Methicillin-resistant Staphylococcus aureus (MRSA)

[Michaelangelica]

methicillin-resistant Staphylococcus aureus

Meet the Hospital Staph (comic)

MRSA infection is far more common in the United States than previously thought, and that it kills more people yearly than AIDS, emphysema, Parkinson's disease or homicide.

MRSA In Australia

CSIRO PUBLISHING - Healthcare Infection

[CraigD]

Meet the Hospital Staph (comic)

MRSA infection is far more common in the United States than previously thought, and that it kills more people yearly than AIDS, emphysema, Parkinson's disease or homicide.

I think it’s important to keep this quote together with the one that immediately follows it in Mike Adams’s article:

The CDC calculated that deaths from MRSA in the United States may amount to nearly 19,000 people yearly, although the agency added that it can be hard to determine if death is caused directly by the disease or merely accelerated by it.

Like other bacterial infections, MRSA is almost never the only infection contributing to illness or death, nor its cause. Bacterial infections are opportunistic, typically occurring when a victims immune system is weakened to a level where it is unable to respond adequately to resist them. So while it’s reasonable to conclude that a disease that directly attacks the immune system, such as HIV/AIDS, or ones that “wear it down”, such as influenza, are direct causes of death, staph infections such as MRSA are more reasonably described as follower-ons that “finish you off”. Trauma, from injury or surgery, can also weaken your immune system to a level that makes you vulnerable to MERSA and other infections. We all carry common bacteria, including MRSA, in our mouths, noses, and guts, but due to our effective immune systems, don’t succumb to infection.

 

It’s also important, I think, to keep mortality rates in perspective. According to US CDC’s NVSS report “Deaths: Final Data for 2005” (caution: 2.5 MB PDF file), “may amount to nearly 19,000” would be about 0.8% of all US deaths in 2008, compared to the #1 cause, heart disease, with 652,000 annual deaths, 26.6% of all deaths. 19,000 falls between #14 Parkinson’s disease (19,544 deaths in 2005) and #15 homicide (18,124).

 

That said, MRSA’s bad and a big problem. While I wouldn’t say “conventional medicine is clueless”, I agree with some of Adams’s points (and enjoy some of his medical humor). In particular, his observation that

Conventional medicine has not merely failed to stop MRSA, it has in fact accelerated the development of MRSA through rampant use of chemical antibiotics. This created the perfect environment in which MRSA superbugs could grow and escape outside the hospitals, into "the wild,"

is, I think, accurate, and widely accepted in the medical and public health community. His next statement, however

Even worse, doctors and hospitals have so far refused to treat MRSA with anything that actually works. Instead of looking to Mother Nature, where cures for MRSA are as common as weeds (literally!), arrogant doctors and Western medical researchers continue to foolishly believe that only synthetic, patented chemical antibiotics have any use whatsoever, and that anything from nature couldn't possibly be of any help.

is, to the best of my knowledge, unsupported by evidence, and the belief that all antibiotics are “synthetic”, rather than “from nature”, very ignorant of pharmacology and medicine. Worse, his next claim

They also don't appear to show any interest whatsoever in the technology of colloidal silver, a substance that quickly kills not just MRSA, but ALL antibiotic-resistant infectious strains. A quick wipe-down of hospitals, schools and gyms with colloidal silver would halt these MRSA infections in their tracks. Colloidal silver can also be used topically, on MRSA skin infections, where it quickly kills bacteria without any negative side effects whatsoever.

is simply wrong on nearly all counts.

 

As the wikipedia article “colloidal silver” notes, colloidal silver was used extensively in conventional medicine prior to the adoption of more effective sulfonamide and penicillin drugs in the 1920s and 30s, and other silver-containing drugs continue to be used in various medical applications. Colloidal silver remains FDA-approved for use as a surface (not human) cleaner, though in my experience, is little used, possibly due to high cost. I’m aware of no evidence showing colloidal silver containing cleaning products to be more effective than more common ones, such as those containing alcohol. MRSA is no more able to survive contact with alcohol than other bacteria – its special resistance is to antibiotic drugs.

