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Boggs' 12.66 ERA is what stands out most about a bullpen that's been shaky adapting to new roles without injured closer Jason Motte. Boggs lost his job as stand-in closer earlier this month and trudged off the mound yet again in the ninth inning of the Pittsburgh Pirates' 9-0 victory on Sunday.
"I made some really good pitches," Boggs said. "I don't have much to show for it."
Manager Mike Matheny still has faith in the right-hander who was one of the majors' best setup men last season.
"I'd loved to have left him in there," Matheny said. "It's one of those days that probably wasn't reflective of his stuff going in a better direction. You've just got to keep fighting."
After deconstructing an outing that included a "blooper into right, a shattered bat into left and a ball that was hit so bad you could only get one out with the base loaded," Boggs struck a note of defiance.
"I'm obviously not ecstatic about how it's going," Boggs said. "Yeah, it's hard to be positive, but at the same time you have to do everything you can to fight every single day and I'm doing that.
"If anybody can't see that, they're crazy."
Boggs allowed two hits, a walk and a run-scoring groundout by Gaby Sanchez in two-thirds of an inning and was charged with three of the Pirates' five runs in the ninth. In 10 2-3 innings overall he's given up 15 earned runs on 17 hits and 10 walks.
Nothing worked for the Cardinals, who were shut down by rookie lefty Jeff Locke and totaled just three hits while getting leapfrogged by the Pirates for the NL Central lead. They lost consecutive games for the first time this season and dropped their first series since opening the season losing two of three at Arizona.
"We had a tough time getting anything going," Matheny said. "It's not a day we were expecting."
David Freese was 0 for 3 with a strikeout on his 30th birthday, dropping his average to .178 with no homers and three RBIs. Matheny said Freese is having difficulty picking up the ball.
"I'm obviously not happy with the way I'm performing," said Freese, the 2011 World Series and NL championship series MVP. "I feel terrible up there.
"Every now and then I'll throw some good at-bats together, get my walk or hit a ball hard, but nothing's really working."
Russell Martin had two of Pittsburgh's four home runs, Garrett Jones had three hits and John McDonald added a key RBI double. The Pirates ended rookie Shelby Miller's streak of 14 scoreless innings at home to start the season and have won nine of 12 overall.
Locke (3-1) has worked 13 scoreless innings while allowing five hits his last two starts. The Cardinals got just three singles and advanced two runners into scoring position against the 25-year-old left-hander, who earned the fifth spot in the rotation with a strong spring.
Justin Wilson allowed a walk the last two innings to wrap up the Pirates' fifth shutout, tied for the league lead with St. Louis and San Francisco. All of them have been collaborations.
Miller (3-2) struggled to put away hitters and was taken out after 113 pitches and giving up two homers in 5 2-3 innings. He struck out seven, one off his season best, and was charged with three runs after John McDonald greeted Fernando Salas with a bloop RBI double.
Left fielder Matt Holliday took a circuitous route and just missed a diving catch with the ball deflecting off his left wrist, and Brandon Inge scored from first on a close play at the plate for a 3-0 lead.
Martin hit his fourth homer with a 412-foot drive to straightaway center in the second. He doubled off the right-field fence in the fourth for his fourth straight extra-base hit, two of them homers, then added a two-run shot to cap a five-run ninth.
It was the seventh career multi-homer game and first since June 10, 2012, for the Yankees against the Mets for Martin, who's hitting .409 since April 15.
Tabata lined a 2-2 pitch over the right-field wall in the fifth for his first homer, giving him a hit in 21 of 23 career games at Busch Stadium.
Jones' second homer and first in 50 at-bats since April 8 barely cleared Shane Robinson's leaping attempt the wall in the seventh to make it 4-0. First base umpire Laz Diaz initially ruled no homer, but it was quickly overturned after the Pirates appealed.
NOTES: Adam Wainwright (4-1, 1.93) goes for his fifth win in as many starts Monday in the opener of a three-game series against the Reds and Mat Latos (1-0, 2.16). ... The Pirates are 4-0 in starts by Wandy Rodriguez (2-0, 1.66) entering a three-game series at Milwaukee and Yovani Gallardo (2-1, 4.97). ... Jason Grilli is the first Pirates pitcher to earn 10 saves in April since Mike Williams also had 10 in 2002.
© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
Hockey's grueling postseason, which begins with three games Tuesday night and ends as late as June 28, has a slew of storylines spilling off the ice.
Here's a pick six to follow when the puck drops.
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CROSBY'S COMEBACK? Pittsburgh Penguins superstar Sidney Crosby was healthy and productive for most of the season, getting 56 points in 36 games, after missing much of the last two years with concussion-like symptoms. A broken jaw, though, has kept him out since March 30 and he's waiting to be cleared by doctors to play in the postseason. Crosby's status for Game 1 at home Wednesday night against the New York Islanders is unclear, but he's expected to be back in the lineup at some point in the seven-game series. After consecutive first-round exits, the top-seeded team in the Eastern Conference is poised to make a run with a deep roster improved before the trading deadline. If Crosby can play, the Penguins might hoist the Stanley Cup for the first time since 2009.
