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September 20, 2012; 4:00 to 5:35 PM
Natcher Building, Visitor's Center Little Theater
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Multi-Drug Resistant Organisms in the Clinical Center — Dr. David Henderson, MD, Deputy Director, Clinical Center

Following brief opening remarks from Mr. Burklow, Dr. Henderson updated CLC members on deaths in the Clinical Center (CC) due to multi-drug resistant organisms. These organisms threaten only very sick, immune-suppressed patients receiving cancer therapy or stem cell implants.

Dr. Henderson said 21 patients became infected with an organism called KPC; 19 were part of an original cluster of patients in the hospital. Two patients came to the center from other hospitals in Maryland with a different type of organism. Of the 19 in the original cluster, 7 died from the infection. 6 other patients in the cluster died from their underlying illnesses. The hospital uses extreme measures to care for the remaining patients in that cluster.

The Clinical Center isn’t aware of any instances of reasonably healthy people becoming infected. Staff members haven’t become ill, and this hospital-based bug isn’t a danger to the local community. This isn’t a problem for anyone visiting NIH or the hospital unless that visitor is going home to someone who has a suppressed immune system.

Very sick patients typically become ill from infections that respond easily to antibiotics. But in 2012, it is common for patients undergoing bone-marrow transplants, stem-cell transplants or cancer chemotherapy to develop an infection from a drug-resistant organism. Indeed, these organisms have become a problem in other parts of the country, including New York, New Jersey and Pennsylvania. These organisms are in many hospitals, and those health facilities aren’t doing as much as the Clinical Center to control the problem.

Dr. Henderson noted that the isolate that was in a patient in June 2011 was the first time the staff had ever seen that organism in the hospital. Mr. Schofer asked how the organism got to the Clinical Center. Dr. Henderson said the bug arrived in a patient from New York City. The staff discovered it after reading the patient’s record. The patient went into isolation, and the Clinical Center staff worked hard to contain the organism. Even so, it showed up in anther patient three weeks after the first patient left the hospital. The infection spreads via the hands of health care workers.

The CC staff has taken numerous measures to find and contain these organisms, including hiring monitors to ensure that health care workers used appropriate hygiene before and after visiting a patient. These steps helped the hospital gain control of the bug.

Dr. Henderson said he took full responsibility for the seven deaths from the infection. A situation like this comes from one person completing one small task incorrectly. Staff members seek to learn from this situation so they can prevent it from reoccurring. The Clinical Center also borrows strategies from other industries to do its job better.

Stony Creek Pond Update — Brian Kim, ORF, NIH; John Hollister, Montgomery County

Mr. Hollister last met with the CLC in February 2010. A preconstruction meeting in late September 2010 established a two-year timeline for the pond project. The discovery of bedrock, however, has pushed the completion date back to February 2013, with some follow-up plantings occurring in the spring.

The bedrock is at the end of the pond. Workers are putting in a storm drain diversion as part of the excavation phase, and that storm drain diversion has run into the bedrock. Mr. Hollister is working with a contractor to determine how he can speed up the project. Workers are hammering away at the bedrock, and Mr. Hollister is considering design changes to get around the problem. After that, the project should go smoothly. The pond should provide a stable aquatic habitat that attracts predatory insects that eat mosquitoes. The pond also will have aerators.

Once complete, the pond should be a cost-effective storm water retrofit. The pond will collect sediment and debris from the watershed. The project also includes underground oil/trash collectors.
Mr. Dabney from the Bethesda Urban Partnership (BUP) noted efforts to keep restaurants from dumping grease into storm drains. However, oil also can come from sidewalks and cars on the road. Whatever happens on the streets of Bethesda shows up in the stream, said Mr. Kim. Trucks will regularly clean out the debris collected in the pond or underground oil/trash collectors.

Round Robin

Ms. Michaels asked questions about the NIH Bethesda Master Plan and the environmental impact study. The county planning board will discuss the master plan on October 18. However, the draft EIS is not yet available. Mr. Neuberg said the draft master plan comes before the draft environmental study. Comments on the draft master plan will be available early October, in time for the meeting on the 18th. After a public comment period on the EIS, the study will be finalized. The final master plan will come first, and then the final environmental study.

Mr. Dabney briefly presented the organization’s 2012 annual report. Among other things, the report highlights the pedestrian tunnel that runs under Wisconsin Avenue to the Bethesda Metro Station. BUP, which now features public art in the tunnel, recently won a second-place award for the art initiative from an international downtown association. Mr. Dabney further announced Oct. 6 as the date of the 23rd Taste of Bethesda. CLC members also discussed parking lot closures and upcoming condo/townhouse developments.

Adjournment

The meeting adjourned at 5:35 p.m. The next meeting will take place in November.

Participants

CLC Members
Marian Bradford
Maggie Dittemore
Darrell Lemke, Bethesda Parkview
Marilyn Mazuzan, Oakmont
Deborah Michael, Glenbrook Village
George Oberlander, Huntington Parkway
Lucy Ozarin, MD, Whitehall
Eleanor Rice, East Bethesda Citizens Assoc.
Ralph Schofer, Maplewood
Beth Volz, Locust Hill
Jennette Wade, Whitehall

NIH Staff
John Burklow, OCPL
Dr. David Henderson, Deputy Director, CC
Brian Kim, ORF, NIH
Brad Moss, ORS, ORF
Phillip Neuberg, ORF
Tara Mowery, OCPL
Sharon Robinson, OCL, OCPL

NIH Alumni Association
Kira Lueders, NIH Alumni Association

Guests
Dave Dabney, Bethesda Urban Partnership
John Hollister, Montgomery County
Joan Kleinman, congressional staffer for Rep. Chris Van Hollen (by phone)

Recorder
Laura Jackson, Audio Associates