|
Superbugs have become a topic of discussion in the media. MRSA is one of the most common talked about superbugs that is now spreading from the hospital to the community.
A lot of media attention has been given to the topic of "superbugs" and the threat that they pose. Accounts often border on sensationalism, seemingly with the intent to provoke fear, rather than to educate the public. One of the most talked about "superbugs" is MRSA - methicillin-resistant Staphylococcus aureus. MRSA used to be associated with hospital-acquired (nosocomial) infection, but is now being encountered more and more commonly in community-acquired infection. Is MRSA a superbug? For that matter, what is a superbug?
When I hear the term superbug, my imagination creates an image of a germ in a super-hero cape. And, of course, this super-hero represents evil rather than good. If I wanted to carry this fantasy a little further, and if I relied on drugs as a cure all, as it seems our pharmaceutical companies would have us believe, I would envision MRSA as the arch-rival of Rx-Marvel or some other caped drug who fights to eradicate the evil MRSA.
Presumably, superbugs are those with special virulence factors that result in the ability to cause infection more readily, cause more severe infection, and/or be extremely difficult to treat.
Had we coined the term superbug in the 1960s, penicillin-resistant Staphylococcus aureus, commonly referred to as "staph", would have been considered a superbug. The emergence of methicillin resistance is similar to the emergence of penicillin resistance in staphylococcus. I'm not sure how many of you can remember back that far, but if you can you may also remember that staph infections occurred just as commonly in those days, and were usually treated with penicillin.
Eventually, Staphylococcus aureus developed resistance to penicillin, and today most strains of the organisms are untreatable using penicillin. Today, we are experiencing the same trend with MRSA, and although infections involving MRSA are still more commonly encountered in a hospital or healthcare environment - hospital acquired MRSA (HAMRSA) - the organism is increasingly being isolated from infections acquired in the community - community-acquired MRSA (CAMRSA). To date, CAMRSA infections have been associated with infection in marginalized populations including prison inmates, homeless people and injection drug users; however, infections are increasingly being reported in sports team participants, and are also being reported in the general population in a number of countries. This trend will no doubt occur in Canada as well.
Next week we'll discuss the differences between Staphylococcus aureus, hospital or healthcare-acquired methicillin-resistant Staphylococcus aureus (HAMRSA), and community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA).
The copyright of the article Methicillin Resistant Staph in Microbiology is owned by Judy Arbique. Permission to republish Methicillin Resistant Staph in print or online must be granted by the author in writing.
Comments
Sep 29, 2006 10:14 AM
Maryan Pelland :
My 20 year-old daughter had a bought of MRSA, skin infections, last year
when she was stationed at Key West with the Navy. It was quite an ordeal
and we found none of the doctors she saw -- Navy or civilian -- knew what
it was or how to treat it. Wouldn't you think, since the problem is known
to be very prevalent among military recruits, they'd make sure military
doctors all get a clue?
Maryan Pelland
Sep 29, 2006 12:21 PM
Judy Arbique :
Yes, you would think that, but even among the military and other groups of
people where there is close contact that may result in passage of these
organisms, the susceptibility of staph to methicillin is approximately 50%,
so I think it will take a while for everyone to get used to the idea that
staph infections that respond slowly, don't respond at all, or get worse
may be caused by MRSA. This isn't to say that we should use antibiotics
other than methicillin routinely...that will only compound the problem.
What it does mean is that physicians should send cultures to the laboratory
to determine whether methicillin will be effective. If the lab result
indicates MRSA, treatment can be changed to an appropriate antibiotic.
Unfortunately, we spend very little time in our physician's office -
military or not, and there is still not enough awareness of antibiotic
resistant organisms. Unfortunately, physicians don't always keep up on
changing trends in antibiotic resistance, and your daughter ended up
suffering because of this. I assume that once the appropriate antibiotics
were prescribed that her condition improved?
It should be noted
as well that as patients we need to comply with prescription directions -
take as often as prescribed until the prescription is completed, unless
otherwise advised by our physician. One of the reasons for increased
antibiotic resistance is noncompliance with prescription orders so that
bacteria are partially treated - perhaps resulting in eradication of our
symptoms, but resulting in carriage of resistant organisms that will be
more difficult to treat should they cause an infection later, or be passed
on to another individual where they either cause infection or get passed on
to another individual, and so on, and so on, and so on...