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CAN CHICAGO CLOSE STRONG, TOO? The Blackhawks began the season with a point in their first 24 games - half of the lockout-shortened season - to surpass an NHL record by eight games. They finished well enough to lead the league in points and are hoping that translates into postseason success, unlike the franchise's only other Presidents' Trophy season. Chicago led the NHL in points during the 1990-91 season, but got eliminated by the Minnesota North Stars in the opening round. The Blackhawks will match up with the same city - against a team now known as the Wild - in the first round. Minnesota lost 10 of its last 16 games, but free agent stars Zach Parise and Ryan Suter have an opportunity to provide a quick return on the $98 million the franchise invested in them last summer.
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RED-HOT CAPITALS: The Washington Capitals closed the season strong, winning 11 of their last 13 games to surge from toward the bottom of the East to the top of the Southeast Division, earning the No. 3 seed to set up a first-round matchup with the New York Rangers. Alex Ovechkin was at his best down the stretch with 22 points in the last 13 games after averaging less than a point in his first 35 games. He finished with an NHL-high 32 goals, lighting the lamp more than any other player in the league for the third time. Even though Ovechkin has jaw-dropping talent, he hasn't gotten past the second round of the playoffs in the first seven seasons of his career and he's playing for a franchise that hasn't advanced further than that since getting swept by Detroit in the 1998 Stanley Cup Finals.
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KINGS' QUEST TO REPEAT: The Los Angeles Kings became the first eighth-seeded team to win the Stanley Cup, finishing off the sixth-seeded New Jersey Devils in Game 6, and can become the first team to repeat in the salary-cap era that began in the 2005-06 season and the first since Detroit won consecutive times in 1997 and 1998. Compared to last season, when the Kings had to rally just to get in the playoffs, they cruised after clinching a spot in the West and will start the postseason on the road as a fifth-seeded team against the fourth-seeded St. Louis Blues.
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ORIGINAL SIX STILL SKATING: For the first time since 1996, each of the NHL's Original Six teams is in the playoffs. The Toronto Maple Leafs had a lot to do with ending the drought. The storied franchise in a hockey-crazed city and country has advanced to the postseason for the first time since 2004. In the Eastern Conference, the fifth-seeded Maple Leafs will match up with fourth-seeded Boston, another Original Six team, second-seeded Montreal will face seventh-seeded Ottawa, and the sixth-seeded New York Rangers will match up with third-seeded Washington. In the West, Detroit extended its franchise record postseason streak to 22, the fifth longest in league history, and closed well enough to avoid a first-round matchup with fellow Original Six member Chicago to move into a winnable series against second-seeded Anaheim. The top-seeded Blackhawks will open against the Wild.
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NEW YORK, NEW YORK: The New York Islanders are in the playoffs for the first time since 2007, and for just the second time in two decades they're in the postseason at the same time as the New York Rangers. Both teams will have a tough time getting out of the first round. The eighth-seeded Islanders are matched up with Pittsburgh, a powerhouse that earned 17 more points in the condensed season. The sixth-seeded Rangers will face perhaps the hottest team in the league, third-seeded Washington.
--- Follow Larry Lage on Twitter at WWW.TWITTER.COM/LARRYLAGE © 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
HOSPITALS SEE SURGE OF SUPERBUG-FIGHTING PRODUCTS
Monday, 29 April 2013 06:18 Published in Health & FitnessIn U.S. hospitals, an estimated 1 in 20 patients pick up infections they didn't have when they arrived, some caused by dangerous `superbugs' that are hard to treat.
The rise of these superbugs, along with increased pressure from the government and insurers, is driving hospitals to try all sorts of new approaches to stop their spread:
Machines that resemble "Star Wars" robots and emit ultraviolet light or hydrogen peroxide vapors. Germ-resistant copper bed rails, call buttons and IV poles. Antimicrobial linens, curtains and wall paint.
While these products can help get a room clean, their true impact is still debatable. There is no widely-accepted evidence that these inventions have prevented infections or deaths.
Meanwhile, insurers are pushing hospitals to do a better job and the government's Medicare program has moved to stop paying bills for certain infections caught in the hospital.
"We're seeing a culture change" in hospitals, said Jennie Mayfield, who tracks infections at Barnes-Jewish Hospital in St. Louis.
Those hospital infections are tied to an estimated 100,000 deaths each year and add as much as $30 billion a year in medical costs, according to the Centers for Disease Control and Prevention. The agency last month sounded an alarm about a "nightmare bacteria" resistant to one class of antibiotics. That kind is still rare but it showed up last year in at least 200 hospitals.
Hospitals started paying attention to infection control in the late 1880s, when mounting evidence showed unsanitary conditions were hurting patients. Hospital hygiene has been a concern in cycles ever since, with the latest spike triggered by the emergence a decade ago of a nasty strain of intestinal bug called Clostridium difficile, or C-diff.
