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Hermit
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What you need to know about "superbugs"
« on: 2006-08-17 23:50:46 » |
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Drug-resistant staph superbug is spreading
P-I reporters Julie Davidow and Susan Phinney contributed to this report from Associated Press reporter .
Source: Seattle PI
Authors: Marilynn Marchione (AP), Julie Davidow (Seattle PI), Susan Phinney (Seattle PI)
Dated: 2006-08-17
Skin infections can be life-threatening if bacteria get into the bloodstream. Drug-resistant strains also can cause a vicious type of pneumonia and even "flesh-eating" wounds.
The CDC paid for the study, published in today's New England Journal of Medicine. Several authors have consulted for companies that make antibiotics.
Researchers analyzed all skin infections among adults who went to hospital emergency rooms in 11 U.S. cities in August 2004. Of the 422 cases, 249, or 59 percent, were caused by methicillin-resistant Staphylococcus aureus, or MRSA. Such bacteria are impervious to the penicillin family of drugs long used for treatment.
Matias Valenzuela, a spokesman for Public Health -- Seattle & King County, said drug-resistant staph isn't new in this area, but it's not a reportable disease, so the agency doesn't have exact numbers. Washington state tracked MRSA infections in 25 hospitals around the state between 2002 and 2004. Among outpatients, 19 percent of those diagnosed with staph infections had MRSA during the second half of 2002, compared with 35 percent during the first half of 2004.
"There has definitely been a gradual increase, just as there has been across the country," said Dr. Jo Hofmann, state epidemiologist.
The study's finding "completely matches what our experience at Vanderbilt Children's Hospital has been," said Dr. Buddy Creech, an infectious-disease specialist whose hospital was not included in the study. "Usually what we see is a mom or dad brings their child in with what they describe as a spider bite that's not getting better or a pimple that's not getting better," and it turns out to be MRSA.
Dr. Cynthia Markus, emergency medicine specialist at Providence Everett Medical Center, said they've been seeing MRSA cases in children and adults frequently for the past two years.
A family physician may have treated them as spider bites and prescribed an antibiotic. But when they're seeing up to two a day, they know they're dealing with MRSA, not spiders.
The germ typically thrives in health care settings where people have open wounds and tubes. But in recent years, outbreaks have occurred among prisoners, children and athletes, with the germ spreading through skin contact or shared items such as towels. Dozens of people in Ohio, Kentucky and Vermont recently got MRSA skin infections from tattoos.
Furgason, the Bellevue teen, said he takes precautions he'd never before considered, including cleaning his helmet and locker with bleach wipes several times a week. "I basically moved on and then used that as a lesson," Furgason said. "Even though I'm young and strong, things can still come get you."
The good news: MRSA infections contracted outside a hospital are easier to treat. The study found that several antibiotics work against them, including some sulfa drugs that have been around for decades. A separate study in the journal reports the effectiveness of Cubicin, an antibiotic recently approved to treat bloodstream infections and heart inflammation caused by MRSA.
However, doctors need to test skin infections to see what germ is causing them and to treat each one as if it were MRSA until test results prove otherwise, researchers said.
"We have made a fundamental shift in pediatrics in our area" and now assume that every such case is the drug-resistant type, Creech said.
And doctors need to lance the wound to get rid of bacteria rather than relying on a drug to do the job.
"The most important treatment is actually draining the pus," Gorwitz said. Many times that is a cure all by itself, she said.
PREVENTION TIPS- Wash hands thoroughly and often with soap and water.
- Keep cuts and scrapes clean and covered with a bandage until healed. [Hermit: Keep bottles of Hydrogen Peroxide available and use it to treat all wounds - even a scratch]
- Avoid contact with other people's wounds or bandages.
- Don't share towels, washcloths, razors, soap, ointments or other personal items.
- Wipe down athletic gear such as mats, head protectors and gym equipment with alcohol or antiseptic solution after each person uses it.
