Mrsa

Skunky

Oct 18, '07 · 10:18 AM4,873

It is raining cats and dogs right now, so the old clinic is a little quiet. On the commute I heard a number of sensational stories on 'MRSA', so I thought I would throw out a few points on the topic. MRSA stands for methicillin resistant Staph aureus. Staph aureus is a bacteria (NOT a virus as was reported on a radio news story I heard!) that is literally everywhere in our environment, including your skin! Don't be alarmed, it is supposed to be there. Not all Staph aureus is created equal, however. At some point in the 1960s IV drug abusers were noted to have 'staph infections' in the skin and bloodstream, and the staph was noted to be resistant to many of the antibiotics in use at that time. That was the beginning of MRSA. Continued skin and bloodborne infection treated with antibiotics in the drug abusers led to mutation in the bacteria's genes which made them 'resist' the antibiotics...unlike your friendly nurse, addicts usually do not take the time to cleanse their skin with alcohol or dispose of needles following injection, hence, the Staph that was on their skin was literally injected into deeper tissue and the blood along with their heroin.

Fast forward to today. Carrying MRSA is no longer an honor for pockets of IV drug abusers. The bacteria is everywhere. True, it is still concentrated in population pockets, but it is safe to say a swabbing of random surfaces in a 'clean' place like SOWAL (say swabbing ATM buttons, door handles, etc) would yield plenty of MRSA. Am I trying to scare you? No. My point is that you are living with MRSA as we speak and you are managing to survive. When I was a resident at the hospital, we drained skin abscesses (boils) all day and night that were full of MRSA...we didn't even bother to culture the stuff anymore.

So what should you do? Simple, use common sense and don't panic. Wash your hands frequently when out in public. If you have a recurrent issue with boils, you may very well be carrying MRSA and should go to your doctor's office and discuss it with her as there are therapies. A MRSA infection is not a death sentence, we do have antibiotics that can eradicate the bug. Finally, and this is HUGE, if you or somebody in your family has an infection (cold, flu, sore throat) and your provider opines that antibiotics are not needed, PLEASE don't take it personally and get bent out of shape. Unwarranted antibiotic therapy just makes this problem worse. :wave:

Replies

SoWal Insider

Oct 18, '07 · 10:26 AM#2

Bored Skunky? :roll: You can come help me clean and get rid of some Mrsa. :wave:

SkunkyAuthor

Oct 18, '07 · 10:43 AM#3

Bored Skunky? :roll: You can come help me clean and get rid of some Mrsa.

Nope, not bored, on tornado lockdown! :yikes:

Beach Fanatic

Oct 18, '07 · 11:11 AM#4

Had one of these things pop up on my elbow a couple of years ago. It looked and felt for a week or so like a pimple (Yea, I know I'm way to old to have pimples). Got real bad on a Sunday morning, went to the ER, was immediately diagnosed as a staph infection and admitted. The ortho surgeon on call came looked at it and declared it to be a bad deal. Ms Seaside got to help him drain the thing (She likes blood, guts and gore). They cultured the stuff to find out how to treat it, stayed in for a week, had a central line put in and took twice daily doses of antibiotics for two more weeks. $18k to fix. :yikes:

All this to support Skunky's comment about this being bad stuff. The ortho said a couple more days and there would have been bone damage. This stuff is everywhere and is just looking for a place to set up housekeeping and multiply.

beats on hood

Oct 18, '07 · 11:36 AM#5

My nephew who is in the 8th grade currently is being treated for an MRSA. He got a sore on his heel, and it was an MRSA staph infection. He's an athlete, so they assume he got it in the locker room. The doctor had to cut out some tissue in his heel to get rid of it. He's on Doxycycline (sp?). After hearing about all of this on TV, I am trying to tell my brother not to allow him to visit Mom in the hospital.

Now, Skunky, I am really worried about the student of mine with the carbuncle. It has grown and covers from his ear all the way under his chin, and it's thicker now, too. He still has to leave class at least once to dry it off.

