breast tissue and brain damage in stroke patients. It is hoped it can now be used to help brain tumour patients. Full body MRI scanners were invented at the Scottish university 50 years ago, but the FCI scanner is the only one of its type used on patients anywhere in the world. The FCI derives from MRI but can work at low and ultra-low magnetic fields, which means it is capable of seeing how organs are affected by diseases in ways that were previously not possible. It can also vary the strength of the magnetic field during the patient's scan - acting like multiple scanners and extracting more information about the tissues. The tech can detect tumours without having to inject dye into the body, which can be associated with kidney damage and allergic reactions in some patients. Those involved in the project will scan glioblastoma patients undergoing chemotherapy after surgery and chemoradiotherapy. It is hoped the research will establish that, unlike conventional MRI scans, FCI can tell the difference between tumour growth and progression, and "pseudo-progression" which looks like tumour but is not cancerous tissue, which could improve care and quality of life. The new tech was described as "another example of the pioneering work coming out of the University of Aberdeen", by the charity Friends of ANCHOR. Professor Anne Kiltie, who is leading the study, said: "If we can detect true tumour progression early, we can swap the patient to a potentially more beneficial type of chemotherapy. "Also, being able to verify that a patient has pseudo-progression will prevent effective chemotherapy being stopped too early, because it was thought that the tumour has progressed, thus worsening prognosis. "Providing certainty will also reduce anxiety for both patients and relatives and improve the quality of life of patients. "Importantly, having a reliable method to identify progressive disease will allow development and more precise evaluation of emerging potential treatments. This is of particular importance as patients currently have a limited choice of treatments for combating their cancer. Scotland and beyond."
The Independent
a day ago
- Health
- The Independent
New scanner could detect brain tumours in world-first
Scientists in Scotland have developed a pioneering new scanner aimed at improving treatment for glioblastoma, the most common and aggressive type of brain tumour. Field Cycling Imaging (FCI), a new technology derived from MRI, will be used by researchers at the University of Aberdeen and NHS Grampian after receiving £350,000 in funding from the Scottish Government. This unique scanner can track brain cancer spread by generating detailed images, working at low magnetic fields and detecting tumours without the need for injected dye. It is hoped FCI will differentiate between tumour growth and "pseudo-progression," allowing for more effective chemotherapy adjustments and preventing premature cessation of treatment. The technology aims to provide more accurate information for patients and clinicians, potentially improving quality of life, treatment effectiveness, and healthcare cost-effectiveness for glioblastoma patients.
The National
a day ago
- Health
- The National
New scanner used for brain tumour patients trialled in world-first
Scientists at the University of Aberdeen and NHS Grampian have been awarded £350,000 of Scottish Government funding to generate never-before-seen images of glioblastoma brain tumours. The technology is hoped to potentially improve treatment and quality of life for patients, by investigating a new way to scan glioblastoma brain tumours – the most common and aggressive type, with more than 3000 new patients in the UK diagnosed each year. Half of all patients die within 15 months of diagnosis even after extensive surgery, radiotherapy and chemotherapy. READ MORE: Anas Sarwar urged to whip Scottish Labour MPs against welfare cuts Field cycling imaging (FCI) is a new and specialist type of low-field MRI scan pioneered in Aberdeen and has already been found to be effective in detecting tumours in breast tissue and brain damage in stroke patients. It is hoped it can now be used to help brain tumour patients. MRI scanners were invented at the University of Aberdeen 50 years ago, but the new FCI scanner is the only one of its type used on patients anywhere in the world. The FCI derives from MRI but can work at low and ultra-low magnetic fields which means it is capable of seeing how organs are affected by diseases in ways that were previously not possible, and can vary the strength of the magnetic field during the patient's scan – acting like multiple scanners and extracting more information about the tissues. The new technology can detect tumours without having to inject dye into the body, which can be associated with kidney damage and allergic reactions in some patients. The team of doctors and scientists involved will scan glioblastoma patients undergoing chemotherapy after surgery and chemoradiotherapy. It is hoped the research will establish that, unlike conventional MRI scans, FCI can tell the difference between tumour growth and progression, and 'pseudo-progression' which looks like tumour but is not cancerous tissue, which could improve care and quality of life. (Image: PA) Professor Anne Kiltie, Friends of ANCHOR chair in clinical oncology at the University of Aberdeen, who is leading the study said: 'We already have evidence that FCI is effective in detecting tumours in breast tissue and brain damage in patients following a stroke. 'Applying this exciting new technology to glioblastoma patients could give us a much more accurate and detailed picture of what is going on in their brain. 'If we can detect true tumour progression early, we can swap the patient to a potentially more beneficial type of chemotherapy. 'Also, being able to verify that a patient has pseudo-progression will prevent effective chemotherapy being stopped too early, because it was thought that the tumour has progressed, thus worsening prognosis. 'Providing certainty will also reduce anxiety for both patients and relatives and improve the quality of life of patients. 'Importantly, having a reliable method to identify progressive disease will allow development and more precise evaluation of emerging potential treatments. This is of particular importance as patients currently have a limited choice of treatments for combating their cancer. 'Ultimately, this study and related future work will improve quality, effectiveness and healthcare cost-effectiveness in the treatment of glioblastoma patients across Scotland and beyond.' Sarah-Jane Hogg, chief executive at Friends of ANCHOR, added: 'This is a really promising development and another example of the pioneering work coming out of the University of Aberdeen. 'Professor Kiltie's role at the University is fully funded by Friends of ANCHOR through our Dream Big appeal, and our thanks go to our donors and fundraisers for the part they've played in supporting this work.' A spokesperson for The Brain Tumour Charity said: 'This pioneering technology is a promising step forward for people who have been diagnosed with the most aggressive type of brain tumour. 'It's positive news in contrast to the accounts we often hear about delays to diagnosis, limited treatment options, and the struggle to get vital innovations to the NHS front line. 'We welcome this, and The Brain Tumour Charity will continue working with clinicians and policymakers in Scotland – and the rest of the UK – to help bring advances to patients more quickly.'
