Other articles by Tom Beal:

Wildfire proves useful UA scientist sees sun power in new lightClouds raise big monsoon question: Are we there yet? Study boosts solar as an investment State in 'bull's-eye' for changeCity breeds ideal climate for virus-carrying pestsUA's goal for Biosphere 2: self-sufficient science hubBiosphere 2 seeks to answer questions about how life affects worldTwo Tucson weather records fallToday's storm brings record low, rainfall amount for Tucson

Administrative & Professional
Jorgensen Brooks Group
Counselor Sales and Marketing
Everready Glass
Sales Reps Health Care
Dependable Health Services
Physical Therapists Health Care
CENTRAL ARIZONA COLLEGE
DIRECTOR OF HEALTH INFORMATION MANAGEMENT Mechanical
Komatsu Equipment Co
Resident Field Mechanic Finance and Accounting
Charles E. Gillman Company
Accounting Specialist Health Care
Sierra Tucson
Eating Disorders Program Coordinator

When hospitals were looking for a quicker way to detect a type of bacteria blamed for 95,000 infections and as many as 19,000 deaths each year, University of Arizona medical microbiologist Donna Wolk stepped up to the bench.

Working from dual labs at University Medical Center and the UA's Bio5 Institute, Wolk tested a machine that employed advanced DNA detection to identify the presence of MRSA from a nasal swab in 72 minutes rather than days.

MRSA, short for methicillin-resistant staphylococcus aureus, is a so-called "superbug" that resists treatment with commonly administered antibiotics.

GeneXpert, the machine that tests for it genetically, was developed by Cepheid of Sunnyvale, Calif., which won approval from the Food and Drug Administration in April 2007 for its deployment in health centers.

It took nine months from the beginning of Wolk's clinical trial to FDA approval — a process that usually takes two to five years, she said.

Wolk is now testing a different analysis, performed by the same machine, that will determine in less than an hour whether wound infections are MRSA or a more easily treatable strain of staph.

The alternative to both tests — growing bacteria cultures in a laboratory — is a one- to two-day process.

One Tucson hospital is using the machine to test every patient upon admission, transfer and discharge.

The quicker results from universal DNA screening have helped Tucson's Veterans Medical Center cut its infection-transmission rates dramatically, said Linda Groetken, MRSA program coordinator there.

Carriers of the bacteria — which the VA has found to be about 8 percent to 10 percent of the incoming population — are isolated so that they can be treated with more rigorous hygiene procedures, Groetken said.

Groetken also oversees a program to increase hand-washing and other routine hygiene throughout the VA hospital, with an emphasis on staff training and patient education.

Besides the scientific challenge, Wolk had an overriding reason for helping to develop the technology. "Nobody should get sick from going to a hospital," she said.

"I got into it because MRSA infections were increasing every year," Wolk said.

"Our goal was to create and work with companies who were creating faster and more accurate laboratory methods for identifying carriers and also the actual infections."

Wolk did not invent the technology, but she worked with the scientists at Cepheid to refine it.

"We helped develop the product from an idea into practice. We got it from bench to bedside."

Groetken provided a "snapshot" of the effectiveness of the VA program, part of a nationwide drive to reduce hospital-acquired infections at VA Health Care centers.

Last month, the Tucson VA hospital's infection rate (patients who acquired an infection during their hospital stay) was 0.4 per thousand days of patient care, Groetken said. In August of last year, it was 0.9 per 1,000.

Health care facilities reported 1,305 cases of "invasive" MRSA to the state Department of Health Services last year, and 1,336 in 2006.

Other area hospitals say they are making progress against the MRSA problem, though none is using universal surveillance.

Mike Letson, spokesman for Tucson Medical Center, said his hospital reduced "hospital- acquired MRSA rates" 34 percent since beginning a renewed push for testing, hygiene and education in May.

TMC uses the Cepheid GeneXpert machine to screen patients in several areas of the hospital, including its intensive-care and neonatal intensive-care units, Letson said.

At UMC, screening is done in intensive care and on another patient floor identified as a high-risk area, said Dr. Sean Elliott, medical director for infection prevention.

UMC has Cepheid's DNA technology but has not yet trained its staff to use it, Elliott said. It is currently using a "rapid-culture" process to test for MRSA and a second type of antibiotic-resistant staph. The turnaround time for rapid-culture testing is 18 hours, he said.

Elliott said UMC has made progress in reducing infections by isolating intensive-care unit patients until the results are in.

He said UMC is saving $250,000 to $400,000 a month — the cost of increased patient days previously caused by hospital-acquired infections.

The jury is out on whether universal screening is worth the cost, Elliott said, but he predicted that hospitals will be moving in that direction either voluntarily or through legislation that requires tracking of hospital-acquired infections.

Wolk said testing heightens awareness of the problem for hospital staff members.

"It's been very effective in hospitals where it's been used in conjunction with infection-control practices," Wolk said. "It has decreased transmission by up to 70 percent."

In addition to the need to protect patients, hospitals have increasing financial reasons to cut their rates of MRSA transmission.

The Centers for Medicare and Medicaid Services instituted rules effective next Wednesday that deny additional payment for hospital-acquired infections resulting from a variety of procedures.

"Basically, we're asking hospitals to do what they reasonably should be doing," Medicare spokeswoman Ellen Griffith said.

"Private insurers, they will look at it and may do something analogous, but the primary goal of this is to improve quality so that when your loved one goes into a hospital, they are taken care of," Griffith said.

Documenting the presence of MRSA at admission will become more important, she said.

Many of us carry MRSA in our bodies, usually with no ill effect. The federal Centers for Disease Control and Prevention estimates that one-third of the population carries some strain of staph bacteria.

In a hospital setting, the bacteria can be transmitted hand-to-hand. It can enter the bloodstream through a wound or a puncture from a medical procedure. The resulting infection is serious and sometimes fatal.

Most reported MRSA infections are health-services based, occurring in hospitals, clinics and nursing homes, but a growing number of infections are now being reported in the community at large.

These community-associated MRSA infections occur most often in prisons and schools, and among sports team members.

Wolk is a board-certified medical microbiologist, which allows her to direct UMC's Microbiology/Molecular Diagnostics lab, a task usually reserved for pathologists who hold medical-doctor degrees.

"It means I oversee patient care as a Ph.D.," Wolk said. "As such, I understand what tools will be most helpful to our patients."

Another device she is testing in her lab for use at UMC also employs genetic techniques to identify and type 20 kinds of viruses, from the common cold's rhinovirus to strains of potentially lethal influenza.

Most of the companies she works with are out of state, Wolk said, though she has advised local biotech firms looking to develop technology for use in a hospital setting.

"We hope to attract or spin off one of our own someday," she said.