 

A graver consequence of Adams and other’s promotion of colloidal silver, IMHO, is the implication that some might draw from their statements that its use is “without any negative side effects whatsoever”. While to the best of my knowledge topical use of it on unbroken skin poses no danger, products such as those endorsed by Adams are currently sold as dietary supplements intended for human consumption, despite well-documented evidence, public warnings, and even safety information companies selling the supplements that small (1-4 g) amounts of colloidal silver can cause injury and possibly death (see the wikipedia article “Argyria”).

 

Silver, in fine thread or particle form, is a very effective antiseptic. You can get clothing with containing it (eg: “X-static brand”) that can be worn for long periods without discomfort or smell, because the silver kills itch and smell-causing microbes. Newer “nanosilver” technology makes it possible to get a similar antiseptic effect with much smaller amounts of silver, making such clothing available at a lower cost, and even allowing it to be injected into regular clothing by special washing machines, such as the Samsung “Silver Nano”.

 

Though some joke at a possible downside of such products being stereotypical computer geeks who need never change their cloths, there are some scientifically credible concerns that these products may pose a substantial threat to public health. Like other metals, silver is considered a toxin, and its release into the environment by factories etc. monitored and regulated by the governments of most states. Test reveal that properly manufactured silver-containing products of these kinds retain their silver with use and washing. However, recent test (see Laundering Socks with Nano Particles Possible Health Environmental Risk)revealed that many nanosilver socks release ionic silver, which is known to be dangerous to fish and other marine animals, suggesting that voluntary and/or government regulation of these currently unregulated products may be necessary.

[Michaelangelica]

Well demolished Craig.

 

I must admit I skimmed the article and did not get the colloidial silver thing. Many alternative therapists are enamoured of it. A quack tried to sell me some years ago.

 

The Australian figures are interesting as they seem lower than USA but vary widely from state to state.

 

It seems some frequent, old-fashioned hand washing would not go astray.

I was a bit appalled seeing a young, scantly-clad, female doctor go from patient to patient in Boston hospital's out-patient clinic once and insisted she washed her hands before examining me.

Hand washing can reduce the spread of germs including MRSA. Hands should be washed for 10 to 15 seconds using soap and water and then thoroughly dried, preferably using paper towel. Hands should be washed after going to the toilet, changing nappies, blowing one's nose and before preparing food. Cuts and other breaks in the skin should be cleaned and covered. It is particularly important to wash hands before and after dressing a cut or other break in the skin.

Golden Staph - Methicillin Resistant Staphylococcus aureus (MRSA) - Queensland Health

 

MRSA is spread by contact, especially with moist areas and skin folds. For this reason, it is extremely important to observe strict handwashing and hygiene.

Methicillin-resistant Staphylococcus aureus (MRSA) - MRSA - Infections

 

The Numbers

In Tennessee, there were more than 1,800 invasive cases of MRSA in both 2005 and 2006. An invasive case occurs when the infection is found in organs other than the skin. As of September 30, 2007, there were 1,400 diagnosed cases of MRSA in Tennessee.

Stopping the Spread

Steps to decrease the possibility of developing MRSA include:

 

1. Washing hands frequently with warm, soapy water.

2. Using 60 %alcohol-based hand gel if soap and water are not available.

3. Keeping hands away from the face, including the nose, eyes and mouth.

4. No sharing personal items like make-up, bar soap, razors, towels, washcloths, clothes or athletic equipment.

5. If participating in sporting activities or exercise, showering immediately afterwards, washing with soap and hot water.

6. Washing towels, washcloths, and practice uniforms after every use in hot water and soap, and drying in a hot dryer.

7. Avoiding contact with the skin infection of others.

Tennessee Department of Health: MRSA Toolkit

[Michaelangelica]

Well "Blow me down!", as the seafaring Bishop said to the actress.:thumbs_up

Silver nanoparticles may kill beneficial bacteria

Silver nanoparticles may kill beneficial bacteria

[CraigD]

Silver nanoparticles may kill beneficial bacteria

The article makes some good observations and cautions, I think. :shrug:

 

Though, from everything I’ve read, the action by which silver and other metals kill bacteria and other organisms is not fully understood, it appears to be indiscriminant, killing effectively all bacteria that come into contact with it, or the chemicals that surround it, apparently by damaging enzymes vital to bacteria’s (which are single celled) metabolism. Silver, in tiny particles threads, or more familiar objects like jewelry, isn’t toxic to large, multicellular organisms like humans because the parts of us that touch it - our skin, mucus membranes, and guts - aren’t living cells with any metabolism to interrupt.