Thanks
for your comments.
judy
Oct 3, 2006 4:55 AM
george p :
I guess I will throw my two cents in. I think I have been dealing with this
problem now for about 6 to 7 years. I know my body and when I started to
notice something was not right on my face I went to the doctor and he told
me to quit picking on it, that is a mental problem. well after seein about
10 difernt doctors in the houston area I convinced they dont know jack shit
and dont care. so this is my opinion (not professional) but maybe it will
help some. I think this bacteria may attach itself to the hair on your body
if not i think your hair makes it easier for this menace (mrsa) to do its
thing. so if you are having a problem it seems to help to keep the area
shaved. most probabaly wont agree with this but i have cleaned the area
with a good quality needle point tweezers, only try to remove the infected
folicles, you will notice them they seem to be darker and very course.you
will probabaly notice what seems like quuawagulated ( i know thats not
spelled right but that is the least of our problem ) blood, i believe most
of this is infection. if you are lucky and can handle the torture you will
get to the root of that problem area. you will know this by the difficulty
and pain followed by some heavy bleeding when you do get this root but that
area will be cured almost instantly. this process is not real easy and you
have to be patient. also you should start from the outside and work in, if
you dont you wont be able to keep up with the reproduction rate of this
virus, it tries so hard to keep its new home. i have also found that kanka
seems to work well, it kinda pulls the virus to the surface and makes it
easier to remove. also compound w has a way of killing it also. I have seen
accetone help in some cases and tea tree oil also can be helpful. another
item to try is blue star oitment. now all of these items will probaly work
differently on most but it may give you some ideas. until doctors get a
grip on this dont give up hope and fight it yourself. dont tear your face
up with tweezers please, but dont let this crap move into anyplace on your
body it feels like. try not to give up and get depressed because this virus
thrives on that. be strong and dedicate a certain amount of time to it and
then do what it takes to continue with your social life. they will find a
cure for this and i hope it wont be long, but until then take a deep
breath, maybe try some of these ideas and then maybe for a minute remember
the so many that wont ever have to worry about this
Oct 3, 2006 3:25 PM
Judy Arbique :
I can't comment on your particular case, but I can caution on seeing MRSA
as an evil villain...MRSA is a common infection causing bacteria that has
developed resistance to methicillin - one of the major drugs used to treat
more serious infections caused by <i>S. aureus</i>.
Shaving the area is more likely to make the situation worse, because
<i>S. aureus</i> commonly found living without effect on our
skin, is an opportunistic pathogen - it looks for breaks in the body's
defense system (like the skin) to gain entry - only then can it cause
infection.
Oct 3, 2006 10:36 PM
george p :
any input is appreciated but it seems to me this problem is one that most
still do not understand and is why more and more people are starting to
have problems that there physicians are having difficulty solving. when
people get a pimple or boil that turns out to be mrsa which came first, the
chicken or the egg. I think the virus attaches to a hair and then enters
the skin through the pore, now you have what appears to be an ingrown hair
but in no time at all becomes sore and infected. the mrsa mimicks the
production of skin but it is courser and raised off the surface. I think
this may be one of the most confusing things to most people who are new to
mrsa, what seems like an area that is swollen is actually not skin but the
infection that is trying to build up a wall around the entry point. once or
twice now i have found that when i started to shave this raised area would
instantly start to bleed when the razor went across it. so i kept shaving
it and with every swipe the raised area would start to shrink. yes it would
also bleed but the blood was not normal it was thick and would kinda roll
off with the razor. after some time i would completely remove this area
that was raised only to reveal perfect skin with a small dark pore. if i
get the last of it out of the pore this area is completely repaired and you
would have never known that just minutes before that you had a dime size
boil on your face. I know some of this may sound strange and I promise you
and everyone else I am here to learn not to teach, I am not a know it all.
I just have had to deal with this for so long and have been desperate for
answers. I have had many tear filled nights from this crap. i promise you i
have seen at least 8 different doctors when i started having this problem
back in 98 and I could not convince one of these doctors I had a problem.
they would try to prescribe me mind altering pills or tell me to stay out
of the sun. one gave me pills for a yeast infection. it was rediculouse and
for me it was hopeless. I have wanted to get a hold of some of these
doctors and give them a piece of my mind but I figure it could create more
problems for me and i do not want that. everything I have said is fact not
fiction and I dont know all of the proper names dealing with this subject
but as far as mrsa being a evil vilian, to me and i bet you quite a few
others there is somthing very evil about a bacteria that enters your skin
causes infection and reaks havock on your life, you go to t
Nov 4, 2006 3:03 AM
Puente Vista :
http://sulfursoap.com/October-2006.html
Interesting thread above
link about MRSA, and how our youth are contracting it in sports. Also
article about MRSA and artificial turf. Also about sulfur soap as a good
hand wash for prevention.
Nov 5, 2006 3:07 AM
Judy Arbique :
Thanks Maryan. Sports teams have seen an increase in MRSA infection -
injuries, close body contact, sharing of locker room supplies and
antibiotic use have all been suggested as reasons. The use of artificial
turf also provides a better "scrape" surface than natural
surfaces so that organisms can penetrate the skin and cause wound
infections...one of these being MRSA.
Interesting about the
sulfur soap; however, thorough washing with liquid soap and water is likely
to be just as effective.
Dec 6, 2006 7:17 AM
Abigail Small :
I have had HS for 20 years now. I worked in the medical/dental field for 8.
Mrsa is not contracted by social contact. Everyone has staph bacteria on
their skin. The problem is this strain is penicillic resistant and once
entered into the blood streem through a lesion or scratch and reproduced at
a remarkable rate, usually around major glands. The MSRA can be
killed(dormant)through the usual course of antibiotics but will recur.
