Super Staph May Outpace AIDS as US Killer

[Kanastrous]

http://www.msnbc.msn.com/id/21326497/

CHICAGO - More than 90,000 Americans get potentially deadly infections each year from a drug-resistant staph “superbug,” the government reported Tuesday in its first overall estimate of invasive disease caused by the germ.

Deaths tied to these infections may exceed those caused by AIDS, said one public health expert commenting on the new study. The report shows just how far one form of the staph germ has spread beyond its traditional hospital setting.

The overall incidence rate was about 32 invasive infections per 100,000 people. That’s an “astounding” figure, said an editorial in Wednesday’s Journal of the American Medical Association, which published the study.

Most drug-resistant staph cases are mild skin infections. But this study focused on invasive infections — those that enter the bloodstream or destroy flesh and can turn deadly.

Researchers found that only about one-quarter involved hospitalized patients. However, more than half were in the health care system — people who had recently had surgery or were on kidney dialysis, for example. Open wounds and exposure to medical equipment are major ways the bug spreads.

In recent years, the resistant germ has become more common in hospitals and it has been spreading through prisons, gyms and locker rooms, and in poor urban neighborhoods.

The new study offers the broadest look yet at the pervasiveness of the most severe infections caused by the bug, called methicillin-resistant Staphylococcus aureus, or MRSA. These bacteria can be carried by healthy people, living on their skin or in their noses.

An invasive form of the disease is being blamed for the death Monday of a 17-year-old Virginia high school senior. Doctors said the germ had spread to his kidneys, liver, lungs and muscles around his heart.

The researchers’ estimates are extrapolated from 2005 surveillance data from nine mostly urban regions considered representative of the country. There were 5,287 invasive infections reported that year in people living in those regions, which would translate to an estimated 94,360 cases nationally, the researchers said.

Most cases were life-threatening bloodstream infections. However, about 10 percent involved so-called flesh-eating disease, according to the study led by researchers at the federal Centers for Disease Control and Prevention.

There were 988 reported deaths among infected people in the study, for a rate of 6.3 per 100,000. That would translate to 18,650 deaths annually, although the researchers don’t know if MRSA was the cause in all cases.

If these deaths all were related to staph infections, the total would exceed other better-known causes of death including AIDS — which killed an estimated 17,011 Americans in 2005 — said Dr. Elizabeth Bancroft of the Los Angeles County Health Department, the editorial author.

Antibiotic-resistant staph infections, usually involving the skin, are showing up more often among healthy people. Here are some prevention tips:

— Wash hands thoroughly and often with soap and water.
— Keep cuts and abrasions clean and covered with a bandage until healed.
— Avoid contact with other people’s wounds or material contaminated by wounds.
— Do not share items such as razors, soap, ointments and balms, towels or wash cloths, clothing or uniforms.
— If participating in contact sports, cover cuts, scrapes and other wounds with a bandage.
— Shower with soap immediately after each practice or game. Wipe down all nonwashable equipment (mats, head protectors, gymnastics equipment, etc.) with alcohol or antibiotic solution after each person uses it.
— If caring for someone with an infection at home, wash hands with soap after each physical contact and before going outside. Only use towels for drying hands once. Change and launder linens frequently, right away if they are soiled.
— When contact with body fluids is expected, wear disposable gloves and wash hands after removing them.
— See a physician promptly if you have a suspicious skin sore or boil.
Sources: Associated Press, Centers for Disease Control and Prevention, physician interviews.
The results underscore the need for better prevention measures. That includes curbing the overuse of antibiotics and improving hand-washing and other hygiene procedures among hospital workers, said the CDC’s Dr. Scott Fridkin, a study co-author.

Some hospitals have drastically cut infections by first isolating new patients until they are screened for MRSA.

The bacteria don’t respond to penicillin-related antibiotics once commonly used to treat them, partly because of overuse. They can be treated with other drugs but health officials worry that their overuse could cause the germ to become resistant to those, too.

A survey earlier this year suggested that MRSA infections, including noninvasive mild forms, affect 46 out of every 1,000 U.S. hospital and nursing home patients — or as many as 5 percent. These patients are vulnerable because of open wounds and invasive medical equipment that can help the germ spread.

