Pneumonia

• Genetic data from the bacteria causing these infections – think CSI for E. coli – tells another story: Most health care-associated infections are caused by previously harmless bacteria that patients already had on their bodies before they even entered the hospital.
• We show that many surgical site infections after spinal surgery are caused by microbes that are already on the patient’s skin.

Surgical infections are a persistent problem

• Among the different types of heath care-associated infections, surgical site infections stand out as particularly problematic.
• A 2013 study found that surgical site infections contribute the most to the annual costs of hospital-acquired infections, totaling over 33% of the US$9.8 billion spent annually.

• Still, surgical site infections occur following about 1 in 30 procedures, typically with no explanation.
• While rates of many other medical complications have shown steady improvement over time, data from the Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention show that the problem of surgical site infection is not getting better.

BYOB (Bring your own bacteria)

• Prior studies on surgical site infection have been limited to a single species of bacteria and used older genetic analysis methods.
• But new technologies have opened the door to studying all types of bacteria and testing their antibiotic resistance genes simultaneously.
• Over a one-year period, we sampled the bacteria living in the nose, skin and stool of over 200 patients before surgery.

• In fact, 86% of the bacteria causing infections after spine surgery were genetically matched to bacteria a patient carried before surgery.
• That number is remarkably close to estimates from earlier studies using older genetic techniques focused on Staphylococcus aureus.
• They likely acquired these antibiotic-resistant microbes through prior antibiotic exposure, consumer products or routine community contact.

Preventing surgical infections

• At face value, our results may seem intuitive – surgical wound infections come from bacteria that hang out around that part of the body.
• If the most likely source of surgical infection – the patient’s microbiome – is known in advance, this presents medical teams with an opportunity to protect against it prior to a scheduled procedure.
• The fact that most infections don’t actually start with sources in the hospital is probably a testament to the efficacy of these protocols.

Dustin Long receives funding from the National Institutes of Health. Dr Bryson-Cahn receives funding from the Gordon and Berry Moore Foundation and is the co-medical director for Alaska Airlines.

• Marie landed in the intensive care unit where I am a bedside nurse because she was too agitated and needed more oxygen.
• As a seasoned bedside critical care nurse, I see firsthand the benefits that family caregivers bring to patient care in the hospital.
• I also witness the emotional stress that caregivers experience when their loved one comes to the ICU.

Caregivers often battle anxiety and depression

• From making medical decisions to advocating for their loved one, family caregivers have many important roles when their loved one is in the hospital.
• However, caregivers carry heavy emotional burdens while supporting loved ones at the hospital.
• Up to 70% of first-degree relatives of ICU survivors suffer from anxiety symptoms, more than a third suffer from depression, and many can experience symptoms of post-traumatic stress disorder, or PTSD.

Communication is critical

• As you provide information about the patient at home, the medical team should be giving you updates about the patient’s condition in the hospital.
• Knowing what to ask is essential to effective communication at the hospital.
• Once familiar with your new environment, you may feel more at ease to truly be present for your loved one.

• Every day, the interdisciplinary medical team sees each patient to discuss updates and treatment plans, and answers questions for the patient and their family.
• Research has also shown that rounds relieve anxiety and stress among family caregivers due to the consistent daily communication and emotional support that they provide.

Nurses can be helpful

• After clinical rounds, the interdisciplinary team of doctors and nurses establishes a daily plan of care for your loved one, which will be carried out by your bedside nurse.
• The nurse will give the ordered medications, perform necessary clinical tasks and assess the patient for their response to the treatment.
• Nurses are the most accessible resource you have when your loved one is in the hospital.

The importance of routines and familiarity

• Preventing ICU delirium through reorientation and familiar faces can help prevent this serious complication and can even reduce their hospital stay.
• Most families that come to the hospital describe the support they received from the medical team in a positive way.

Courtney Graetzer does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

• MiNK executives will host a conference call and webcast at 8:30 a.m.
• “In 2023, MiNK made significant strides in advancing our allogeneic iNKT cell programs, contributing to a growing body of clinical data that underscores the unique advantages of iNKTs and their pivotal role in immunity,” said Dr. Jennifer Buell, Chief Executive Officer and President at MiNK.
• The study reports survival rates exceeding 70% among patients on mechanical ventilation and surpassing 80% among those receiving VV ECMO support.
• These results stand in stark contrast to the 10% survival rate observed in the in-hospital control during the same period.

• The first tumor agnostic approval of a HER2 directed therapy and ADC was based on efficacy data in 192 adult patients with previously treated unresectable or metastatic HER2 positive (IHC 3+) solid tumors who were enrolled in one of three multicenter phase 2 trials from the DESTINY clinical development program, including DESTINY-PanTumor02 , DESTINY-Lung01 or DESTINY-CRC02 .
• In DESTINY-PanTumor02, efficacy was assessed in a subgroup of previously treated patients (n=111) with centrally or locally assessed HER2 positive (IHC 3+) solid tumors including either biliary tract, bladder, cervical, endometrial, ovarian, pancreatic or other tumors.
• In DESTINY-Lung01, efficacy was assessed in a subgroup of patients (n=17) with centrally confirmed HER2 positive (IHC 3+) non-small cell lung cancer (NSCLC).
• In DESTINY-CRC02, efficacy was assessed in the subgroup of patients (n=64) with centrally confirmed HER2 positive (IHC 3+) colorectal cancer.