NOW I CARRY PURELL WITH ME EVERYWHERE. I'm not on prophylactic antibiotics, but maybe I should go back on them since he's in my class again and I have a heart valve problem. :yikes:

Edited Oct 18, '07 · 11:38 AM

Beach Fanatic

Oct 18, '07 · 11:56 AM#6

Skunky, I carry antibacteria baby wipes everywhere,have for years I used to wipe those horrible pay phones with them before cells and door knobs etc, Do they really kill germs?? Does Purell?? It would be hard to carry alcohol around. I hate public restrooms period from the door on but my granddaughters have to "go" everywhere I take them..

bean

Oct 18, '07 · 12:05 PM#7

Thanks for the info Skunky but the replies following your post are making me a little nervous.

Meow

Oct 18, '07 · 12:08 PM#8

Thanks for the info Skunky but the replies following your post are making me a little nervous.

:roll:...Skunky gets bored and scares the cr*p out of sowallers. Oh man.

SkunkyAuthor

Oct 18, '07 · 12:21 PM#9

No, no, no. I am trying to do the opposite. I heard the radio news this morning and the topic of MRSA was being reported on in a fashion meant to whip-up hysteria. I was trying to point out that MRSA is everywhere and 99% of us don't have any problems with it. The news was making it sound like this was something like Ebola virus being released in Virginia.

BR-Why not giving the kid an 'A' and tell him to never show up again?;-)

CP-I am not too sure about the antibacterial ingredient in your wipes. There are different ingredients used in those products with varying potencies and mechanisms of action. But I can tell you that Purell, or any alcohol containing gel is a great product. Alcohol quickly KILLS just about anything you might encounter (in contrast to an 'antimicrobial' ingredient)...bacteria, microbes, fungi and many viruses succumb to alcohol...it destroys the organism's cell membrane. Obviously, you shouldn't use it on a kids face or anything, but for hands you can't beat it.

Beach Fanatic

Oct 18, '07 · 12:26 PM#10

I'm just going to go wash my hands again. They're talking about E. Coli on the produce thread. Kinda funnE cuz SJ's 'tar is the nekkid pumpkin :moon:

woman right now. ;-)How ironic? Handwashing is the bomb.

Edited Oct 18, '07 · 12:26 PM

SoWal Expert

Oct 18, '07 · 12:27 PM#11

No, no, no. I am trying to do the opposite. I heard the radio news this morning and the topic of MRSA was being reported on in a fashion meant to whip-up hysteria. I was trying to point out that MRSA is everywhere and 99% of us don't have any problems with it. The news was making it sound like this was something like Ebola virus being released in Virginia.
.

You mean like the headline on WEAR's website claiming it is a worse epidemic than AIDS? :roll:

bean

Oct 18, '07 · 12:30 PM#12

No, no, no. I am trying to do the opposite. I heard the radio news this morning and the topic of MRSA was being reported on in a fashion meant to whip-up hysteria. I was trying to point out that MRSA is everywhere and 99% of us don't have any problems with it. The news was making it sound like this was something like Ebola virus being released in Virginia.

BR-Why not giving the kid an 'A' and tell him to never show up again?;-)

CP-I am not too sure about the antibacterial ingredient in your wipes. There are different ingredients used in those products with varying potencies and mechanisms of action. But I can tell you that Purell, or any alcohol containing gel is a great product. Alcohol quickly KILLS just about anything you might encounter (in contrast to an 'antimicrobial' ingredient)...bacteria, microbes, fungi and many viruses succumb to alcohol...it destroys the organism's cell membrane. Obviously, you shouldn't use it on a kids face or anything, but for hands you can't beat it.

That's what I got out of it. I was just surprised at the quick responses of sowallers that have experienced it. I know my neighbor's 8th grade boy had it from picking mosquito bites.

Do you think it's becoming more common?

Also, let's say a person is on Augmentin a few times a year for sinus infections. Does it still make them non-resistant to say...Cefzill or other types of anti-biotics?

