Thursday, July 26, 2007
The ongoing fight against bacterial infection

By Anthony Policastro, M.D

There are many bacteria that cause infections. Some of them are common. Some are not. One of the more common bacteria goes by the name of Staph aureus (short for staphylococcus aureus). Infections with staph aureus are seen frequently. When I was doing my residency, we had a family of antibiotics to treat it. The name of that family was methicillin. If we saw an infection that looked like staph aureus, we had several antibiotics to choose from. Most of the infections we saw were skin infections. Staph aureus is the most common cause of skin infections with pus in them. It is also one of the common causes of impetigo. It can cause serious infections in other parts of the body. Fortunately, those infections are less common. It was easy to see a skin infection and know that it was staph aureus. All that needed to be done was order methicillin and treat the infection. Over the years two things happened. The first was that we began to see some staph aureus that were no longer sensitive to methicillin. It was a few bacteria at first. However, the frequency became more and more. The result is that now most staph aureus is resistant to methicillin. The name we give to these new strains is Methicillin Resistant Staph Aureus (MRSA). MRSA is now so common that many people have heard the term. The second thing that happened is that the skin infections became more severe. At one time, you could treat a patient with methicillin. If the infection did not get better quickly, you could change the antibiotic. It was not a problem to delay using the right antibiotic. However, within the last 2 - 3 years MRSA infections have become much more aggressive. They grow faster. They grow deeper into the body tissue. They spread faster. It is important to treat them early. It is important to treat them quickly. It is important to treat them aggressively. If someone gets a skin infection, there are four things they should look for. One is redness. If it stays at the site of the infection, that is not very worrisome. If the redness begins to enlarge, that is more of a problem. The second thing to look for is tenderness. The more tender an infection is, the more it is likely to be under pressure. Treating it to relieve that pressure is important. The third thing is to see if the area is hot. The fourth is to look for swelling.If someone has an infection that is red, hot, swollen and tender, they should be seen for it. Other signs suggest that the infection is starting to spread. Individuals with those signs need to be seen urgently. Fever means that the entire body is reacting to a local infection. A red line extending from the infection suggests that the infection is spreading along the lymph tracks in the body. Swollen glands near the infection means that the infection has already spread to those glands. These three things warrant a visit to the physician or emergency room very quickly. Once the infection is diagnosed, it will need to be treated with an antibiotic. That antibiotic will need to be something other than methicillin. We used to use Keflex for these infections, but MRSA is usually resistant to that as well. The drugs that we commonly use are called Clindamycin or Bactrim. Staph aureus is still common. However, the way it behaves has changed. The way we treat it has also changed. It is a bacteria that deserves some respect.

Memory walk
The Kent-Sussex Memory Walk Committee is fully involved in the planning of Memory Walk 2007, the only annual fundraiser sponsored by the Alzheimer's Association in Sussex County. The walk will take place at Grove Park in Rehoboth Beach on Sept. 29, with registration beginning at 8:30 a.m. Darryl Ciarlante and Joe Zuber, owners of Dos Locos Restaurant at 208 Rehoboth Ave., Rehoboth Beach, will be the honorary chairs this year. Eighteen Teams are pre-registered, and we are actively recruiting for teams and individual walkers at this time. Registration is available online at For more information, contact the Branch Office in Georgetown at 854-9788.

Excellence in Nursing Practice
The Delaware Excellence in Nursing Practice Awards were presented to nurses who exemplify the profession as selected by their peers. The awards were presented during a banquet at the Modern Maturity Center on Tuesday, July 17. Those in attendance included Gov. Ruth Ann Minner, Rep. Bethany Hall-Long, 8th District and representatives from area colleges and universities, associations, area hospitals and public health. Major sponsors for the event were Christiana Care Health System, Bayhealth Medical Center, Delaware Healthcare Association and Nemours/duPont Hospital for Children. George Rudloff, President of the Delaware Organization of Nurse Executives and Penny Seiple, president of the Delaware Nurses Association, Norine Watson, representing the nomination review panel announced the finalists and the award winners from each of the seven categories. Nurse Educator-Teresa Towne MSN, RNC, Clinical Nurse Educator, Bayhealth Medical Center Acute Care-Mary Newman RN, CPON Direct Care Nurse-Pediatric Oncology Nemours/duPont Hospital for Children Advanced Practice-Cheryl Layfield RN, MSN, CFNP, NCFN, CEN, CCRN Nurse Practitioner, Indian River School District New Graduate-Michael Golecki RN, Direct Care Nurse-Pediatric Intensive Care Unit, Nemours/duPont Hospital for Children Long-Term Care-Dawn Marvil RN, LifeCare at Loftland Park Community Based-Maryann Merrylees RN, St. Francis Hospital, St. Clare Medical Outreach Nurse Leader-Betty Paulanka EdD, RN, Dean/Professor University of Delaware School of Nursing The Delaware Nurses Association and the Delaware Organization of Nurse Executives administer the Delaware Excellence in Nursing Practice Award. Plans are underway for next year's award event.

CNA of the Year
To recognize the importance of Certified Nursing Assistants (CNAs) as invaluable members of the health care team, nominations are being accepted at Delaware Technical & Community College, Owens Campus, for the annual CNA of the Year award. The award will be presented at the 11th annual CNA Recognition Day held on Friday, Oct. 19, at the Owens Campus in Georgetown. The honoree will be chosen from nominations submitted by family members, friends, employers, and patients based on the CNA's dedication to providing care, comfort, and commitment to his/her patients. Nomination forms must be completed and returned to the college no later than Sept. 15. CNA Recognition Day is an annual event held at the Owens Campus and is co-sponsored by the college along with local hospitals, long-term care facilities, and home health agencies. It provides an occasion for CNAs to improve their professional skills, develop their professional identity, and increase their sense of pride and self-esteem. The event includes workshops, exhibits, door prizes, and networking opportunities as it brings together CNAs from Delaware and the Eastern Shore of Maryland. For more information about the award, the event, or to receive a nomination form, call 302-856-5400, ext. 3190.