- See a doctor if you have a sore or boil, and don't try to drain it yourself at home.
[Hermit: To this list I would add, "Stay away from people, they are dangerous creatures who host lots of nasty bugs."]
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With or without religion, you would have good people doing good things and evil people doing evil things. But for good people to do evil things, that takes religion. - Steven Weinberg, 1999
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Blunderov
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Re:What you need to know about "superbugs"
« Reply #1 on: 2006-08-18 03:01:43 » |
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[Blunderov] In a massive coincidence (?), just last night I was forced to lance an instance of what sounds like an MRSA.* Happily my home surgery appears to have been effective, if a bit extempore; a very sharp, very pointy art cutting knife and a lot of Dettol did the trick nicely. (Thanks Hermit, for the tip about peroxide. I'd forgotten about that. Good stuff for the survival kit.)
This is scary though. It had worried me for some time that by squeezing the boil in an attempt to burst it, the infection might instead be driven deeper into the tissue and perhaps find it's way into the blood-stream. This would not be "a good thing". Hence the decision to lance it. Ugg.
En passant, it seems Staph is also a normal denizen of the human ecosystem; and is usually referred to as an "infection" when it misbehaves, although I think Hermit's "irruption" is a far more accurate word. Taxonomy can be a most vexing affair; where DOES one thing begin and another end?
Best regards.
http://www.usnews.com/usnews/health/briefs/beauty/hb041112d.htm
Staphylococcal infections are caused by the common gram-positive cocci Staphylococcus (staphylococci).
Staphylococci normally grow in the nose and on the skin of 20 to 30% of healthy adults (and less commonly in the mouth; mammary glands; and urinary, intestinal, and upper respiratory tracts). These bacteria do no harm most of the time; however, a break in the skin, burn, or other injury may allow the bacteria to penetrate the body's defenses and cause infection. Commonly, staphylococcal infections produce collections of pus (abscesses), which can appear not only on the skin but also in internal organs. Staphylococcal infections range from mild to life threatening.
People prone to staphylococcal infections include newborns; injecting drug users; breastfeeding women; and people with skin disorders, surgical incisions, a weakened immune system, or chronic diseases (especially diabetes, lung disease, disease of the veins and arteries, and cancer). Intravenous catheters, particularly those that remain in the body for more than 1 or 2 days, often become contaminated with staphylococci, allowing the bacteria to enter the bloodstream (bacteremia). Postoperative staphylococcal infections usually appear a few days to several weeks after surgery but may develop more slowly if the person received antibiotics at the time of surgery.
Staphylococci tend to infect the skin, but they can travel through the bloodstream and involve almost any site in the body, particularly the heart (endocarditis) and the bones (osteomyelitis). Staphylococcal endocarditis is common in injecting drug users. Staphylococcal osteomyelitis predominantly affects children, although it also develops in older people--especially those with deep skin ulcers (bedsores or pressure sores).
Staphylococcal pneumonia is a severe infection that develops mainly in people with chronic lung diseases (such as chronic bronchitis and emphysema) or influenza.
Some strains of staphylococci produce toxins. These toxins cause staphylococcal food poisoning, toxic shock syndrome, and scalded skin syndrome.
Symptoms
There are many kinds of staphylococcal skin infections. The least serious is folliculitis, an infection of a hair root (follicle) that produces a slightly painful, tiny white pimple at the base of a hair. Impetigo consists of shallow, fluid-filled blisters surrounded by yellow crusts. Impetigo may itch or hurt. Staphylococcal skin abscesses (boils, furuncles) are warm, painful, collections of pus below the skin surface. Staphylococcal cellulitis is a spreading infection that develops under the skin, producing pain and redness. Two particularly serious staphylococcal skin infections are toxic epidermal necrolysis and, in newborns, scalded skin syndrome, both of which lead to large-scale peeling of skin. All staphylococcal skin infections are very contagious.
