http://news.yahoo.com/s/ap/20070625/ap_on_he_me/staph_infections_2<b>Staph superbug may be infecting patients</b>

ATLANTA - A dangerous, drug-resistant staph germ may be infecting as many as 5 percent of hospital and nursing home patients, according to a comprehensive study.

At least 30,000 U.S. hospital patients may have the superbug at any given time, according to a survey released Monday by the Association for Professionals in Infection Control and Epidemiology. The estimate is about 10 times the rate that some health officials had previously estimated.

At issue is a superbug known as Methicillin-resistant Staphylococcus aureus, which cannot be tamed by certain common antibiotics. It is associated with sometimes-horrific skin infections, but it also causes blood infections, pneumonia and other illnesses.

The potentially fatal germ, which is spread by touch, typically thrives in health care settings where people have open wounds. But in recent years, "community-associated" outbreaks have occurred among prisoners, children and athletes, with the germ spreading through skin contact or shared items such as towels.

The infection control professionals' association sent surveys to its more than 11,000 members and asked them to pick one day from Oct. 1 to Nov. 10, 2006, to count cases of the infection. They were to turn in the number of all the patients in their health care facilities who were identified through test results as infected or colonized with the superbug.

The final results represented 1,237 hospitals and nursing homes — or roughly 21 percent of U.S. inpatient health care facilities, association officials said.

The researchers concluded that at least 46 out of every 1,000 patients had the bug.

There was a breakdown: About 34 per 1,000 were infected with the superbug, meaning they had skin or blood infections or some other clinical symptom. And 12 per 1,000 were "colonized," meaning they had the bug but no illness.

Most of the patients were identified within 48 hours of hospital admission, which means, the researchers believe, that they didn't have time to become infected to the degree that a test would show it. For that reason, the researchers concluded that about 75 percent of patients walked into the hospitals and nursing homes already carrying the bug.

"They acquired it in a previous stay in health care facility, or out in the community," said Dr. William Jarvis, a consulting epidemiologist and former CDC officials who led the study.

The infection can be treated with other antibiotics. Health care workers can prevent spread of the bug through hand-washing and equipment decontamination, and by wearing gloves and gowns and by separating infected people from other patients.Ouch. I suppose the best advice about going to hospitals today is, don't.

5% is awefully low.

For an easily transmittable and potentially fatal bacterial infection, that's alarmingly high.

By comparison, only 0.3% of the U.S. population carries HIV, and you have to repeatedly have sex with them or share needles with them to get infected, yet you are so afraid of them you want to ship them off to a leper colony.

Particularly troublesome is the estimate that 75% of them came in with the infection, and the fact that they are not immediately isolated. If I were a health care worker, I'd be worried.

You're kidding right?

I have been talking about MRSA for years here.

Your position has basically been, 'so what?, we will all have it soon enough anyway," in the past.

Honestly, in my opinion now, you were correct. And my previous Paul Revere attitude was misplaced.

You having it now, is pretty much a moot point. You will all have it within 15 years, epidemiologically speaking, this bug is already out. You will all get it.

potentially fatal bacterial infection,


You like that word, don'tcha?

Completely worthless word, potentially.

It is staph. You already have staph bacteria growing on your body right now. Everyone does. This one will just replace it, if you don't already have MRSA.

Staph is a flora bug. MRSA will be the flora of the future.

BTW, I will only further respond to your post three as; I will assume that it is merely rhetorical hyperbole.

Additionally,

We are growing these superbugs in people with HIV and AIDS.

That is where they are coming from. Of course they are nosicomial infections, because that is where the long term IV anti biotic regimens take place.

Patient 1 with MRSA was an AIDS patient in Japan, back in 1989 and 1990.
Patient 1 with VRE was an AIDS patient in New York.
Patient 1 with VRSA(MRSA evil older brother) was an AIDS patient in New York.


We are growing these bugs, and will continue to grow them, with long term antibiotic therapy on people with compromised immune systems. And consequentially, as the life expectancy of AIDS patients increase, and are on long term antibiotic therapy, they will begin developing faster.

In 1991, the CDC called MRSA THE number one emergent disease threat. And it was a reportable disease. Up until 1998, that is, when they stopped tracking it. They just gave up on it.

Your position has basically been, 'so what?, we will all have it soon enough anyway," in the past.With continued antibiotic (ab)use, yes, it is inevitable. But that doesn't mean we shouldn't take steps to slow it down where it's rampant.We are growing these superbugs in people with HIV and AIDS.Still clinging to that theory, are you? I thought you gave up on it years ago.

Even if, hypothetically speaking, these bacteria were grown in three men (who, by the way, weren't expressly identified as AIDS patients, according to your source), that would not have been enough to cause them to spread throughout the world and take hold as they did.

Decades of serious antibiotic abuse are an infinitely greater culprit.

Well Vanco in only available IV. ONLY.

The stories of grandma having jars of Vanco pills that she just hands around at sniffles, kinda falls short.

We are not talking about tetracycline resistant bugs.

We are talking about antibiotics which were previously only give to the most sick of extreme sick patients.

Vanco is an IV piggy back med, you can only get it in hospitals. You use to only get it if you had AIDS, now you get it because you have MRSA.

