Health
CORVALLIS, Ore. – A new study suggests that nicotinamide, more commonly known as vitamin B3, may be able to combat some of the antibiotic-resistance staph infections that are increasingly common around the world, have killed thousands and can pose a significant threat to public health.
The research found that high doses of this vitamin increased by 1,000 times the ability of immune cells to kill staph bacteria. The work was done both in laboratory animals and with human blood.
The findings were published Tuesday, Aug. 28, in the Journal of Clinical Investigation by researchers from Cedars-Sinai Medical Center, the Linus Pauling Institute at Oregon State University, UCLA, and other institutions. The research was supported by several grants from the National Institutes of Health.
The work may offer a new avenue of attack against the growing number of “superbugs.”
“This is potentially very significant, although we still need to do human studies,” said Adrian Gombart, an associate professor in OSU’s Linus Pauling Institute. “Antibiotics are wonder drugs, but they face increasing problems with resistance by various types of bacteria, especially Staphylococcus aureus.
“This could give us a new way to treat staph infections that can be deadly, and might be used in combination with current antibiotics,” Gombart said. “It’s a way to tap into the power of the innate immune system and stimulate it to provide a more powerful and natural immune response.”
The scientists found that clinical doses of nicotinamide increased the numbers and efficacy of “neutrophils,” a specialized type of white blood cell that can kill and eat harmful bacteria.
The nicotinamide was given at megadose, or therapeutic levels, far beyond what any normal diet would provide – but nonetheless in amounts that have already been used safely in humans, as a drug, for other medical purposes.
However, there is no evidence yet that normal diets or conventional-strength supplements of vitamin B3 would have any beneficial effect in preventing or treating bacterial infection, Gombart said, and people should not start taking high doses of the vitamin.
Gombart has been studying some of these issues for more than a decade, and discovered 10 years ago a human genetic mutation that makes people more vulnerable to bacterial infections.
In continued work on the genetic underpinnings of this problem, researchers found that nicotinamide had the ability to “turn on” certain antimicrobial genes that greatly increase the ability of immune cells to kill bacteria.
One of the most common and serious of the staph infections, called methicillin-resistant S. aureus, or MRSA, was part of this study. It can cause serious and life-threatening illness, and researchers say the widespread use of antibiotics has helped increase the emergence and spread of this bacterial pathogen.
Dr. George Liu, an infectious disease expert at Cedars-Sinai and co-senior author on the study, said that “this vitamin is surprisingly effective in fighting off and protecting against one of today’s most concerning public health threats.” Such approaches could help reduce dependence on antibiotics, he said.
Co-first authors Pierre Kyme and Nils Thoennissen found that when used in human blood, clinical doses of vitamin B3 appeared to wipe out the staph infection in only a few hours.
Serious staph infections, such as those caused by MRSA, are increasingly prevalent in hospitals and nursing homes, but are also on the rise in prisons, the military, among athletes, and in other settings where many people come into close contact.
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SACRAMENTO – The California Department of Public Health (CDPH) cited 14 California hospitals today for administrative penalties after determining that the facilities’ noncompliance with licensing requirements caused, or was likely to cause, serious injury or death to patients.
The fines total $825,000.
“We have a commitment to ensuring quality patient care for every Californian,” said Dr. Ron Chapman, director of CDPH and the state public health officer. “We work with hospitals to ensure they meet licensing requirements and share our goal of excellence in care.”
The following hospitals received penalties:
– California Hospital Medical Center – Los Angeles, Los Angeles, Los Angeles County: The hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures relating to the initiation of cardiopulmonary resuscitation. The penalty is $75,000. This is the hospital’s second administrative penalty.
– Fountain Valley Regional Hospital and Medical Center, Fountain Valley, Orange County: The hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures relating to the competency of a licensed vocation nurse. The penalty is $25,000. This is the hospital’s third administrative penalty.
– John F. Kennedy Memorial Hospital, Indio, Riverside County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo a second surgery. The penalty is $50,000. This is the hospital’s fifth administrative penalty.
– Kaiser Foundation Hospital – Los Angeles, Los Angeles, Los Angeles County: The hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures relating to cardiac monitoring. The penalty is $50,000. This is the hospital’s first administrative penalty.
– Kaiser Foundation Hospital – San Francisco, San Francisco, San Francisco County: The hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures relating to self-administered bedside medications. The penalty is $100,000. This is the hospital’s third administrative penalty.
– Kaiser Foundation Hospital – South San Francisco, South San Francisco, San Mateo County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. The penalty is $75,000. This is the hospital’s second administrative penalty.
– Menlo Park Surgical Hospital, Menlo Park, San Mateo County: The hospital failed to ensure the health and safety of a patient when it did not follow established surgical policies and procedures. The penalty is $50,000. This is the hospital’s first administrative penalty.
– Saint Agnes Medical Center, Fresno, Fresno County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. The penalty is $50,000. This is the hospital’s fourth administrative penalty.
– Saint Francis Memorial Hospital, San Francisco, San Francisco County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. The penalty is $50,000. This is the hospital’s first administrative penalty.
– Simi Valley Hospital & Health Care Services, Simi Valley, Ventura County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo an additional surgery to remove a retained foreign object. The penalty is $25,000. This is the hospital’s first administrative penalty.
– St. Jude Medical Center, Fullerton, Orange County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. The penalty is $100,000. This is the hospital’s fourth administrative penalty.
– St. Mary’s Medical Center, San Francisco, San Francisco County: The hospital failed to ensure the health and safety of a patient during a transfer. The penalty is $50,000. This is the hospital’s first administrative penalty.
– Stanford Hospital, Stanford, Santa Clara County: The hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures relating to tracheostomy care. The penalty is $50,000. This is the hospital’s first administrative penalty.
– University of California, Irvine Medical Center, Orange, Orange County: The hospital failed to ensure the health and safety of a patient when it did not follow surgical policies and procedures. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. The penalty is $75,000. This is the hospital’s fourth administrative penalty.
Administrative penalties are issued under authority granted by Health and Safety Code section 1280.1.
Incidents that occurred prior to 2009 carry a fine of $25,000. New legislation took effect Jan. 1, 2009, that increased fines for incidents that occurred in 2009 or later.
Under the new provisions, an administrative penalty carries a fine of $50,000 for the first violation, $75,000 for the second, and $100,000 for the third or subsequent violation by the licensee. Incidents that occurred prior to 2009 are not counted when determining the fine amounts.
When hospitals receive their survey findings, they are required to provide CDPH with a plan of correction to prevent future incidents.
Hospitals can appeal an administrative penalty by requesting a hearing within 10 calendar days of notification. If a hearing is requested and the penalty upheld following an appeal, the penalties must be paid.
All hospitals in California are required to be in compliance with applicable state and federal laws and regulations governing general acute care hospitals, acute psychiatric hospitals, and special hospitals. The hospitals are required to comply with these standards to ensure quality of care.
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