NOSOCOMIAL INFECTIONS Phase 1: Testing the efficacy of Nano-Mg (OH) 2 Dorothea A. Dillman PhD, RN, CCRN, LNC

Nosocomial Infections The National Nosocomial Infection Surveillance (NNIS) system through the CDC defines it as a localized or systemic condition  That results from adverse reaction to the presence of an infectious agent(s) or its toxin(s)  And that was not present or incubating at the time of admission to the hospital.

Nosocomial Infections Incidence  5% - 10% of all acute-care hospitalizations;  ¼ of nosocomial infections occur in ICUs  the incidence rate is 5 infections per 1,000 patient-days. Based on the 35 million patients admitted to 7,000 acute-care institutions in the United States, the incidence of Hospital Acquired Infections (HAIs) is more than 2 million cases per year. HAIs result in an additional 26,250 deaths (range 17,500-70,000) Data updated August 2007 by Quoc V Nguyen, MD, Assistant Professor, Department of Pediatrics, New York State Health Department

Nosocomial Infections Mortality/Morbidity  Nosocomial infections are estimated to more than double the mortality and morbidity risks of any admitted patient and probably result in as many as 70,000 deaths per year in the United States. This is the equivalent of 350,000 years of life lost in the United States.  90,000 deaths/year Data updated August 2007 by Quoc V Nguyen, MD, Assistant Professor, Department of Pediatrics, New York State Health Department Weinstein RA. Emerg Infect Dis 1998;4: Jarvis WR. Emerg Infect Dis 2001;7:

Nosocomial Infections Attributable annual cost: $4.5 –$5.7 billion Cost per Infection  Average nosocomial infection, mean cost = $13,973  Wound infections$3,000 -$27,000  Sternal wound infection$20,000 -$80,000  Catheter-associated BSI$5,000 -$34,000  Pneumonia$10,000 -$29,000  Urinary tract infection$ 1,962 Cost is largely borne by the healthcare facility, not 3 rd party payors Weinstein RA. Emerg Infect Dis 1998;4: Jarvis WR. Emerg Infect Dis 2001;7: Nettleman M. In: Wenzel RP, ed. Prevention and Control of Nosocomial Infections, 4thed. 2003:36.

Nosocomial Infections Nosocomial infections by pathogen:  Staphylococci  Pseudomonas  Escherichia coli Antibiotic-resistant nosocomial infections  Methicillin resistant staphylococcus aureus (MRSA)  Vancomycin-resistant staphylococcus aureus  Vancomycin-resistant enterococci (VRE) 70% are due to antibiotic-resistant organisms Burke JP. New Engl J Med 2003;348: Safdar N et al. Current Infect Dis Reports 2001;3:

Nosocomial Infections Studies show that ~70% of bacteria that cause nosocomial infections are resistant to at least one antibiotic commonly used to treat them. According to the CDC's National Nosocomial Infection Surveillance System (NNIS system), multidrug- resistant pathogens have become increasingly problematic in recent years, especially in the critical care setting

Nosocomial Infections The CDC estimates that ~36% of nosocomial infections can be prevented if health care workers adhere to specific infection control guidelines when caring for patients In 1985, the CDC's study on the Efficacy of Nosocomial Infection Control reported that hospitals reduced infection control rates by approximately one third when the following 4 key infection control components were implemented

Infection Control 4 key infection control components:  An effective hospital epidemiologist  An infection control practitioner for every 250 beds  An active surveillance mechanism  Ongoing control efforts

Controlling Nosocomial Infections Guidelines for Environmental Infection Control in Health-Care Facilities\  uide_03.pdf The scientific community has published a vast amount of information and guidance related to nosocomial infection surveillance.  When healthcare workers fail to recognize or prevent practices that contribute to HAI, surveillance techniques are ineffective.

Controlling Nosocomial Infections Bacteria grow wherever there is air, dust, and moisture and the patient care environment continues to be ideal for providing readily available pathogens. Developing additional means to protect patients when practice techniques fail may significantly reduce the incidence of nosocomial infections.

Controlling Nosocomial Infections Research Plan  Utilizing a product throughout the patient environment that will destroy and prevent the growth of infecting pathogens.  Utilizing delivery methods that will make the product easy to use for complete coverage.  The product must be safe to handle and safe for all sensitive, electronic equipment.

Feasibility Study Phase 1: Feasibility study on the anti-pathogenic behavior of nano-Mg (OH) 2 Experimental Design  Demonstrate efficacy of nano-Mg (OH) 2 against common nosocomial organisms Staphylococci, Pseudomonas, Escherichia coli, Clostridium Difficile, Klebsiella, Serratia, Candida Albicans Methicillin resistant staphylococcus aureus (MRSA), Vancomycin-resistant staphylococcus aureus, Vancomycin- resistant enterococci (VRE)  Use same concentrations as Dr. Yulin Deng in his experimental study of nano-Mg (OH) 2 on E-coli