MRSA, Other Superbugs Continue To Threaten Health

MRSA Superbug
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A 50 percent decline in hospital acquired cases of methicillin resistant Staphyloccus aureus (MRSA) in the past year could be seen as encouraging news except for the fact that other superbugs, such as antibiotic-resistant gram negative rods are beginning to emerge in hospital settings. In addition, cases of community-acquired MRSA, especially in children, are reported to be on the rise.

The decline in MRSA infections in the hospital setting can largely be attributed to the more rigid infection control standards that have been implemented over the past year. Handwashing has been emphasized in required infection control courses required by all hospital employees in the United States. Counter surfaces and medical equipment are regularly disinfected and surgery suites are routinely cultured to ensure a sterile environment.

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The first cases of MRSA were confined to hospital settings. In 2007, CDC surveillance studies identified MRSA as the cause of more than 94,000 serious infections and close to 19,000 deaths annually. Most deaths were due to infections of central lines and indwelling catheters. Reducing hospital acquired infection rates is a victory but additional measures are needed to control the spread of MRSA in the community. Community acquired infections with MRSA can be more serious because they are frequently not diagnosed until they're life threatening.

MRSA strains identified as community acquired differ from hospital‐acquired MRSA strains in that they are generally susceptible to most other antibiotics. Community acquired strains share the presence of the staphylococcal chromosome mec (SCCmec) type IV in their genomes, are frequently virulent, and predominantly cause skin and soft tissue infections. The genome sequence of the prototypic community acquired MRSA strain, MW2, is accompanied additional virulence factors not commonly present in other S. aureus strains. While not as threatening as infections of the blood, infections of tissue with community acquired MRSA can also be fatal.

Community acquired MRSA infections have been linked to recent hospitalizations in patients or their family members. Studies show that many people are colonized with MRSA although they're not infected. Carriage rates of MRSA in the general population range from 25% to 50%; higher rates than in the general population are observed in injection drug users, persons with insulin-dependent diabetes, patients with dermatologic conditions, patients with long-term indwelling intravascular catheters, and health-care workers. Children are also reported to have higher rates of colonization because of their frequent exposure to respiratory secretions. Risk factors for MRSA are the same as risk factors for S. aureus infection including shared towels, shared exercise equipment and toys, gymnasium and playground settings and crowded living conditions. Fatalities in children and young athletes have been well publicized in recent years although these infections were first reported among drug users in the 1980s.

A recent report from the Infectious Diseases Society of America shows that antibiotic resistant gram negative bacterial infections are also on the rise. Although they're primarily confined to the hospital setting they've also been seen in patients treated in an outpatient setting. Gram negative infections are alarming because, unlike MRSA, they're generally resistant to all available antibiotics, with the exception of Colistin, which can damage the kidneys. The January 2009 death of Brazilian model Mariana Bridi da Costa, after a series of amputations that could not stop the spread of her gram negative bacterial infection, is an example of just how serious this threat is.

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One area often overlooked in the battle against the transfer of dangerous infectious diseases in medical environments are the ubiquitous keyboards & mice. Standard keyboards & mice can not be disinfected because germs collect under keys and in open seams. Utilizing healthcare stimulus funds for disenfectable keyboards & mice is an excellent way to help reduce hospital cost. This is explained in the recent Man & Machine, Inc. White Paper titled, “Minimizing Transmission of Infectious Disease in Heath Care Environments by Use of Disinfectable PC Keyboards and Mice.”
Sometimes, Death Is Good….. For A Vicious Unicellular Microorganism. There are a variety of different types of foreign bacterial infections one can get from many different sources, yet some are more common than others. If they are not beneficial for your physiology, they all should die in order to restore your health. Bacteria are a simple life form, yet are incredibly productive and efficient. As with other life forms, it exists to reproduce, and does so about every hour, and evolves and adapts to its environment as needed. To do this, it fully utilizes all available resources and energy to develop the protein that is essential for its survival, and bacteria have the ability to adapt as needed to assure this happens. It needs exactly 7 genes to produce the essential ribosomes for this to occur. Any more or less genes than 7, the bacteria is not maximizing its efficiency to survive and reproduce. Amazing. Strept infections are caused by what are called gram positive bacteria, and are the most common bacteria that infect others. Staph bacterial invasions are gram positive as well, yet it is the MRSA, Methicillin Resistant Staff Aureous bacteria of this type often are very difficult to treat normally when a patient suffers from their damage from being invaded by these bacteria. Another difficult situation is when a patient is infected by VRE, Vancomycin Resistant Enterococci, as well. These MRSA and VRE pathogenic or disease causing bacteria are the ones that are the most clinically concerning for the health care provider. In most cases, such bacteria invade a resident of a medical institution, and have proved to result in very dangerous infections. If so, they are called nosocomial infections, and such infections are not limited to resistant strains of bacteria. Greater than 5 percent of nosocomial infections are determined to be MRSA infections, others have determined. This results in about 100,000 serious hospital infections, as well as about 20,000 deaths from MRSA infections annually. Group A strep infections can cause diseases such as strep throat and pneumonia. Since there are several types of bacteria, a diagnostic test called a culture and sensitivity is usually performed to assure the correct antibiotic is selected for treatment, as the bacteria are identified with this method. Typically, fluid from the area suspected of being infected is obtained from the patient suspected to have an infection and smeared on what is called a petrie dish. And then these dishes are incubated for 2 to 3 days. Gram positive bacteria stain during this process a dark violet or blue. Gram negative bacteria would be pink in color, and are capable of harm as well to a human being. When the culture is complete, technology offers recommendations on the appropriate class or brand of antibiotic for this bacteria present in another person- presuming the bacteria will not be resistant to the antibiotic recommended, as this happens on occasion. Usually, classes of antibiotics that are used to treat gram positive strep infections that are not VRE or MRSA are cephalosporins, macrolides, or general penicillins. If the microbe that is causing the infection is resistant to the antibiotic from such classes that are administered to the infected patient, other options should be considered. With two antibiotics in particular, which are methicillin and vancomycin, which is the case with VRE and MRSA bacteria, then there are other more aggressive antibiotics that will be chosen for this patient. Such brands and types of antibiotics for MRSA and VRE bacteria include Zyvox, which has both IV and oral dosage options. There are also other antibiotics, such as Cubicin. However these antibiotics for antibiotic resistant bacteria are given usually due to infections that have progressed to a more serious nature within a patient infected in such a way. Progressive medical conditions include sepsis, or blood infection, osteomyelitis, or bone infection, or Pneumonia, which is a serious lung infection. A hospital stay is normally required with such patients, as the last antibiotics mentioned for MRSA and VRE bacterial infections are given by IV administration initially for several days, if not several weeks. There are numerous classes and types of antibiotics available, yet bacterial resistance to most of these antibiotics constantly remains serious concern for the health care provider, and the infected patient. With MRSA at the top of the list of concerns for the health care providers, this concern continues to progress, unfortunately. Medical institutions should possibly consider quarantine for those patients at their locations that have been determined to be infected with the MRSA bacteria. Dan Abshear