Dr. Buddy Creech, an infectious disease specialist at Vanderbilt University, said the JAMA study emphasizes the broad scope of the drug-resistant staph “epidemic,” and highlights the need for a vaccine, which he called “the holy grail of staphylococcal research.”

The regions studied were: the Atlanta metropolitan area; Baltimore, Connecticut; Davidson County, Tenn.; the Denver metropolitan area; Monroe County, NY; the Portland, Ore. metropolitan area; Ramsey County, Minn.; and the San Francisco metropolitan area.

[Pezzoni]

This has been 'big' in the UK recently (justifiably - apparently rates of MRSA in the UK are amoungst the highest in Europe).

I wonder if the way the healthcare system is run in the US makes a difference to it? I know that the chain of private hospitals I worked in over the summer have had no MRSA cases (in the last year, I think), whereas the NHS hospitals are relatively flooded with it.

[Mayabird]

The article failed to mention how the overuse of anti-bacterials in soaps and nearly everything else is only fueling their evolution more. And it can't help that the resistant strains don't have to compete with other bacteria species and strains on the skin once those are all killed off.

Heh, I wonder if my super-acne bacteria are keeping me safe from them.

[Kanastrous]

Heh, I wonder if my super-acne bacteria are keeping me safe from them.

Cue swelling music from Braveheart and clip of vast super-acne bacteria rallying to the defense of Mayabird's skin...

[Elaro]

The article failed to mention how the overuse of anti-bacterials in soaps and nearly everything else is only fueling their evolution more. And it can't help that the resistant strains don't have to compete with other bacteria species and strains on the skin once those are all killed off.

Heh, I wonder if my super-acne bacteria are keeping me safe from them.

...

I'm never washing my hands again. (I keed, I keed.)

[Andrew_Fireborn]

And people wonder how advanced species can be wiped out.

I'm still surprised the stuff hasn't yet managed to kill several times as many. The whole Germaphobe crap that is still all over cleaning product commercials by all rights should have doomed us.

Seriously, why do they think that 0.1% of germs they legally have to admit survive, survive!? And living in such a germ free environment is only going to weaken the immune system... Since the body loves to cut underused systems despite an overabundance of energy resources.

Oh well, maybe it'll find an AIDS strain it likes, and they'll merge with a little flu and get airborne... And the world will have peace.

[sketerpot]

...

I'm never washing my hands again. (I keed, I keed.)

Just don't use antibacterial soap. Regular soap works fine, and shouldn't have any evolutionary effects on bacteria.

Personally, I just use water for regular handwashing unless I'm sick or it's cold season.

[Knife]

The trouble with Methicillin is that it's not as potent as other penicillins, but it's used in Staph infections because it's resistent to penicillinase (an enzyme that can nullify the lactem ring in penicillin that does the deed that kills bacteria).

So this particuar string of Staphyococus (don't know what particular one...Areora?) has the double wammie of having penicillinase and being resistent to methicillin in general and since methicillian isn't that potent in the first place, and a narrow spectrum (IIRC) it just doesn't do the trick.

Methicillin, AFAIK, is like the one trick pony. It worked because of the resistence to penicillinase but it took very little change in the microbe to become too tough for the methicillin.

So, and take this with a grain of salt, the way they whoop up on this bug is actually pretty individualized. They'll introduce all sorts of non penicillin based antibiotics and see which one works the best for that particular patient.

Anyway, a lot of that shit is fear mongering. The best way to not come up with these bugs would be for your doc to get a lab test, prescribe the antibiotics and then YOU MUST TAKE ALL YOUR DRUGS.

People who don't take all their drugs, tend to kill off the weaker bugs who are easily killed by the antibiotics. But if you stop before all the drugs are gone and before they have the chance to kill off the tougher ones, you can spread those bugs and the next poor soul starts off with bugs that are tougher and harder to kill.

