Blog | Thursday, January 10, 2013

Outbreak linked to cardiac surgeon


An outbreak linked to a cardiac surgeon
The Los Angeles Times reports today on an outbreak of nosocomial Staphylococcus epidermidis endocarditis in patients undergoing valve replacement surgery at Cedars-Sinai Medical Center. The outbreak involved 5 patients, 4 of whom required replacement of the prosthetic valve. All the cases were linked to a cardiac surgeon who had what sounds like an eczematous process on his hands.

The article notes: "The infections raise questions about what health conditions should prevent a surgeon from operating and how to get the best protection from surgical gloves. Surgeons with open sores or known infections aren't supposed to operate, but there is no national standard on what to do if they have skin inflammation, said Rekha Murthy, medical director of the hospital's epidemiology department. She added that there were also no national standards on types of gloves used, whether to wear double gloves or how many times surgeons should change those gloves during a procedure."

Rekha's comments point out a few examples of the many unknowns in health care epidemiology. As hospital epidemiologists we are held accountable to fix problems, but often we're bereft of the answers to such basic questions. This has been a recurrent theme on this blog, and as fellow blogger Eli Perencevich, MD, ACP Member, has stressed, we lack funding to perform the research to fill the gaps in our knowledge base. After this week's Infectious Diseases fellowship match, which demonstrated that few young doctors remain interested in our field, it appears that we may also eventually lack the human resources to address these problems.

Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Richmond, Va., with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. This post originally appeared at the blog Controversies in Hospital Infection Prevention.