Beach Fanatic

Oct 18, '07 · 12:32 PM#13

Because of the kids here, we use a 90+% gel in patient care areas.

Kills the bads stuff NOW!!!

Kind of hard on the hands though.

bean

Oct 18, '07 · 12:48 PM#14

Because of the kids here, we use a 90+% gel in patient care areas.

Kills the bads stuff NOW!!!

Kind of hard on the hands though.

Where are you?

SkunkyAuthor

Oct 18, '07 · 12:48 PM#15

That's what I got out of it. I was just surprised at the quick responses of sowallers that have experienced it. I know my neighbor's 8th grade boy had it from picking mosquito bites. Do you think it's becoming more common?

Also, let's say a person is on Augmentin a few times a year for sinus infections. Does it still make them non-resistant to say...Cefzill or other types of anti-biotics?

I don't know if it is becoming 'more common', but that story is typical. The bacteria is on our skin, and a kid scratching a bite raw opens the skin and the bacteria slips right in! Neosporin is a good thing!

I read a study not too long ago where asymptomatic volunteers had a swabbed sample taken from their throat. These samples were then grown in culture. After they had provided their sample, they were given a short course of antibiotics (can't remember which one), perhaps 5 days worth. After the antibiotic regimen was complete, cultures were again obtained and compared to the originals. There was a surprising bump in the number of antibiotic resistant bugs after this! So even a seemingly benign treatment can create problems, potentially.

Antibiotic resistance depends on the mechanism the drug uses to kill bacteria. OK, not to get too eggheadish, but cephalosporins like cefzil and beta lactams (good old penicillins) both work in a similar manner in attacking the bacteria's cell membrane. Augmentin is amoxicillin (a beta lactam) combined with clavulanic acid. Many of the bugs that have gained resistance to b-lactams have done so by 'learning' how to produce an enzyme that breaks down the b-lactam before it can work (beta lactamase). The clavulanic acid in augmentin simply counteracts b-lactamase so the b-lactam can do it's job. So I think using augmentin will not have an effect on creating resistance to some cephalosporins, but not vice-versa. We might ask Audie or Cork, they are the pharmacists and I am digging deep to remember this stuff!

Beach Fanatic

Oct 18, '07 · 1:09 PM#16

Where are you?

I sent you a PM.

bean

Oct 18, '07 · 1:11 PM#17

I don't know if it is becoming 'more common', but that story is typical. The bacteria is on our skin, and a kid scratching a bite raw opens the skin and the bacteria slips right in! Neosporin is a good thing!

I read a study not too long ago where asymptomatic volunteers had a swabbed sample taken from their throat. These samples were then grown in culture. After they had provided their sample, they were given a short course of antibiotics (can't remember which one), perhaps 5 days worth. After the antibiotic regimen was complete, cultures were again obtained and compared to the originals. There was a surprising bump in the number of antibiotic resistant bugs after this! So even a seemingly benign treatment can create problems, potentially.

Antibiotic resistance depends on the mechanism the drug uses to kill bacteria. OK, not to get too eggheadish, but cephalosporins like cefzil and beta lactams (good old penicillins) both work in a similar manner in attacking the bacteria's cell membrane. Augmentin is amoxicillin (a beta lactam) combined with clavulanic acid. Many of the bugs that have gained resistance to b-lactams have done so by 'learning' how to produce an enzyme that breaks down the b-lactam before it can work (beta lactamase). The clavulanic acid in augmentin simply counteracts b-lactamase so the b-lactam can do it's job. So I think using augmentin will not have an effect on creating resistance to some cephalosporins, but not vice-versa. We might ask Audie or Cork, they are the pharmacists and I am digging deep to remember this stuff!

I find this extremely interesting so thanks for your eggheadish response.