[PeZook]

I'll add that way too many people don't stay in bed when they're sick, too, helping spread the infection. Really, the world isn't going to collapse if you take a week off work. It may just collapse if you turn out to be resistant to a superbug and take a train to work, though.

[Alyrium Denryle]

The article failed to mention how the overuse of anti-bacterials in soaps and nearly everything else is only fueling their evolution more. And it can't help that the resistant strains don't have to compete with other bacteria species and strains on the skin once those are all killed off.

Heh, I wonder if my super-acne bacteria are keeping me safe from them.

...

I'm never washing my hands again. (I keed, I keed.)

You think that is bad, just wait until I tell you about Transformation...

[Crossroads Inc.]

Oh well, maybe it'll find an AIDS strain it likes, and they'll merge with a little flu and get airborne... And the world will have peace.

Airborne HIV... ((curls up n a corner and crys))

[Broomstick]

I'll add that way too many people don't stay in bed when they're sick, too, helping spread the infection. Really, the world isn't going to collapse if you take a week off work. It may just collapse if you turn out to be resistant to a superbug and take a train to work, though.

The problem in the US is that for a lot of people taking a week off sick can cost them their job, which then means they loose their medical insurance.

[PeZook]

The problem in the US is that for a lot of people taking a week off sick can cost them their job, which then means they loose their medical insurance.

It's the de facto problem here, too, despite the fact an employer can't just fire you over sick leave. The potential implications, however, are quite grand - the yearly flu epidemic is caused precisely because of that kind of attitude, it helps spread resistant bacteria and viruses, reduces overall productivity (since just one infected guy inside a packed bus can infect up to fifty people!)

Now replace the flu with a flu-like killer virus. Yay! Civilization falls because of petty greed

[His Divine Shadow]

Has anyone here heard about Phage Therapy? It seems relevant as a potential replacement or alternative to antibiotics.

[Knife]

Has anyone here heard about Phage Therapy? It seems relevant as a potential replacement or alternative to antibiotics.

You'd have to find that particular bacterialphage first, then spend years making sure that it won't kill the host first or even down the line. Then you have the problem of a chance at viral DNA/RNA or a chunk of it, accidently getting introduced into the bacterias DNA. Fuck knows what that would do to it or you.

But honestly, while MRSA is kind of scarry, most people (IIRC it's like 50%) carry this particualr Staphyococcus on them but it's kept in check by normal flora and your immune system. In most cases it takes something fucked up happening to let the little fucker start reproducing.

IE: getting another illness and taking the wrong drug or too much drugs and killing off some of your normal flora that keeps this bug in check.

or injury or other illness that compromises your immue system.

[Max]

Wow... I actually had a problem with this in 2004. I was in a drug induced coma for 45 days because of it. Basically, I went into the ER with my roommate complaining of not being able to breath and a pain in my lower back. That's the last thing I remember. 45 days later, that pain was kidney failure, and I had multiple system failure by the time I reached the actual ER. Fluid in my lungs. Very scary for my family. I was on about 7 different machines from what I was told. When they finally figured out what I had, they had to get CDC approval to use Vancomyacin to treat me. My mom said I had about 20% chance of living, my sister said 10%, my roommate said the doctors told him 1%..which they agreed was the closer percentage when I asked. It was all very surreal, and still is.

Anyway, being someone who had MRSA, I felt compelled to give a brief overview of my experience. VRSA is apparantly worse, as it's resistant to the Vancomyacin.

[Max]

Sorry for the doubl post... I meant to say "45 days later, I woke up, and found out that the pain was..."

[Einhander Sn0m4n]

Hmm, Dave caught a MRSA attack in his leg. Looked just like a brown-recluse bite after starting out as a glorified zit. I'm kinda thankful for all the mud-wallowing I did as a kid now. I can imagine my house is crawling with God knows how many kinds of hospital superbugs, yet I almost never get any kind of infection. I think my immune system is not only powerful but well-trained so I don't have crippling allergies.

[Admiral Valdemar]

Triclosan laced toiletries are the bane of the clinical microbiologist. You may as well go over to the Norks and hand them fourth generation nukes and B-2s.

