Antibiotic resistantKlebsiella in New York. Klebsiella pneumoniae, a nosocomial pathogen that often causes pneumonia and bacteremia in ICU patients, has developed resistance to carbapenem antibiotics-known as a last-resort treatment. A surveillance study conducted in 11 hospitals in Brooklyn found that of 602 isolates of K. pneumoniae, 271 (45%) were resistant to cephalosporins, and of those, nine (3.3%) were also resistant to carbapenems. In addition, an observational study of outbreaks at two New York City hospitals revealed that 47% of patients with bacteremia with imipenem-resistant K. pneumoniae (nine of 19 for whom complete records were available) had died within 14 days of the initial positive culture.
New Jersey nurse anesthetists lose battle. On June 29 the New Jersey Supreme Court upheld a regulation passed by the state's Board of Medical Examiners mandating that, in the physician's-office setting, a nurse anesthetist must be supervised by an anesthesiologist or a physician with anesthesia privileges. The ruling will most likely drive many nurse anesthetists out of the state because surgeons will have no incentive to hire both a nurse anesthetist and an anesthesiologist.
In 2001 the Centers for Medicare and Medicaid Services (CMS) published a ruling that allows states to opt out of a federal law requiring physician supervision of nurse anesthetists. Unlike New Jersey, 14 states-Alaska, Idaho, Iowa, Kansas, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Oregon, South Dakota, Washington, and Wisconsin-have taken advantage of the CMS ruling.
Involuntary admission for not taking medications in Maine? Lawmakers in Maine are considering a highly contested bill concerning people with mental illness. If passed, the bill will give mental health professionals who are monitoring patients released from a psychiatric center the authority to recommit them against their will if they have not been taking medications and are exhibiting symptoms. Called "An Act to Improve the Delivery of Maine's Mental Health Services," the bill has created controversy among the mental health community, with some believing that it would benefit those with mental illness and others arguing that it would infringe on their liberties.