Staphylococcal breast infections (mastitis) and abscesses typically develop 1 to 4 weeks after delivery. The infected area is red and painful. Breast abscesses often release large numbers of bacteria into the mother's milk, and these milk-borne bacteria may infect the nursing infant.
Staphylococcal pneumonia often causes a high fever, shortness of breath, rapid breathing, and a cough that produces sputum that may be tinged with blood. In both newborns and adults, staphylococcal pneumonia can cause lung abscesses. These abscesses may extend to involve the membranes surrounding the lungs (empyema), which adds to the breathing difficulties caused by the pneumonia.
Staphylococcal bacteremia is a common cause of death in people with severe burns. Typically, the bacteremia causes a persistent, high fever, and sometimes shock.
Staphylococcal endocarditis can quickly damage the heart valves, leading to heart failure (with weakness and difficulty breathing) and death.
Staphylococcal osteomyelitis causes chills, fever, and bone pain. Redness and swelling appear over the infected bone, and fluid may build up in joints near the areas invaded by the bacteria.
Diagnosis and Treatment
Staphylococcal skin infections are usually diagnosed by their appearance without laboratory testing. Other more serious staphylococcal infections require samples of blood or infected fluids for culture. The laboratory establishes the diagnosis and determines which antibiotics can kill the staphylococci. Sometimes x-rays and other imaging scans can identify an area of infection, but they generally do not help the doctor make an early diagnosis.
Minor skin infections--such as folliculitis and tiny patches of impetigo--are usually treated with an ointment such as nonprescription triple-antibiotic mixture (bacitracin, neomycin, polymyxin B) or prescription mupirocin. For most other skin infections, oral antibiotics (such as cloxacillin, dicloxacillin, and cephalexin) are adequate. More severe infections, especially blood infections, require intravenous antibiotic therapy, often for up to 6 weeks.
The choice of antibiotic depends on the site of infection, the severity of the illness, and the susceptibility of the particular staphylococcal strain. Some strains are resistant to many antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to nearly all antibiotics and is increasingly common in big city and university hospitals. Among the few antibiotics that are still effective against MRSA are vancomycin and trimethoprim-sulfamethoxazole.
Antibiotics alone do not cure abscesses; they must also be drained. Abscesses deeper in the body may require surgery.
To read the rest of this excellent article on coccal infections, please click here:
http://www.merck.com/mmhe/sec17/ch190/ch190r.html
http://www.usnews.com/usnews/health/briefs/beauty/hb041112d.htm
MRSA outbreak
Infection spreads among Connecticut college football team
By Helen Fields
11/12/04
Methicillin-resistant Staphylococcus aureus infections were once a worry only for people in hospitals. But in recent years, there have been more and more reports of MRSA being transmitted in the community. S. aureus, or staph, is a common bacterium, and many healthy people carry it around without ever knowing about it. It can cause skin infections, though, and MRSA is resistant to many of the antibiotics commonly used to treat staph infections. Researchers report an MRSA outbreak in a Connecticut college football team in the journal Clinical Infectious Diseases.
What the researchers wanted to know: How did MRSA spread among these college football players?
What they did: After several MRSA skin infections were reported to the Connecticut Department of Health among the players on a college football team, the university's health center took samples from the noses of the players, trainers, and coaches to find out if anyone was carrying MRSA there (no one was, although many had normal staph bacteria). They also took groin and armpit samples from patients with infections. The players, trainers, and coaches were interviewed in person to find out about skin injuries, whether they shared towels, and other ways that the bacteria could have spread. The researchers compared the 10 players who had MRSA skin infections with the 90 who didn't.
What they found: Players who'd had turf burns were seven times more likely to get an MRSA infection. Players who shaved part of their body were six times more likely to develop MRSA infections; the risk was even higher for those who shaved their genitals or groin. Cornerbacks and wide receivers were the most likely to be infected; the researchers say the bacteria were probably spread by frequent body contact between those players in drills and scrimmages. Then the bacteria would have been ready to infect the skin after any turf burns or razor nicks. The players who shaved were doing it for looks, not for the game.