The diarrhea-causing C-diff is now linked to 14,000 U.S. deaths annually. That's been the catalyst for the growing focus on infection control, said Mayfield, who is also president-elect of the Association for Professionals in Infection Control and Epidemiology.
C-diff is easier to treat than some other hospital superbugs, like methicillin-resistant staph, or MRSA, but it's particularly difficult to clean away. Alcohol-based hand sanitizers don't work and C-diff can persist on hospital room surfaces for days. The CDC recommends hospital staff clean their hands rigorously with soap and water - or better yet, wear gloves. And rooms should be cleaned intensively with bleach, the CDC says.
Michael Claes developed a bad case of C-diff while he was a kidney patient last fall at New York City's Lenox Hill Hospital. He and his doctor believe he caught it at the hospital. Claes praised his overall care, but felt the hospital's room cleaning and infection control was less than perfect.
"I would use the word `perfunctory,'" he said.
Lenox Hill spokeswoman Ann Silverman disputed that characterization, noting hospital workers are making efforts that patients often can't see, like using hand cleansers dispensers in hallways. She ticked off a list of measure used to prevent the spread of germs, ranging from educating patients' family members to isolation and other protective steps with each C-diff patient.
The hospital's C-diff infection rate is lower than the state average, she said.
Westchester Medical Center, a 643-bed hospital in the suburbs of New York City has also been hit by cases of C-diff and the other superbugs.
Complicating matters is the fact that larger proportions of hospital patients today are sicker and more susceptible to the ravages of infections, said Dr. Marisa Montecalvo, a contagious diseases specialist at Westchester.
There's a growing recognition that it's not only surgical knives and operating rooms that need a thorough cleaning but also spots like bed rails and even television remote controls, she said. Now there's more attention to making sure "that all the nooks and crannies are clean, and that it's done in perfect a manner as can be done," Montecalvo said.
Enter companies like Xenex Healthcare Services, a Texas company that makes a portable, $125,000 machine that's rolled into rooms to zap C-diff and other bacteria and viruses dead with ultraviolet light. Xenex has sold or leased devices to more than 100 U.S. hospitals, including Westchester Medical Center.
The market niche is expected to grow from $30 million to $80 million in the next three years, according to Frost & Sullivan, a market research firm.
Mark Stibich, Xenex's chief scientific officer, said client hospitals sometimes call them robots and report improved satisfaction scores from patients who seem impressed that the medical center is trotting out that kind of technology.
At Westchester, they still clean rooms, but the staff appreciates the high-tech backup, said housekeeping manager Carolyn Bevans.
"We all like it," she said of the Xenex.
At Cooley Dickinson Hospital, a 140-bed facility in Northampton, Mass., the staff calls their machines Thing One, Thing Two, Thing Three and Thing Four, borrowing from the children's book "The Cat in the Hat."
But while the things in the Dr. Seuss tale were house-wrecking imps, Cooley Dickinson officials said the ultraviolet has done a terrific job at cleaning their hospital of the difficult C-diff.
"We did all the recommended things. We used bleach. We monitored the quality of cleaning," but C-diff rates wouldn't budge, said nurse Linda Riley, who's in charge of infection prevention at Cooley Dickinson.
A small observational study at the hospital showed C-diff infection rates fell by half and C-diff deaths fell from 14 to 2 during the last two years, compared to the two years before the machines.
Some experts say there's not enough evidence to show the machines are worth it. No national study has shown that these products have led to reduced deaths or infection rates, noted Dr. L. Clifford McDonald of the Centers for Disease Control and Prevention.
His point: It only takes a minute for a nurse or visitor with dirty hands to walk into a room, touch a vulnerable patient with germy hands, and undo the benefits of a recent space-age cleaning.
"Environments get dirty again," McDonald said, and thorough cleaning with conventional disinfectants ought to do the job.
Beyond products to disinfect a room, there are tools to make sure doctors, nurses and other hospital staff are properly cleaning their hands when they come into a patient's room. Among them are scanners that monitor how many times a health care worker uses a sink or hand sanitizer dispenser.
Still, "technology only takes us so far," said Christian Lillis, who runs a small foundation named after his mother who died from a C-diff infection.
Lillis said the hospitals he is most impressed with include Swedish Covenant Hospital in Chicago, where thorough cleanings are confirmed with spot checks. Fluorescent powder is dabbed around a room before it's cleaned and a special light shows if the powder was removed. That strategy was followed by a 28 percent decline in C-diff, he said.
He also cites Advocate Christ Medical Center in Oak Lawn, Ill., where the focus is on elbow grease and bleach wipes. What's different, he said, is the merger of the housekeeping and infection prevention staff. That emphasizes that cleaning is less about being a maid's service than about saving patients from superbugs.
"If your hospital's not clean, you're creating more problems than you're solving," Lillis said.
--- Online: CDC: HTTP://WWW.CDC.GOV/HAI/
© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
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