STV News
a day ago
- Health
- STV News
New scanner used for brain tumour patients trialled in world-first
A 'pioneering' new scanner derived from MRI technology could be used to track brain cancer spread and lead to improved treatment for patients, researchers have said. Scientists at the University of Aberdeen and NHS Grampian have been awarded £350,000 of Scottish Government funding to generate never-before-seen images of glioblastoma brain tumours. The technology is hoped to potentially improve treatment and quality of life for patients, by investigating a new way to scan glioblastoma brain tumours – the most common and aggressive type, with more than 3,000 new patients in the UK diagnosed each year. Half of all patients die within 15 months of diagnosis even after extensive surgery, radiotherapy and chemotherapy. Field cycling imaging (FCI) is a new and specialist type of low-field MRI scan pioneered in Aberdeen and has already been found to be effective in detecting tumours in breast tissue and brain damage in stroke patients. It is hoped it can now be used to help brain tumour patients. MRI scanners were invented at the University of Aberdeen 50 years ago, but the new FCI scanner is the only one of its type used on patients anywhere in the world. The FCI derives from MRI but can work at low and ultra-low magnetic fields which means it is capable of seeing how organs are affected by diseases in ways that were previously not possible, and can vary the strength of the magnetic field during the patient's scan – acting like multiple scanners and extracting more information about the tissues. The new technology can detect tumours without having to inject dye into the body, which can be associated with kidney damage and allergic reactions in some patients. The team of doctors and scientists involved will scan glioblastoma patients undergoing chemotherapy after surgery and chemoradiotherapy. It is hoped the research will establish that, unlike conventional MRI scans, FCI can tell the difference between tumour growth and progression, and 'pseudo-progression' which looks like tumour but is not cancerous tissue, which could improve care and quality of life. Professor Anne Kiltie, Friends of ANCHOR chair in clinical oncology at the University of Aberdeen, who is leading the study said: 'We already have evidence that FCI is effective in detecting tumours in breast tissue and brain damage in patients following a stroke. 'Applying this exciting new technology to glioblastoma patients could give us a much more accurate and detailed picture of what is going on in their brain. 'If we can detect true tumour progression early, we can swap the patient to a potentially more beneficial type of chemotherapy. 'Also, being able to verify that a patient has pseudo-progression will prevent effective chemotherapy being stopped too early, because it was thought that the tumour has progressed, thus worsening prognosis. 'Providing certainty will also reduce anxiety for both patients and relatives and improve the quality of life of patients. 'Importantly, having a reliable method to identify progressive disease will allow development and more precise evaluation of emerging potential treatments. This is of particular importance as patients currently have a limited choice of treatments for combating their cancer. 'Ultimately, this study and related future work will improve quality, effectiveness and healthcare cost-effectiveness in the treatment of glioblastoma patients across Scotland and beyond.' Sarah-Jane Hogg, chief executive at Friends of ANCHOR, added: 'This is a really promising development and another example of the pioneering work coming out of the University of Aberdeen. 'Professor Kiltie's role at the University is fully funded by Friends of ANCHOR through our Dream Big appeal, and our thanks go to our donors and fundraisers for the part they've played in supporting this work.' A spokesperson for The Brain Tumour Charity said: 'This pioneering technology is a promising step forward for people who have been diagnosed with the most aggressive type of brain tumour. 'It's positive news in contrast to the accounts we often hear about delays to diagnosis, limited treatment options, and the struggle to get vital innovations to the NHS front line. 'We welcome this, and The Brain Tumour Charity will continue working with clinicians and policymakers in Scotland – and the rest of the UK – to help bring advances to patients more quickly.' Get all the latest news from around the country Follow STV News Scan the QR code on your mobile device for all the latest news from around the country