What the study means to you: An MRSA infection usually isn't a serious problem for an otherwise healthy person. But an unhealthy person who contracts an MRSA infection and is unable to fight it off could be in danger, because regular antibiotics won't work on it. That's why public health officials get excited about MRSA outbreaks—no one wants these bacteria to become common. In this case, two of the men were hospitalized with cellulitis, an infection of the connective tissue under the skin; one had to get IV vancomycin for three weeks, and the other for two weeks.
Caveats: The researchers say using the whirlpools in the locker room might also have increased infection risk, because they weren't properly disinfected. Unfortunately, they didn't have enough detail about players' use of the whirlpools to figure out just how that related to their risk.
Find out more: Information about methicillin-resistant Staphylococcus aureus from the Centers for Disease Control and Prevention.
Read the article: Begier, E.M., et al. "A High-Morbidity Outbreak of Methicillin-Resistant Staphylococcus aureus Among Players on a College Football Team, Facilitated by Cosmetic Body Shaving and Turf Burns." Clinical Infectious Diseases. Nov. 15, 2004, Vol. 39, pp. 1446–1453.
Abstract online: http://www.journals.uchicago.edu
* The irruption began in spite of the fact that, at the time, I was undergoing a course of antibiotics for something else entirely. A bit suspicious, if not conclusive.
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DJ dAndroid
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Re:What you need to know about "superbugs"
« Reply #2 on: 2006-08-21 10:07:57 » |
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I am an Adult Care-Worker in a homeless shelter. More specifically I work in the filthiest section, namely 'Intox' which is indeed a drunk-tank. The whole concept of new super infections is terrifying to say the least. A few years ago the whole (18 million dollar) building was shut down and quarantined after a nasty infection got around. I fortunately wasn't there for that one, one of my coworkers caught a staph infection at one point. Scary business!
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Shouldn't robots have the same right as humans to have gender and express their sexuality?
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http://www.claytonbailey.com/monrobot.htm
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Hermit
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Re:What you need to know about "superbugs"
« Reply #3 on: 2006-08-21 15:00:48 » |
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Blunderov,
Perhaps I should retract my advice about hydrogen peroxide. No matter how valuable it may be in the war against disease, it apparently carries other dangers to the possessor.
"Since August 10 we have found bomb-making equipment. There are chemicals including hydrogen peroxide, electrical components, documents and other items. We have also found a number of video recordings -- these are sometimes referred to as martyrdom videos," Clarke said. [ Reuters ]
Actually. with the exception of the "martyrdom videos" (recordings of religious broadcasts designed to invoke depression and suicide?) you could probably find any of the rest in the house of most any geek. Given that it turns out that these "terrorists" apparently didn't have airline tickets, passports or any of the other things one might imagine might be needed to become martyrs by blowing aircraft out of the sky, I'm not utterly amazed that the Brits are looking to make the case that anyone possessing Hydrogen Peroxide is a terrorist. Dangerous place for germicidalists, Britain.
Regards
Hermit
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With or without religion, you would have good people doing good things and evil people doing evil things. But for good people to do evil things, that takes religion. - Steven Weinberg, 1999
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Blunderov
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Re:What you need to know about "superbugs"
« Reply #4 on: 2006-08-22 04:06:57 » |
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[Bl.]I love the internet. I really mean that. Does anyone remember when it sometimes took days, or weeks, to find out the simplest thing? But now I can push a key and find out everything I want to know about hydrogen peroxide. Which turns out to be very interesting stuff indeed.
