MRSA Notes

Nah, Im not talking about natural selection selecting us hu-mans out, but the process of natural selection that keeps bacterial and viral infections growing stronger and more resistant all the time.

While not directly related to MRSA, this article regarding some research done in Vancouver on disease transmission and the survival of the fittest bugs was interesting to me, and hopefully it will be to you too. Here is a snip that relates the process of gene sharing to file sharing - to appeal to the geek that is in you (I know its there…lol):

According to Finlay, the phenomenon can be compared to file sharing. “Bacteria have their own Internet,” he said. “They can download each other’s genetic sequences.” Scientists can easily determine which genes are most popular by looking at the number of microbial species that have “downloaded” them. Genes common to multiple species are considered important for long-term survival. Genes that allow infectious microbes to spread to as many hosts as possible are favored.

Ok so now we see how they are doing it - what can we do to stop it??

MRSA Support chairman, and friend, Tony Field has come out this week and accused Irish hospitals of discharging patients early, without MRSA testing, then when the patients come back in a few weeks, they call their MRSA “community-acquired.” All of this effort just so they can show lower infection rates. [source]

Is this an eye on what the future might hold for the United States, assuming *someday* we will get our hospitals to make their infection rates public?

Read Tony’s MRSA Story over at MRSA Resources.

Congratulations to Eastern Idaho Regional Medical Center for receiving the Qualis Health Award of Excellence for leading the way in hospital infection prevention. They have made a hospital wide effort to reduce MRSA in their facility by extremely good handwashing by the staff, screening patients and using isolation techniques to control MRSA, and it has shown as results in reducing the number of infections transmitted to patients during their stays. Congratulations - I hope more hospitals will sit up and take notice!

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Good news for the future of speedy MRSA testing (currently a rushed test still takes 24 hours or more to get results)! Cepheid’s Xpert MRSA Test has been cleared by the FDA for marketing to hospitals. For all ‘yall with the need to know more, here are some gory details:

The GeneXpert System is a closed, self-contained, fully-integrated and automated platform that represents a paradigm shift in the automation of molecular analysis, producing accurate results in a timely manner with minimal risk of contamination. The GeneXpert System is the only system to combine on-board sample preparation with real-time PCR (polymerase chain reaction) amplification and detection functions for fully integrated and automated nucleic acid analysis. The system is designed to purify, concentrate, detect and identify targeted nucleic acid sequences thereby delivering answers directly from unprocessed samples. Modular in design, the GeneXpert System has a variety of configurations to meet the broad range of testing demands of any clinical environment.

This new test will be able to give the hospital results in 1 hour.

This program has been in place in the adult wards, but now children admitted to the pediatric wards at John’s Hopkins will be screened for MRSA and VRE (Vancomycin-resistant Enterococci). They conducted a study that reinforced the idea:

In a study of 330 patients that lasted four months, weekly testing found 54 percent of patients carrying potentially harmful MRSA bacteria. Standard testing after symptoms appeared missed 35 percent of the people carrying the bugs.

“The results were quite clear to us: Aggressive patient safety programs should consider testing on admission as standard practice,” said hospital epidemiologist Dr. Trish Perl. However, she said that large-scale studies would be needed before making the practice standard around the nation. Source

Hopefully this WILL be the start of nation wide MRSA testing upon admission to hospitals. Normally patients are only tested after they have symptoms, and look at the mess we have. How wonderful this would be to really start getting a grip on the HA-MRSA (and other superbug) problems!

Johns Hopkins also offers this advice for infection prevention to incoming patients:

* Be aware that hand washing is the best way to prevent the spread of germs. Wash hands for at least 15 seconds.
* Practice good personal hygiene.
* Let your nurse know if your gown or linens are soiled.
* Feel free to remind staff members to wash their hands or wear gloves before examining you or giving you your medicine.
* Ask friends and relatives who have colds, respiratory symptoms or other contagious illnesses not to visit you or anyone in the hospital.
* Get vaccinated, if it is recommended. Flu and pneumonia vaccines can help prevent illnesses, particularly in young children, the elderly, and high-risk patients.

Results from a survey of 364 certified U.S. athletic trainers (presented at the Society for Healthcare Epidemiology of America) revealed that 53% of them had treated MRSA in the atheletes under their care:

Of the infections treated: 86 percent were in males and 35 percent were in females; 65 percent were in football players; 21 percent in basketball players; and 20 percent were in wrestlers.

The infections typically occurred in: the lower leg (38 percent); forearm (31 percent); and the knee (29 percent). Source

Thats a huge percentage - and there is no mention of the percentage who had problems beyond that of the more simple skin afflictions. I would like to see that information sometime…

This is the story of a man in Maryland, and his experience with MRSA. Thanks for sharing this with us, and again, if you are interested in sharing your experiences with others, please feel free to email me at christina@b5media.com.