Topicals do nothing other than reduce the some of the redness. This website
has a natural remedy that reduces pain, swelling, abcessing, and will treat
the bacteria in the blood stream. I do not work for this site nor do they
try to sell you any products. I had to find the product myself and I found
it in the most common place...the kitchen. I am not mad, I was just
desperate and now I am healing in and out. Please take a look!
http://earthclinic.com/CURES/boils.html This is currently being studied in
the US for its anti cancer properties. The research on this is out there. I
will let you do your own research since I want to remain unbiased. If you
suffer from MSRA (HS) this may be the miracle your looking for. It works!
Dec 7, 2006 3:51 AM
Judy Arbique :
Thank-you for your comments. I must caution EVERYONE that one of the
reasons that we have antibiotic-resistant organisms such as MRSA is the
over-prescribing of antibiotics, the availability of
"black-market" antibiotics, and antibiotics obtained without the
order of a physician.
It is NOT a good idea to self-treat based
on self-diagnosis. Even physicians are not supposed to do this...they too
should seek treatment from another physician so that personal bias is not
introduced into the algorithm.
Dec 15, 2006 4:18 AM
Robbie Jo Morrow :
I will be going back to ER today and I am sure they will ask me what am I
doing about this and what I am doing to treat it before the outbreak????
They are the ones now insatalling EJ's then central lines because the veins
are too damaged from Vanco for anything else. I will stay there for at
least a week on Vanco and pain meds then go home only to be back in a
couple of months. Any suggestions?
Jan 8, 2007 5:52 AM
Robbie Jo Morrow :
Well I'm back home again (infection controlled???) The wound is still there
and they placed an IJ this time for the Vanco. I don't know how long this
is going to go on but I find myself telling everone that has a infected
wound MSRA!!!! I hope I don't sound crazy or start friends to panic but
this really makes you think..... I have been going to SBMC when in the
hospital. They know me all too well. I am automatically put in isolation
(private rooms) an after reading all this I have began really watching the
nurses. The are super but has anyone ever thought about the blood pressure
sleves just going from room to room every few hours?????
Gob
Bless all I know too how hard this is to handle.
Robbie
Jan 8, 2007 3:39 PM
Judy Arbique :
Good point about the blood-pressure cuffs Robbie...if you or someone else
is on isolation because they carry MRSA or other antibiotic-resistant
organisms, dedicated patient equipment should be used...this applies also
to blood-pressure cuffs. Our hospital recently stopped using reuseable
tourniquets for blood collection for just this reason.
Jan 8, 2007 8:51 PM
m ricklin :
i worked in a hospital for 4.5 years, and was around this all the time. i
wore gloves, masks, gowns etc. to protect myself as much as possible. But,
i must say working in a hospital turned me into a germophobe. i don't like
to shake hands, touch door knobs etc..it drives me crazy because i still
don't want to catch MRSA and i don't even work in the hospital anymore. I
do have a question though. I work with someone that had a staph infection
after getting a broken hand fixed, but he was only in the hospital for
seven days, and another in my military unit that got a staph infection
after breaking a hand, and surgery. he was in the hospital for 3 mos. And,
a skin graft was done to repair it. If there are just scars present, and or
the wound is healed do i have to woory about catching something from either
one of them, because i kind of avoid them so i don't catch a staph
infection. do i have anything to worry about, or am i just being crazy? can
anyone help me out? thanks. artyman
Jan 11, 2007 11:55 AM
Judy Arbique :
I understand what you're saying about worrying more about catching things
after working in a hospital, but the purpose for gowning and gloving before
working with patients who carry or have infections caused by MRSA is to
protect other patients in the hospital whose immune systems are already
compromised and who may develop an infection from organisms that we, as
healthcare workers, carry from one patient to another. The concern is not
that the healthcare worker will be made ill by MRSA...Staphylococcus aureus
is an opportunistic pathogen meaning that it will take any opportunities
presented to it like abraded skin, incisions, wounds, etc.
I
would stop avoiding your friends that had staph infections...you carry
staph on your body yourself as they do...they ended up with infection
caused by staph because of the injuries they had that allowed the organism
access INto the body. Start shaking hands and hugging...life's too short!!
May 28, 2007 11:26 AM
John Cooper :
Recently diagnosed w staph. What has worked the best has been BETADINE
washs (2 x per week for 3 weeks) . Leave wash over entire body for 5mins
then shower. AWESOME results. Really works.
May 28, 2007 3:04 PM
Judy Arbique :
What do you mean when you say you were recently diagnosed with staph?
Do you mean Staphylococcus aureus or do you mean a
methicillin-resistant strain of S. aureus (MRSA)? Do you have a staph
infection...if so, where and what type?
If you don't have an
infection, then I would assume that you are colonized with MRSA, and that
is why you were advised to take betadine baths???
16 Comments
|