 

Nanosilver may be superior to other common antibacterial agents, such Triclosan or alcohol in soaps and creams, because it can be permanently incorporated into cloths. Unlike Triclosan and alcohol, however, nanosilver doesn’t readily degrade when washed away, so it’s very important that cloths made with it don’t allow it to be washed away. Otherwise, the downstream ecosystem is exposed to the risks Zhiqiang Hu describes in the preceding article.

 

This indicates, IMHO, that regulators such as the US EPA and FDA need to develop coordinated, comprehensive ways to assure that nanosilver clothing don’t leak nanosilver. IMHO, systems like the Silver Nano line of washing machine, which inject silver ions directly into water, should not be permitted at all.

 

The ultimate worry with relying on nearly any antimicrobal agent is that microbes will develop resistance to them – especially in the case of bacteria, a “genetically talkative” domain of organism able to pass resistance between different species. The prospect of bacteria and other microbes becoming widely resistant to cleaning products is scary, because, as noted upthread, washing hands and cleaning surfaces is the best and effectively last line of defense against dangerous microbes. Worse, attempts to clean might wipe out non-resistant microbes that would otherwise eliminate the dangerous ones by beating them in the competition for resources or various sorts of “microbe combat”, making the situation worse than before cleaning.

 

Fortunately, although resistance to antimocrobals such as triclosan have been demonstrated in lab conditions, they don’t seem to be appearing in the wild. Still, I think a policy of “don’t use what’s not necessary” is best. Unless near-sterile conditions are needed, cleaning with plain, surfactant soap is better than using an antimicrobial.

 

I’ve an personal anecdote on the subject. In the 1990s, based on various medical literature, the healthcare organization for which I work published a policy requiring that none of its handsoaps or floor cleaners contain Triclosan. Shortly after reading this memo, I popped the plastic case on a soap dispenser in my building’s nearest bathroom, and read the ingredients label on the bag of handsoap inside, discovering Triclosan. I made a call, and a couple of weeks later, noticing a different color handsoap, checked its ingredients again, finding no Triclosan. A couple of months later, though, the color changed, and Triclosan returned. Another call, this involving several callbacks and an explanation that the switch-back was due to a supplier’s “free upgrade” to an “improved” product, and the soap went back to Triclosan free. A few years later, having heard the story, a coworker checked the handsoap, finding it was back to Triclosan-containing. This time, a call lead to an explanation that our supplier no longer offered a product without it, a promise to look into getting them to or changing suppliers, and finally a regretful call explaining that they couldn’t, and that a change in suppliers was too costly and complicated.

 

So, for the past decade or so, we, and I’m fairly sure most everybody else, have been washing our hands in policy-violating soap. Fortunately, this has not bred any epidemic-causing superbugs.

[Michaelangelica]

LOL on the story

Mmmmm

maybe not

maybe lol

although I would think if you kept reporting this to management they would have found you a RPITA (acronym starts with Royal and ends with a synonym for bottom)

 

A totally off topic story

A friend who worked in hospitals for years,told me there was a guy she worked with, who used to take home the old used X-Ray film and strip off the silver.

He would melt these down into brick shaped and sized lumps of pure silver.

Over the years he managed to make a good dozen or so of these, which he used around the house as door-stops.

His house was broken into and the only thing of value the burglars could find to pinch was the TV. Not realisng that the tarnished silver bricks everywhere though the house could have set them up Right Royally :shrug:

[Eye Sky]

Craig-

I had a first hand experience with MRSA. It is affecting very healthy indiviguals, and it is NOT common. Staph is - not MRSA. My 14 healthy year old son got it. Went to Schneider's Hospital (considered one of the 2 best in the US) They were unable with all their infectious disease experts to determine what the problem was. Until 3 days later. At which point sepsis set in, and they were trying to correct that. Vicomycin is the only drug to combat MRSA. Even the ME (medical examiner) was perplexed. It took him 6

months of sending sample after sample to the CDC to find out why a healthy 14 year old walked in, and didn't walk out.

