Friday Staphylococcus aureus Blogging

I think this is the one that put me in the hospital. Still can’t figure out how I caught it though.

Posted by Hello

Posted by Hello

Here is an interesting story on the subject though.

Staphylococcus aureus, a common germ that infects countless scrapes and scratches a year, is fast becoming an uncommon public health threat. Drug-resistant strains of staph known as MRSA, once confined to hospitals and nursing homes, have been turning up among pro football players in St. Louis, Marine recruits in North Carolina, inmates in Georgia prisons, gay men in Los Angeles, native Americans in Minnesota and pediatric wards in Atlanta.

“Close to one-fifth of what used to be a hospital-specific problem is now a community problem, and that’s a large number,” said Scott Fridkin of the Centers for Disease Control and Prevention. “We didn’t think it would be anywhere near that high when we started the study.”

Now to scare you a little:

Until a few years ago, reports of MRSA were so rare outside of hospitals that many doctors may have unwittingly aided its spread by treating it with antibiotics that didn’t work.

In the last few years, outbreaks of several new staph strains have been reported in dozens of states, as well as in England, France, Switzerland, Saudi Arabia, India, Australia and New Zealand. In the United States, at least two dozen people have died of MRSA pneumonia during the last two flu seasons.

Overall, health authorities have only a piecemeal picture of MRSA’s prevalence — much of it based on isolated outbreaks and limited surveillance of a few communities.

A 2002 survey by the Georgia Division of Public Health, for instance, found that nearly 600 people seeking treatment for staph infections at hospitals and clinics in the eight-county metro Atlanta area were infected by MRSA. The rate doubled in just a year, but the study was discontinued for budgetary reasons.

The Georgia survey found that 70 percent of people treated for such infections were getting antibiotics to which the microbe was already resistant — an error that gave otherwise mild infections an opportunity to fester and spread.

Fortunately, association with necrotizing faciitis is rare (only 14 cases so far -all in Los Angeles).

Part of the problem is caused by an evolutionary response to the overuse of antibiotics:

MRSA struck the St. Louis Rams in September 2003, when five linebackers who did not cover their artificial turf abrasions were infected. Investigators suspect players passed the bug to each other by sharing towels, using a whirlpool without showering, and by only sporadic hand washing. They also passed the bacteria — through contact on the field — to three San Francisco 49ers during a game in St. Louis on Sept. 14.

CDC epidemiologist Sophia Kazakova, who headed the Rams study, said the reasons for the outbreak are unclear, but the team’s heavy use of antibiotics may have been a contributing factor.

“The players in our investigation were receiving 10 times the number of anti-microbial prescriptions dispensed to the public,” she said.

(snip)

In the 1940s, when modern medicine first used antibiotics, no one realized that was the beginning of an arms race between man and microbe that would rage across the medical landscape for the next 60 years.

Penicillin, introduced during World War II, greatly reduced staph as a threat in hospitals and operating rooms. But within two years, a strain of penicillin-resistant staphylococcus had emerged. By the 1950s, the germ was universally present in hospitals. And by the 1970s, it had spread to the community at large. Today, 95 percent of all staph strains in the world are resistant to penicillin.

Modern medicine fought back. And so did staph. A new class of antibiotics, led by methicillin, was introduced in the early 1950s. And within a few years, methicillin-resistant staph had emerged in hospitals and nursing homes, where the new antibiotics were most heavily used.

Today, staph is one of the leading causes of the estimated 2 million infections and 88,000 deaths among people who get an infection in a hospital. At least 55 percent of all hospital staph infections, 60 percent of infections in intensive care units and 71 percent in nursing homes are now caused by MRSA.

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6 Responses

  1. This is a great post. As a physician newly released in the world of private practice, I am amazed by the overwhelming demand by patients for antibiotics when there is not even a hint of an indication. Over the last 8 months, I have seen on average probably 10 patients per day with cold symptoms for less than 3 days who are suprised or angry when I refuse to give a prescription for antibiotics. That is what their other doctor(s) have been doing for them their whole lives. Some of them will even say, ‘I have a cold’ and expect an penicillin shot to make them better. Most of them don’t find it funny when I remind them of the common saying, ‘we can put a man on the moon, but we can find a cure for the common cold’.

    One point I would like to make here is that the community acquired MRSA is different from the hospital acquired (nosocomial)variety. They have different genetic compositions and different antibiotic susceptibilities. Luckily some of the older oral anitibiotics are still effective for the rising number of abcesses and skin infections caused by the CA-MRSA.

  2. Thanks for the info. I didn’t realize there were more than one strain. From the perspective of a patient, I know a lot of people who get mad at their doctors when the doctor doesn’t immediately prescribe antibiotics. Of course, the other danger from over prescribing antibiotics is the people who don’t take the entire course – which also helps create the antibiotic resistant strains.

  3. Henry’s right about people wanting antibiotics right away. I work with some that go to the doctor probably 2 – 3 times a month. I got over the flu finally, but had a nasty nasal passage infection. I finally went to the doc. He prescribed Doxycyline. I was on that for some days. I finally took Sgt Mango to the vet and he was prescribed Amoxyciline for his sneezing, coughing, and nasal problem. That evening, he got on the bed, stuck his face into my face and sneezed a big nasty wet sneeze – it hit me in the nasal/mouth area. I don’t know if his germs would cross to human, but my sinuses are bothering me again.

  4. Henry’s right about people wanting antibiotics right away. I work with some that go to the doctor probably 2 – 3 times a month. I got over the flu finally, but had a nasty nasal passage infection. I finally went to the doc. He prescribed Doxycyline. I was on that for some days. I finally took Sgt Mango to the vet and he was prescribed Amoxyciline for his sneezing, coughing, and nasal problem. That evening, he got on the bed, stuck his face into my face and sneezed a big nasty wet sneeze – it hit me in the nasal/mouth area. I don’t know if his germs would cross to human, but my sinuses are bothering me again.

  5. I’m sure you know what I meant on my first comment, but I will correct myself to be certain: ‘we can put a man on the moon, but we CAN’T find a cure for the common cold’. Sorry about that.

  6. In a bit of gestalt psychology, my brain just inserted the missing “can’t” so I didn’t notice the error.

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