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Google Algorithm to Search Out Hospital Superbugs
Googling Yourself writes "Researchers in the UK plan to use Google's PageRank algorithm to find how super-bugs like MRSA spread in a hospital setting. Previous studies have discovered how particular objects, like doctors' neckties, can harbor infection, but little is known about the network routes by which bugs spread. Mathematician Simon Shepherd plans to build a matrix describing all interactions between people and objects in a hospital ward, based on observing normal daily activity."
They're not using the PageRank algorithm itself, but an algorithm similar to how they conjecture Google works. In actuality, they're building a graph of interactions and finding the most linked to nodes, which is a fairly easy graph problem and nothing too exciting. It's the novelity of using this in hospitals that makes it notable. The PageRank reference is just for media attention/allowing non-compsci people to understand it, though.
Markov chains are the original, mathematical theory. This is just an application of Markov chains to tracking disease transmission, a fairly common method that long pre-dates Google. Google's page rank algorithm is another application of Markov chains to citation ranking (and, as it turns out, it wasn't the first time that it was applied to that either).
For purely selfish reasons I love that the superbugs invasion means I no longer have to wear ties when seeing my patients. Now if I could just figure out a way to get rid of my nasty pager. :)
Indeed it is!
There's also a view that having (letting?) staff wear their uniforms outside the hospital both brings in bugs from outside the hospital and lets them out into the real world.
There are some absolutely basic things that the NHS could do, but for some inexplicable (cost related?) reasons won't do. It doesn't need high-tech investigations and it's not rocket science - just basic hygene sense.
politicians are like babies' nappies: they should both be changed regularly and for the same reasons
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Towards the Singularity.
In 2005, Britain's going nucking futs over MRSA. It was used as a reason to justify taking the NHS (National Health Service. Translation: universal healthcare) and molding it into whatever each Party wanted the world to be like. You couldn't pick up a newspaper without SuperBug this or SuperBug that on the front page.
Meanwhile, in America, the sound of crickets gently chirp. Chreeeep, chreeeep, chreeeep. Nobody gave a tinker's cuss about MRSA. At all.
OK. That's the scene. People in Britain thinking that MRSA is going to turn the country into 28 Days Later. America thinks MRSA is some rapper's name.
And then the official numbers came out for MRSA deaths for that year.
England/Wales, in 2005: 1629 deaths.
United States, in 2005: 18,650 deaths.
There are more people in the States than England and Wales. So I looked up the numbers for the land of the free and the home of the Whopper and Pommie/Limey/Rosbif-TaffyLandSheepCountry.
US population at the time - 295 million.
Eng-Cym population in the last census (and it won't have doubled from 2001-2005) - 52 million.
So what were the chances this would have killed YOU? Well, remote (if you're reading this now), but what about back then? The equation is:
[population of the country in 2005] / [deaths from MRSA there in 2005]
= [chance of being killed by MRSA in 2005].
The chances you had of MRSA killing you in England and Wales, with everyone going mental over it, in 2005 - 1 in 32,000.
Chances of dying the same death in a country with market-driven health system, where people are NOT specifically looking for MRSA - 1 in 15,800.
I'll let those numbers sink in. British readers might want to look at them again and make sure up is still up.
And now I'm going to pretend to be really stupid here: I could be spectacularly wrong, but it LOOKS like the numbers prove a person was twice more likely to kick the bucket from MRSA in the States than in Blighty (OK, England and Wales. I'll let someone else add Scotland and Northern Ireland to the mix). America, with its pay-as-you-go health system making monster profits, not as good as a system some people would tell you is on its last legs.
What was even funnier (maybe 'funnier' isn't quite the right word) was the excuse used in the UK National Statistics Office for why their number was so HIGH:
This is either the longest and most researched Flaimbait ever to appear on SlashDot, or I just blew. Your. Freaking. Mind.
Unless you're American: in which case, just think of this like the slang you don't understand in Doctor Who, words like 'chav' and 'ASBO'.
Shiny. Let's be bad guys...
Ayn Rand is endorsing Ron Paul. It's like how one infection points to another- just like Google!
"Antibacterial" household products contain something different than soap. What thing that is, varies.
/. after all.
I'm not a chemist or a doctor. And I assume that if this is mistaken in any way, someone will correct me, since this is
For household use you don't need antibacterial agents to effectively wash your hands - because the act of actual abrasion with the surface-tension eliminating properties of soap removes most things from your skin. For the most part, your hands don't harbor a lot of problems IN the surface, because your body is busy killing that.
In my opinion, there are also two major classes of these antibacterial agents - which I'll classify as "simple" and "complex" To my knowledge, it's extremely difficult and rare for bacteria to become resist to "simple" antibacterial agents.
Simple antibacterial agents are things that kill everything. Like bleach (e.g. Chlorox), or high concentrations of alcohol (e.g. Glass Plus). To a lesser extent vinegar, ammonia, salt... These things are not necessarily good for people, but people are really big and can avoid drinking them in really high doses... but they're still really bad for bacteria etc to swim completely in and they get annihilated, because these things basically just melt cell walls.