 

http://www.northshorelij.com/workfiles/newsletters/vitality.pdf

pages 40 and 41

 

the above article,further explains "waging war against the super bug" and how the NY State Dept of health has awarded a 200,000$ grant to study it further.

[Celeste]

I had the misfortune of contracting CA MRSA on my skin 2 years ago. Thankfully, Bactroban was able to wipe it out in 5 days. Others aren't so lucky. :eek:

 

Since then, I've been abit paranoid and have followed up with some of the research from time to time. The scary thing about CA-MRSA starting on the skin, is the ease of which it spreads. I washed my bedding, towels, and clothes in a solution of bleach everyday for 10 days, and limited my contact with everybody. I was also told that if I started feeling ill with signs of fever, to get to the ER immediately. I still don't know how I got it, but the doctors felt it was a very small break in my skin from shaving...

Anyway, here's alittle info...oh, and I don't buy into collodial silver for MRSA...

albeit, recent research is showing some success with a mixture of essential oils...(though it hasn't been properly investigated.)

 

 

Patients colonised with MRSA

 

Patients colonised with MRSA may have a special antibiotic called mupirocin applied onto their skin (Bactroban) or the inside of their nose (Bactroban nasal). This helps to eliminate the MRSA and reduces the risk of the bacteria spreading either to other sites on the patient's body, where they might cause infection, or to other patients. Some strains of MRSA are, however, resistant to mupirocin.

 

 

Although MRSA are resistant to many drugs, most remain susceptible to the antibiotics vancomycin and teicoplanin (Targocid).

 

Empiric outpatient options for treatment of some CA-MRSA strains include Avelox, clindamycin, doxycycline or minocycline, trimethoprim-sulfamethoxazole (Bactrim or Septra), or linezolid, but it is important to be familiar with the susceptibility patterns of CA-MRSA strains in your community.

 

Fortunately, in the last few years further antibiotics that are active against MRSA have been developed and licensed for clinical use.

 

One such drug, called linezolid (Zyvox) may be given either by intravenous infusion (in severely ill patients) or in tablet form. Clinical trials have so far shown it is useful (either alone or in combination with other antibiotics) for the treatment of pneumonia and skin and soft tissue infections.

 

More recently, another drug called daptomycin (Cubicin) has been licensed for the treatment of skin, soft tissue, heart and blood infections including those caused by MRSA.

 

The new compound, codenamed XF-73, is applied as a gel into patients' noses.

Tests showed that the compound destroyed the five most common strains of MRSA in the nasal passage - and that the bug was unable to develop resistance, even after repeated exposure.

 

Waiting for approval this year:

Televancin, developed by Theravance Inc and Astellas Pharma of Tokyo. Televancin is a once-daily injectable antibiotic that would be used to treat skin infections, including those caused by resistant bacteria like methicillin-resistant Staphylococcus aureus (MRSA).

 

Ceftobiprole: Ceftobriprole is being developed by a unit of Johnson and Johnson Co. and Switzerland-based Basilea Pharmaceutica Ltd. The FDA is expected to make a decision on whether to approve ceftobriprole sometime next month.

 

 

A study published in the Journal of the American Medical Association found that in 2005, 14 percent of MRSA infections began in a public setting with no known cause, and another 58 percent began in a public setting after a person had been in a health care facility. Only 27 percent of the infections began in a hospital. In that year, nearly 19,000 Americans died from MRSA infections.

 

"Frank R. DeLeo, Ph.D., at NIAID's Rocky Mountain Laboratories (RML) in Hamilton, Mont:

To understand how CA-MRSA is evolving in complexity and spreading geographically, Dr. DeLeo's group sequenced the genomes of 10 patient samples of the USA300 bacterium recovered from individuals treated at different U.S. locations between 2002 and 2005. They then compared these genomes to each other and to a baseline USA300 strain used in earlier studies. Eight of the 10 USA300 patient samples were found to have nearly indistinguishable genomes, indicating they originated from a common strain. The remaining two bacteria were related to the other eight, but more distantly.

 

Interestingly, of the eight nearly indistinguishable USA300 patient samples, two caused far fewer deaths in laboratory mice than the others, highlighting an emerging view that tiny genetic changes among evolving strains can profoundly affect disease severity and the potential for drug resistance to develop.