[Adrian Laguna]

The article failed to mention how the overuse of anti-bacterials in soaps and nearly everything else is only fueling their evolution more.

I've been using anti-bacterial dishwasher as soap lately. Mostly because it's there, I think it's cheaper per volume than normal hand soap, I dunno I didn't buy it. Guess I should consider using something else.

[General Zod]

It's the de facto problem here, too, despite the fact an employer can't just fire you over sick leave. The potential implications, however, are quite grand - the yearly flu epidemic is caused precisely because of that kind of attitude, it helps spread resistant bacteria and viruses, reduces overall productivity (since just one infected guy inside a packed bus can infect up to fifty people!)

Now replace the flu with a flu-like killer virus. Yay! Civilization falls because of petty greed

If you work in an at-will state and you have no paid days off, then the employer is perfectly within their bounds to fire you unfortunately. Plus many schmucks working for just above minimum wage tend to not get vacation days. Or health insurance for that matter.

[Knife]

The article failed to mention how the overuse of anti-bacterials in soaps and nearly everything else is only fueling their evolution more.

I've been using anti-bacterial dishwasher as soap lately. Mostly because it's there, I think it's cheaper per volume than normal hand soap, I dunno I didn't buy it. Guess I should consider using something else.

Its not fueling evolution, rather taking out the competition. There is a concern, don't get me wrong, but don't let the pendulum swing too far the other way.

[Mayabird]

The article failed to mention how the overuse of anti-bacterials in soaps and nearly everything else is only fueling their evolution more.

I've been using anti-bacterial dishwasher as soap lately. Mostly because it's there, I think it's cheaper per volume than normal hand soap, I dunno I didn't buy it. Guess I should consider using something else.

Its not fueling evolution, rather taking out the competition. There is a concern, don't get me wrong, but don't let the pendulum swing too far the other way.

Yeah, sorry, that's what I get for deciding to take a shortcut instead of picking my words carefully.

Yeah, wipes out the competition, which includes strains that don't have some sort of resistance they got randomly, and strains which happen to get increasingly strong resistance get selected for again. But the important thing is that the more you use it, the more you have bacteria that are resistant to it.

Incidentally, these bacteria are usually at a disadvantage for whatever reason in an environment without antibiotic and antibacterial selection pressures. For instance, they may have some resistance because they're less efficient at absorbing certain kinds of molecules - a bad thing for them when the molecules can be food, but a good thing when they're in the form of an antibiotic.

[Max]

Hmm, Dave caught a MRSA attack in his leg. Looked just like a brown-recluse bite after starting out as a glorified zit. I'm kinda thankful for all the mud-wallowing I did as a kid now. I can imagine my house is crawling with God knows how many kinds of hospital superbugs, yet I almost never get any kind of infection. I think my immune system is not only powerful but well-trained so I don't have crippling allergies.

I had a similar mark on my waist, and it was thought to have been a brown recluse bite as well.

[Alyrium Denryle]

I've been using anti-bacterial dishwasher as soap lately. Mostly because it's there, I think it's cheaper per volume than normal hand soap, I dunno I didn't buy it. Guess I should consider using something else.

Its not fueling evolution, rather taking out the competition. There is a concern, don't get me wrong, but don't let the pendulum swing too far the other way.

Yeah, sorry, that's what I get for deciding to take a shortcut instead of picking my words carefully.

Yeah, wipes out the competition, which includes strains that don't have some sort of resistance they got randomly, and strains which happen to get increasingly strong resistance get selected for again. But the important thing is that the more you use it, the more you have bacteria that are resistant to it.

Incidentally, these bacteria are usually at a disadvantage for whatever reason in an environment without antibiotic and antibacterial selection pressures. For instance, they may have some resistance because they're less efficient at absorbing certain kinds of molecules - a bad thing for them when the molecules can be food, but a good thing when they're in the form of an antibiotic.

It gets even worse

When you wash someone's system with anti-biotics. You wipe out all non-resistant strains, leaving a bunch of their DNA free floating in the host. This can get taken up via transformation into the resistant strain and could confer resistance to a second antibiotic in that one strain depending on method of conferring the resistance.