For the most part these are quite safe to clean with... they don't especially build up in your system, so as long as you never get a super high dose, usually by breathing or drinking it, you're safe. But I don't recommend you swim in bleach, get it in your eyes, and drink it either. Those example cleaners are relatively harmless in most controlled cleaning situations - but there are plenty of options in this category that aren't - like strong acids - we just don't usually put them in consumer cleaners in high doses.
So I have no objection to, say, a little bleach being added to surface cleaners.
The antibiotics you take orally are wildly different, and must be complex. They can't be TOO bad for you, or they'd be rat poison and not a drug. So they try to attack something bacteria-cell specific that human cells are immune to. But bacteria operate in a range of ways, so often this only works on some bacteria. And they mutate... so the more specific and narrow the antibiotic is, the easier it is for the bacteria to become immune. The broader it is, the more likely it hurts you.
Some companies - because it's what the uneducated consuming public wants - are putting vaguely these kind of agents in household cleaning products. Not EXACTLY the same drugs we're taking orally. But chemicals that have narrow, complex effects on bacteria, which probably encourage mutation. Those mutations may or may not impact the effectiveness of current or future drugs.
HOWEVER, as much as I think antibacterial hand soap is pretty high on the list of evils, it's not NEARLY as bad as the number of people who merely don't finish the antibiotics they were prescribed. Those people are ruining the world.
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wooden cutting boards are awesome - but the explanation I always heard was the tannins etc in the wood being actively antibacterial.
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Triclosan is the substance that most "antibacterial" soaps contain. It has very little to do with the development of antibiotic resistance. However, several studies have shown that soap and water are about as effective with it, as without it, in terms of preventing infections.
Development of antibiotic resistance has to do with 3 factors:
1. Overprescription of antibiotics - i.e. giving Abx to someone who has a cold. Whether it's self-medication, or done by an MD is irrelevant in this case.
2. Improper prescription of antibiotics - i.e. not everything in the world can be cured with a 5-day course of Azithromycin (Zithromax). Too many doctors just hand it out like candy. We should really rely on testing for bug susceptibility in many more cases than we do now.
3. Improper use of antibiotics - i.e. not finishing the course. This is an old problem, that seems to have no solution, especially when it comes to the "internet-know-it-all" patients... who think that 5 minutes of googling qualifies them to self-medicate at will.
If only it were as simple as you say!
Staphylococcus aureus lives on normal skin. You're probably crawling with billions of these little buggers. Such is life. Most of the time, methicillin-sensitive Staph outgrows the methicillin-resistant Staph (in theory, there is a difference in rate of replication, since MRSA has that extra cassette that it needs to copy)
But in certain places in the U.S., community-acquired MRSA infections make up as many as 35% of all infections (from simple skin infections to bacterial sepsis), at which point isolation practices are pretty pointless, particularly since they've never been proven to actually decrease rate of transmission. (Although granted, if you die from MRSA, it's going to be hospital-acquired MRSA that gets you.)
Other multi-drug resistant bacteria are prevalent in the environment--in the soil, on flat surfaces, in computer keyboards--and don't cause illness in immunocompetent people. Examples are Pseudomonas aeruginosa, Acinetobacter baumanii, Enterobacter cloacae, Stenotrophomonas maltophila, and Alcaligenes xylosoxidans. But Gram-negative rods, more so than Gram-positive cocci, are likely to kill you in less than 24 hours. (Necrotizing fasciitis--caused by so-called "flesh-eating bacteria"--is more likely caused by Group A Streptococcus, which is very sensitive to straight-up penicillin, and MSSA)
MRSA and other multi-drug resistant bacteria are simply not transmitted by air. Respiratory isolation rooms (negative pressure rooms with separate air filters) are good for preventing the spread of pulmonary tuberculosis, and various non-fatal viral illnesses, but that's about it. And when you've got 30-40 kids with RSV, there's no way you're going to isolate all of them.
Most vectors of these bacteria are not sick from them, and they're so prevalent that it's not practical to exclude people who are colonized with this stuff. Most health-care workers are definitely colonized, for example, and it's no good preventing these people from working. Making people who have upper respiratory symptoms wear masks may be helpful, but making everyone do so? Studies don't show any difference in transmission.
Any linens that might have been contaminated are destroyed anyway.
The measures that have been proven to decrease transmission of bacteria and viruses are (1) thorough hand washing, meaning lathering up and running your hands under water for at least 15 seconds or (2) using the alcohol-based anti-bacterial gels (although this won't destroy Clostridium difficile spores) Everything else (masks, gowns, gloves), in terms of preventing transmission of these bacteria, is, according to the studies, infection control theater. (I'm not talking about universal precautions here, which definitely keep health care workers from getting HIV and hepatitis.)
And when you come in on a backboard with C-collar because you were in a car-crash, infection control sort of takes a back seat until they take care of your airway, breathing, and circulation. There's no way you're going to keep someone dying from trauma in a quarantined area until you make sure they're not colonized with any of this stuff.
Bottom line: wash you hands, and stop asking your physician for antibiotics whenever you or your kid have the sniffles. That'll cut the incidence of MRSA and other multi-drug resistant bacteria.
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