HEALTH

Picking up a nasty bug while in hospital?

Concerned about picking up a nasty bug while in hospital? Forget about whether your doctor washed his hands before examining you. Ask when he last dry-cleaned his tie. Neckties worn by doctors can and do carry dangerous pathogens, a clever new study released Monday reveals. It suggests a bedside visit by a well-dressed physician could dole out disease along with comfort and care. The presence of bugs on ties suggests doctors aren't washing their hands enough, or at the right times, said Dr. Allison McGeer, one of Canada's leading infection control experts. "If physicians washed their hands when they were supposed to, their ties would not be contaminated," she said flatly. McGeer suggested these finding probably also pertain outside hospitals, noting male pediatricians often wear ties with cartoon themes to entertain their young patients. "And they should probably think twice about that." Lead author Steven Nurkin came up with the idea that ties might pose a contamination threat while doing surgical studies at the New York Hospital Medical Centre of Queens. Nurkin, who will shortly get his medical degree from the Bruce Rappaport faculty of medicine, in Haifa, Israel, presented his findings Monday at the annual meeting of the American Society for Microbiology in New Orleans. In an interview, Nurkin said he began wondering about the possibility of contamination when he noticed swinging ties coming in contact with patient bedding, even patients themselves. After all, earlier research had shown that items doctors routinely carry - pens, pagers, cell phones and stethoscopes - are often teeming with all sorts of bugs. And cloth is known to harbour pathogens, which is why surgical staff change gowns between patients. But whereas doctors now know to clean their phones and pagers, "the necktie, you don't," Nurkin said. So he and some colleagues from the hospital's infectious disease lab swabbed the ties of 42 doctors, physician assistants and medical students, and cultured the swabs to see what if anything would grow. They compared the results to swabs taken of the ties of 10 hospital security guards, who were used as a control because though they work in a similar environment, they rarely come in contact with patients. Nearly half of the doctors' ties were positive for bugs like Staphylococcus aureus, which can cause wound infections, pneumonia, meningitis and food poisoning among other things.

Only one of the security guards' ties tested positive. McGeer said it's easy to see how this happens - and the type of threat it might pose for the transmission of antibiotic-resistant bacteria and other pathogens. "I go see a patient who has MRSA," she explained, using the acronym for methicillin-resistant Staph aureus. "I get MRSA on my hands, I transfer it to my tie. Then I wash my hands. . . . While I talk to the (next) patient, I fiddle with my tie. And then I transfer the MRSA back from my tie to my hands. And that's what would create the problem." Though the small study found no ties contaminated with MRSA, a tie that can become contaminated with regular Staph can also become contaminated with the antibiotic-resistant form. No one is suggesting ties are modern-day Typhoid Marys in hospital settings. But they may be contributing, in a small way, to the spread of hospital-acquired infections, said McGeer, head of infectious diseases at Toronto's Mount Sinai Hospital. "It's an indication of absence of handwashing and it probably is associated with some risk," she said, noting the last thing a tie-wearing doctor probably does before bending over to examine a patient is to tuck his tie into his shirt. "We talk now about the mobile environment in hospitals. And what we mean by the mobile environment are inanimate objects that get passed from patient to patient. Stethoscopes, commodes, wheelchairs, walkers, whatever. And we don't want those contaminated. And I guess ties have now moved into that category." So what's the solution to the tie dilemma? Nurkin is skeptical whether male doctors are likely to embrace the bow tie. Nor does he think disposal tie condoms - one suggestion from his group - are the answer. His suggestion? "Abolishing ties from clinical practice all together." CP.

Woman gave birth to a child using 21-year-old frozen sperm

A British woman gave birth to a baby boy using sperm from her husband that was frozen 21 years earlier, their doctor said Tuesday. Dr. Elizabeth Pease, a consultant in reproductive medicine at St. Mary's Hospital in Manchester where the baby was born two years ago, said she believed the age of the sperm made the case a world record. Pease said the father had five vials of his sperm "cryopreserved" at the age of 17, before treatment for testicular cancer that left him sterile. Some of the sperm was defrosted to inseminate his partner's eggs when the unidentified couple decided to try to have children in 1995. The first attempt was unsuccessful and the couple began fertility treatment, again using more of the stored sperm. In 2001, the woman successfully conceived during the couple's fourth attempt at in vitro fertilization. She gave birth in 2002. Greg Horne, the senior embryologist at St. Mary's Hospital, said the case proved that long-term freezing can successfully preserve sperm quality and fertility. "This is important to know because semen stored by young cancer patients is undertaken at a time of great emotional stress when future fertility is unlikely to be an immediate priority," he said. "It also suggests that we need to extend follow-up studies of cryobanked sperm up to 25 years at least," he added. Dr. Virginia Bolton, a consultant embryologist at King's College Hospital in London, said the case was welcome news but "not hugely surprising." "From animal studies, the only damage it seems that could occur to frozen sperm is through background radiation," she said. -AP

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