It's possible that the authorities that Hermit referred to were/are concerned about the following characteristic of hydrogen peroxide "...vapours can form sensitive contact explosives with hydrocarbons such as greases."
http://en.wikipedia.org/wiki/Hydrogen_peroxide
[Bl.]To my mind, the most dangerous aspect of the current pandemic confiscation of civil liberties is that it could quite easily mark the return to a new Dark Age. It's not about reading your mail. It's about what you are allowed to know.
http://www.rationalmind.net/2006/06/01/chemistry-sets-now-illegal/
"Chemistry sets now illegal
Wired news is carrying a story on how an out-of-control Consumer Product Safety Commission has made chemistry sets illegal in an orgy of terrorist paranoia. This is a sad development indeed, as many of America’s great inventors got into technology experimenting with chemicals and home-made fireworks.
The chemophobia that’s put a damper on home science has also invaded America’s classrooms, where hands-on labs are being replaced by liability-proof teacher demonstrations with the explicit message Don’t try this at home. A guide for teachers of grades 7 through 12 issued by the American Chemical Society in 2001 makes the prospect of an hour in the lab seem fraught with peril: “Every chemical, without exception, is hazardous. Did you know that oxygen is poisonous if inhaled at a concentration a bit greater than its natural concentration in the air?” More than half of the suggested experiments in a multimedia package for schools called “You Be the Chemist,” created in 2004 by the Chemical Educational Foundation, are to be performed by the teacher alone, leaving students to blow up balloons (with safety goggles in place) or answer questions like “How many pretzels can you eat in a minute?”
The same political idiocy afflicts model rocketry."
[Bl.] In short, these days, suspicion can attend any sort of scientific enquiry at all. Biological, chemical, nuclear and, we learn from Hermits post, even electrical. So what's left? Theology? A licensed priesthood of government-approved scientists? Both? <lightbulb moment> Actually, isn't this already true? Consider the corporate-funded, copyrighted, patented, trade-secreted university research that already goes on.
This does not look good for Everyman. Poor old Everyman; he never catches a break does he?
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Blunderov
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Re:What you need to know about "superbugs"
« Reply #5 on: 2006-08-22 04:12:57 » |
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Quote from: DJ_dAndroid on 2006-08-21 10:07:57
I am an Adult Care-Worker in a homeless shelter. More specifically I work in the filthiest section, namely 'Intox' which is indeed a drunk-tank...
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[Bl.] Respect. You must have a bullet proof psyche. I don't think I could do this work.
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Hermit
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Re:What you need to know about "superbugs"
« Reply #6 on: 2006-08-23 11:44:05 » |
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[Blunderov] To my mind, the most dangerous aspect of the current pandemic confiscation of civil liberties is that it could quite easily mark the return to a new Dark Age. It's not about reading your mail. It's about what you are allowed to know.
Agreed. Completely insane.
Of course, given that a fire on a plane is usually fatal, why be complicated. A kapok coat and a box of matches would probably do the trick. An explosive, even a primitive one like gunpowder is unnecessary, but even if some homicidal, suicidal lunatic decided that explosive or an accelerator was needed, we can still buy black powder over the counter at Walmart. While this remains the case, banning the sale of charcoal briquettes, sulfur anti-fungal dust for treating rosebushes and potassium nitrate based fertilizers (also all available at low prices at your local Walmart) might be seen as silly, while the sale of sulfur, saltpeter and carbon hardly increases the danger, but gunpowder is needed for the sacred ritual of turkeys (hominid) blowing away turkeys (fowls) (amongst other things of varying lethality), and would probably lead to a revolution lead by the NRA if anybody tried banning it (hooray for the NRA), the other listed items are seen as useful, whereas Sulfur, Potassium Nitrate and Carbon are clearly dangerous chemical precursors which most Americans would agree probably should be banned. Then again, we know that Americans have proved willing to sign an appeal to attempt to ban that dangerous, but widely disseminated chemical, Hydrogen Dioxide, so why should anyone wonder why they might not consider banning a lethal precursor like Hydrogen Peroxide.