A few years ago I was on so many antibiotics after sinus issues that led to pnemonia. Augmentin,Cefzil, Avalox, a couple of others and then AugmentinXR is what finally did it.
Unfortunately Sam has been on too many also with her allergy/asthma background. When she was younger she had ear infections and then she still gets sinus infections every now and then.( any cold turns into an infection with her) We really need to bite the bullet again and start her allergy shots back up. We just haven't had good experiences with it in the past.

I din't know Cork was a pharmacist!!!? Wow, she does it all doesn't she?

SoWal Insider

Oct 18, '07 · 7:44 PM#18

My mother-in-law checked into a hospital with a femur fracture, and checked out of this earth with a staph infection 30 days later still lying in bed at the hospital. Makes you wonder.

SkunkyAuthor

Oct 18, '07 · 8:06 PM#19

My mother-in-law checked into a hospital with a femur fracture, and checked out of this earth with a staph infection 30 days later still lying in bed at the hospital. Makes you wonder.

MRSA infections acquired in hospitals are a huge problem. An issue you can watch for in the near future is that the feds plan to stop paying for extended hospital stays and procedures related to conditions which look to be the hospital's fault, ie, line infections, bed sores, fall trauma, etc. It is envisioned as a way to cut back on medicare spending.

SoWal Expert

Oct 18, '07 · 8:08 PM#20

I find this extremely interesting so thanks for your eggheadish response. A few years ago I was on so many antibiotics after sinus issues that led to pnemonia. Augmentin,Cefzil, Avalox, a couple of others and then AugmentinXR is what finally did it.
Unfortunately Sam has been on too many also with her allergy/asthma background. When she was younger she had ear infections and then she still gets sinus infections every now and then.( any cold turns into an infection with her) We really need to bite the bullet again and start her allergy shots back up. We just haven't had good experiences with it in the past.

I din't know Cork was a pharmacist!!!? Wow, she does it all doesn't she?

Kate would be sick every day if she wasn't on the allergy shots. They have made all the difference. Maybe switch allergists and start over?

SoWal Expert

Oct 18, '07 · 8:16 PM#21

My mother-in-law checked into a hospital with a femur fracture, and checked out of this earth with a staph infection 30 days later still lying in bed at the hospital. Makes you wonder.

MRSA infections acquired in hospitals are a huge problem. An issue you can watch for in the near future is that the feds plan to stop paying for extended hospital stays and procedures related to conditions which look to be the hospital's fault, ie, line infections, bed sores, fall trauma, etc. It is envisioned as a way to cut back on medicare spending.

I've heard this, Skunky. Could nursing facilities be far behind? That's what I'm thinkin'.
Bob, I hear some version of this story quite often. :shock:

SkunkyAuthor

Oct 18, '07 · 8:33 PM#22

I've heard this, Skunky. Could nursing facilities be far behind? That's what I'm thinkin'.
Bob, I hear some version of this story quite often. :shock:

I think there is plenty of MRSA in nursing facilities already.

SoWal Expert

Oct 18, '07 · 8:38 PM#23

I think there is plenty of MRSA in nursing facilities already.

Ha! I meant the Medicare reimbursement thing.

SkunkyAuthor

Oct 18, '07 · 8:46 PM#24

Ha! I meant the Medicare reimbursement thing.

Oh. Well, I have no idea :blush:

SoWal Expert

Oct 18, '07 · 8:50 PM#25

Oh. Well, I have no idea

I'm just thinking that if they do it with hospitals, they will do it with us too.

hmmmm......can't remember

Oct 18, '07 · 11:58 PM#26

Kate would be sick every day if she wasn't on the allergy shots. They have made all the difference. Maybe switch allergists and start over?

Allergy shots=good thing. I had asthmatic bronchitis every two months in 2004 from allergy drainage. I had frequent flyer points with my pharmacy for antibiotics and prednisone. Scary. My doctor didn't like putting me on that stuff so much, but he and I both agreed that it was a good idea for me to continue to breathe. I started allergy shots that fall, and haven't had bronchitis in a couple of years. In fact, in the last two years I've only had my mystery virus and a headcold...pretty cool.