Blog | Wednesday, November 27, 2013

Don't BUGG me! (some more)

Recently I blogged about the BUGG study. This paper has generated a fair amount of media coverage, and as I looked through the headlines this morning, I was struck by the variability of the messages they seem to contain. Take a look at the headlines below all describing the BUGG study:
• Gloves, Gowns in ICUs Cut Down on MRSA
• Cheaper Way to Stop MRSA Adds No Patient Risk
• Widespread Glove, Gown Use In ICUs Could Reduce Spread Of MRSA
• Gloves and gowns use in ICU not completely effective against infection, says study
• ICU gloves and gowns may reduce infection
• Use of gloves, gowns by health care workers for ICU patient contact does not reduce MRSA infection
• Gloves, Gowns In ICU Reduces MRSA 40 Percent
• Gloves and Gowns Don’t Cut Hospital Care Infections, A Study Finds
• Universal gloves, gowns in ICU reduced MRSA acquisition
• Universal glove use not associated with reduction in acquiring antibiotic-resistant bacteria
• Widespread gown and glove use by health-care workers in ICU reduces MRSA 40 percent
• Gown And Glove Use In ICU Cuts MRSA by 40 Pct
• Gloves and Gowns Don’t Stop Spread of All Infections in Hospitals
• ICU Gloves and Gowns Might Reduce MRSA Infection, Study Says
• Universal Gown And Glove Use By Health-Care Workers In ICU Reduces MRSA 40 Percent
• Gloves and gowns do not protect against MRSA or VRE, study shows
• Study Examines Effect of Use of Gloves and Gowns For All Patient Contact in ICUs on MRSA or VRE
• Universal gown and glove use by health-care workers in ICU reduces MRSA 40 percent
• Wearing gown and gloves for all ICU patient contact reduces MRSA infections by 40%
• Study-Hospital Precautions Do Nothing to Stop Infections

Interestingly, if you examine each headline carefully you find that almost every one of them is technically correct, though if you had never read the paper you would likely be very confused. It’s a great example of how technical papers get translated for the general public. In this case it’s related to understanding the difference between colonization and infection, the differences between types of outcomes (are we talking about device-associated infections or pathogen-specific infections?), and combined vs. single outcomes (MRSA and VRE combined vs. MRSA and VRE evaluated separately).

Lastly, even if you read the paper and have a good understanding of its findings, the implications of the study will be different based on the value judgments of the reader. Despite all of the confusion, I think that you’ll seldom find a better designed or better executed study in health care epidemiology. In Facebook parlance, “It’s complicated.”

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.