I contracted the bacterial infection about 3 years ago. The infection corresponds with hospital check up i had at Mercy hospital in Baltimore city, although the hospital would never claim accountability, needless to say I missed a total of 45 school days due to the extremely painful swelling abscess on my chest, buttocks, and legs. The swelling was so great that it was painful to move, sit, essentially do anything. I have had about 5 emergency room visits due to the abscesses, 8 visits to my general physician and 2 surgeries.

It was embarrassing so i told no one except my doctor about it. I was irritable, grumpy, in excessive pain and miserable Initially my doctor told me they were hair bumps (Im of mixed ancestry, African American and Jewish, brown skinned but lots of body hair on my chest, arms and legs) Im also a weight lifter. My doctor told me to stop shaving my body hair and the abscesses would go away. They never did; the perpetually returned every 2-3 months with a vengence. I would take prescription after prescription of Bactruim and soak every afternoon in a hot bath and squeeze the abscess to release the pus. I dont need to tell you how painful this was. I would take up to 4-5 maximum strength Excedrin before I would initiate this procedure and this went on for 2 years. It wasnt until i came across a doctor who had experience with MRSA and how to effectively treat it that I was able to get effective treatment and some degree of closure. He prescribed a prescription strength industrial soap to kill the bacteria hiding somewhere on my body. I showered with the soap for a week twice a day. Ive been MRSA free since, but I feel if doctors where more knowledgeable about the dangers of MRSA and exactly what it is then my needless suffering and psychological anguish could have been avoided. I hope my personal account helps.

This is Debbie’s story. Debbie is a military wife living in Alaska who acquired the even more resistant VRSA (Vancomycin resistant Staph) from a hospital when they were stationed in North Carolina. Keep Debbie and her family in your prayers. If you would like to share your story, please feel free to email it to me at christina@b5media.com. Your experiences are so helpful to others going through MRSA infections.

My name is Debbie ,and I am a 49 yr old marine wife and mother of 7 children and 14 grandchildren. I do not live in New Jersey, however I have something called HA-VRSA , which , is Vancomyacin Resistant MRSA. I guess I just realized tonight not many people are as lucky as me to have this illness ( being very sarcastic).I had routine back surgery in March 1999,and ended up with hospital borne MRSA. There was a “Code of Silence” back then and no one wanted to tell me, however, a nurse came sneaking in my room one night and told me what is was ,and told me to get a lawyer. She said she would never admit to telling me as she would lose her job.

I spent a better part of a year in the hospital, and then over 6 months in a hospital bed at home on a PIC line. I almost died twice during that time frame. I was in a wheelchair for 3 years, however, I did finish my AA with honors between being in the hospital ,and in the wheelchair at home. So, I was quite proud of myself to roll across the stage and accept my diploma with a 3.89.

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Interestingly enough, I recently had a great conversation with another blogger (during a blogger meetup while I was in Toronto last week) about LASIK (Laser-Assisted In Situ Keratomileusis) surgery - this is the laser surgery that is so popular now for vision correction. This is something that I have been hesitant about getting, mostly because I am just plain old scared to have someone mess around with my precious eyes and take the risk of making them into a worse mess than they already are. He had almost made me feel comfortable about getting the surgery.

But, last week, in the American Journal of Opthamology, researchers are warning patients and doctors of the very real risk of MRSA keratitis, an MRSA infection in your eye as a result of LASIK surgery. I think I will go back to my “thanks, but no thanks” stand on LASIK. Here are some of the details of the study, you can read more about it here:

Infectious keratitis developed in 13 eyes of 12 patients after PRK. Organisms cultured were Staphylococcus aureus (n = 5), including a bilateral case of methicillin-resistant Staphylococcus aureus; Staphylococcus epidermidis (n = 4); Streptococcus pneumoniae (n = 3); and Streptococcus viridans (n = 1). Four patients manipulated their contact lenses, and 2 patients were exposed to nosocomial organisms while working in a hospital environment. Prophylactic antibiotics used were tobramycin (nine cases), polymyxin B-trimethoprim (three cases), and ciprofloxacin (one case). Final best spectacle-corrected visual acuity ranged from 20/20 to 20/100.

Thirteen eyes in 12 patients. That is not a good statistic. The sample size is quite small though, so there could be other underlying factors, but with as rampant as MRSA is these days, it is just a risk I am not willing to take. How about you?

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After a week out of town, with a few days tacked on each end visiting with my best girlfriend from Tennessee who came down to watch the kids while I traveled, I am back. Rather than going back and attempting to catch up with everything I have missed while I have been out, I am going to start anew with what is going on now. Please let me know if I have missed something important, as I have nearly 2 weeks of material to root through, and I would rather jump in with both feet than take two more hours to catch up and take the risk of getting distracted. I hope you have all been doing well, and are healthy as can be!

I also have quite a few emails from readers to get back to - I will work on catching up on those over the next few days. I sure always appreciate hearing from you, and the time and effort you put into telling me your stories. They are emotional for me, and sometimes I have to be in the right frame of mind to answer them, so if you will bear with me, I will be back in touch with all of you very soon.