 

"The USA300 group of strains appears to have extraordinary transmissibility and fitness," says Dr. DeLeo. "We anticipate that new USA300 derivatives will emerge within the next several years and that these strains will have a wide range of disease-causing potential." Ultimately, Dr. DeLeo and his colleagues hope that the work will lead to the development of new diagnostic tests that can quickly identify specific strains of MRSA."

 

 

Disease/Infection News: Over the counter antibacterials: Benzethonium chloride products identified as best for killing MRSA

 

One type of over-the-counter product for topical wound care is more effective than others in killing methicillin-resistant Staphylococcus aureus bacteria, or MRSA, which is potentially deadly and in recent years has moved from its historic hospital setting to a much broader public concern.

A new laboratory study indicates that many antibacterial products have some value, but a product made with benzethonium chloride kills common types of non-hospital - or "community associated" - MRSA bacteria better than other compounds. Clinical studies to confirm the results are needed, experts say.

 

The findings were presented today at a meeting of the American Society of Health-System Pharmacists, by David Bearden, a clinical associate professor in the College of Pharmacy at Oregon State University.

 

The surge in MRSA infections - which have been called a "superbug" and medical experts say killed more people than AIDS in 2005 - has alarmed health professionals. Many new cases are being found in a public, rather than health care setting, and are now attacking younger, healthier individuals. Since many of these systemic infections begin with cuts, minor wounds or skin infections, proper first aid care is taking on greater importance than ever.

 

"A good cleaning with soap and warm water is still the first and best line of defense against infection in the cuts, scrapes and minor wounds that everyone gets," Bearden said. "But there's also a place for antibacterial treatments, usually creams or ointments. With the significant increase in community-associated MRSA infections in recent years, we wanted to find out which products might work the best for this concern."

 

In laboratory studies, OSU scientists compared three types of compounds for their effectiveness in killing four strains of MRSA bacteria that are most commonly found in a public setting. The compounds were those made with neomycin and polymyxin; those made with polymyxin and gramicidin; and those made with benzethonium chloride with tea tree and white thyme oil.

 

All of the products had some antibacterial effectiveness against MRSA bacteria, the OSU study found, but only the benzethonium chloride compound had a genuine "bactericidal" effect - meaning it reduced the number of bacteria by a factor of 1,000 - against all four of the tested MRSA strains

 

 

 

Killing MRSA on surfaces:

 

 

Medscape September 18, 2007 (Chicago) — Aerosolized hydrogen peroxide demonstrates an excellent ability to neutralize methicillin-resistant Staphylococcus aureus (MRSA) environmental contamination, according to a new study. The neutralization appears to approach 100% and to last for weeks. It holds the promise of cost-effective infection control. ie....Seventy-four percent of 359 swabs taken before cleaning yielded MRSA, 70% by direct plating. After cleaning, all areas remained contaminated, with 66% of 124 swabs yielding MRSA, 74% by direct plating. In contrast, after exposing six rooms to hydrogen peroxide vapour, only one of 85 (1.2%) swabs yielded MRSA, by enrichment culture only.

 

A bleach:water solution of 1:10 (3/4 cup bleach in 1 gallon of water) kills MRSA and is effective for bathrooms and locker rooms, * but this bleach solution only remains effective for 24 hours after mixing , so should be discarded at the end of the day . The solution can be put in a spray bottle and the area sprayed with the solution and allowed to dry to kill MRSA.

 

• A bleach:water solution of 1:100 (1 Tablespoon bleach in 1 quart of water) can be used effectively to clean areas less likely to be as contaminated (kitchens) *as above.

 

• Hand soaps are effective in washing off the germs when used correctly. The important thing to remember is to wash your hands vigorously with warm soapy water for at least 15 seconds.

 

• Sani-Cloth Plus Hard Surface Disinfectant, Super Sani-Cloth Germicidal Disposable Cloths, Sani-Cloth HB, Sani-Dex ALC, and Vionex wipes kill MRSA.

 

• Hibiclens soap kills MRSA.

 

Prevention is still the best way to handle MRSA.

Say NO to overuse of antibiotics!