The trouble these asinine half-wits have is that they are being reactive, in the complete absence of knowledge possessed by any high school, let-alone 1st year student anywhere else in the world, and clearly imagine that "terrorists" are just as brain-challenged. Just as one silly example, it would be trivial to use innumerable non Hydrogen Peroxide (or gunpowder) OTC chemicals whether bought as chemicals or as ingredients containing the chemicals, to do quite enough damage to bring down a plane. Many of these could be used as binary systems a lot more safely (i.e. they won't go bang before you want them to) than TATP - and contra current inspection practice, definitely needn't be taken aboard in liquid form (but then, neither does TATP). For example, one can still purchase Iodine, Chlorine and Ammonia from Walmart. The energy levels of Nitrogen Chloride or Nitrogen Iodide are such as to make the things one can do with Hydrogen Peroxide look infantile, but banning antiseptics, swimming pool cleaners and window cleaners because they could be used to improvise materials which decompose rapidly at room temperature when disturbed would be so ridiculous that only somebody who thought that a slippery slope was located in a ski-resort in Colorado would attempt it. Or maybe not. After all, it isn't only in Iraq that the US gubbermint has resorted to the dissemination of terror. See e.g.
http://www.wired.com/wired/archive/14.06/chemistry.html and its sequel at http://www.unitednuclear.com/legalactionletters.htm to learn what the slippery slope-eyed American gubbermint is up to. Pay particular attention to the left hand sidebar, "latest news" at http://www.switch2hydrogen.com/ too for a real zinger. Apparently the Hydrogen economy is a non-starter not just because of the laws of energy but also because Americans cannot be trusted with the precursor chemicals.
For a nice analysis of the idiocy required to imagine that the toilet-lab TATP plot was realistic, visit the Register, home of the BOFH.
Regards Hermit
PS Agreed re DJ_dAndroid's psyche. Apropos of which:
There was once a maiden named Psyche
Who was heard to ejaculate criche
For when riding her biche
She ran over a tyche
And into a hedge that was pspyche
PPS Can you have a "lightbulb moment" without electricity?
PPPS For the analogous-spelling challenged:Psyche => Psyche (pronounced s-eye-key)
criche => crikey (pronounced Kr-eye-key)
biche => bike (as in bicycle)
tyche => tyke (as in dog)
pspyche => spikey (as in thorns) (pronounced Sp-eye-key)
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With or without religion, you would have good people doing good things and evil people doing evil things. But for good people to do evil things, that takes religion. - Steven Weinberg, 1999
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Blunderov
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Re:What you need to know about "superbugs"
« Reply #7 on: 2006-08-23 17:35:58 » |
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Quote from: Hermit on 2006-08-23 11:44:05
The trouble these asinine half-wits have is that they are being reactive, in the complete absence of knowledge possessed by any high school, let-alone 1st year student anywhere else in the world, and clearly imagine that "terrorists" are just as brain-challenged... |
[Bl.] Lol re the psyche Hudibrastics!
I have a picture, "The Bath of Psyche" by Lord Frederic Leighton 1830-1896, in my bathroom.
http://www.tate.org.uk/servlet/ViewWork?workid=8577
Grand Victorian camp. But I digress.
With regard to the reactivity, one has to wonder what sort of a mindset would make this kind of useless action seem reasonable. It seems to speak to a deeply materialistic outlook; one where "things" are all that is real, or significant.
Marxists have long insisted on the connection between materialism and decadence. It will be interesting to see whether future events bear this out. There doesn't seem to be any compelling reason to suppose that they won't. Then again, this "decadent phase" of Capitalism has been going on since WW1 so there may be a way to go yet.
Time, as always, will tell.
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Hermit
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Re:What you need to know about "superbugs"
« Reply #8 on: 2006-08-23 20:43:45 » |
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[Blunderov] I have a picture, "The Bath of Psyche" by Lord Frederic Leighton...
Grand Victorian camp. But I digress.
[Hermit] Grand Camp? Perhaps. I'm partial to Bouguereau myself, so I probably shouldn't say anything :-)
Kind Regards
Hermit
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With or without religion, you would have good people doing good things and evil people doing evil things. But for good people to do evil things, that takes religion. - Steven Weinberg, 1999
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