The Dr Feelgood wives tales are only there to make people feel good. No one in the medical community want to go down on paper labeling these new superbugs 'gay diseases', or even worse, saying that 'gays caused them'.

Just fear.

Of the truth.

But that doesn't mean we shouldn't take steps to slow it down where it's rampant.

Dude, MRSA is out in the public.

Staph lives on surfaces, even dry surfaces, for over 7 days. Up to 21 days in some studies I have read about.

It is already on your tanning beds, your gym machines, on toilet seats, on paper towel dispenser handles, on doorknobs. Keyboards and mice. On that Starbucks cup of mocha.



Wash your hands.

I wash my hands about a 100 times a day.

That little pimple on your butt? I bet you your month's fee at your local gym, that it is Staph.

Well Vanco in only available IV. ONLY.But MRSA evolved to be resistant to first line antibiotics and such, not vancomycin.

VRSA and VRE are a different story, but they are not widespread. Of course inevitably they will be, as MRSA becomes ubiquitous, and end of the line drugs will become first line drugs.

However, it all starts with people popping antibiotics whenever they have a cold and/or not completing a full course of treatment, and billions of animals constantly pumped with the stuff.

If antibiotics were properly used from the start, only in those individuals where it is absolutely necessary and with the proper course of treatment, there wouldn't have been a significant selection pressure for bacteria to evolve into resistant forms, and we wouldn't be having this problem (today at least).

Just fear.
Of the truth.I take it that, since you first came out with this hypothesis three years ago on the forum, you have actually found some evidence to support that hypothesis.

ESBLs are springing up now.


Until we start genetically breeding more and more bacteria to produce the toxins for the new antibiotics, expect for all of them to start falling down one by one.

If you continue to ascribe to the idea that we should let carriers of 'potentially fatal' diseases just walk amongst the general populace, spreading disease....they will continue to spread.

I don't know what your motion of concern is.

I don't.

Wash your hands. That's all you can do.


Count yourself lucky that you lived in THE short time where antibiotics actually worked. Your grandchildren will not be this lucky. The age of antibiotics will soon be over.

If you continue to ascribe to the idea that we should let carriers of 'potentially fatal' diseases just walk amongst the general populace, spreading disease....Not when the disease is easily communicable.I don't know what your motion of concern is.

I don't.First, hospitals are MRSA hot spots and they are doing too little to prevent contamination of other patients.

Second, antibiotic abuse continues, worsening the problem.

These are things we can still try to fix.

You have NO idea what you are talking about.

I am embarrassed with myself, in fact. I am ashamed.

As I expected, you still can't prove it.

nm

Not when the disease is easily communicable.
Isolate or not?

I don't get your point. Staph is one of the most easily communicable diseases on the planet. Always has been.


First, hospitals are MRSA hot spots and they are doing too little to prevent contamination of other patients.
Hospitals, nursing homes, care homes, group homes, gyms, and schools are hotspots.

What is your point?

If you have ever been in one, chances are, you got it. If you have cared for someone from one, chances are, you got it.

Second, antibiotic abuse continues, worsening the problem.
Well, not really. Try to get some tetracycline for your sniffles now. The medical community knows full well about the dangers of MRSA, I assure you. Considering that most doctors and nurses HAVE IT! Of course we know about it, what a stupid thought.

These are things we can still try to fix.
What are you going to fix, and how do you propose fixing it?

5% is unbelievable to me. 35% of the patients I have have to be put in isolation because they have it, at least.

Hospitals, nursing homes, care homes, group homes, gyms, and schools are hotspots.No, gyms and schools are not. Infections in such areas have been documented but they are relatively rare.If you have ever been in one, chances are, you got it.If 5% of patients in the dirtiest setting -- hospitals -- are infected, you'll have to show me the data saying that over 50% in public settings are infected. Otherwise, your statement makes no sense.What are you going to fix, and how do you propose fixing it?Since patients are getting regularly infected by it in hospitals, I propose better isolation procedures, and better treatment procedures so that people don't walk out of there carrying it to the public. Since you know about it, obviously what you're doing is not very effective.

I also propose that billions of animals stop being routinely and unnecessarily* pumped with antibiotics, which is still contributing to the problem of antibiotic resistance (think billions of bacteria-filled petri dishes also containing antibiotics and food).

<font size=0>*Unnecessary if they're kept in clean, humane conditions, which is of course not the norm in the livestock industry.</font>

ooooh,

Now you propose better isolation.

Praise be to Tudamorf, in you infinite wisdom.

Animals are not given Vanco.

You are 5 years behind the curve, Tuda.


Where have you been?

Very hot topic indeed. I would have to agree with Fyyr on this however. MRSA could have been stopped maybe 20 years ago. Its over now. And I think the 5% number is way low too. Nearly every nursing home used to tests their incomming residents for it and deny them if they had it. Now, it is assumed everyone has it. In fact, most places do not isolate for MRSA any longer - its that rampant.

VRE and VRSA - now those are something we can do something about. I agree that stringent isolation and infection control devices need to enacted at every health care facility to ensure no spread of these diseases occur.

However, just because the health care setting is where most of these infections are spread, does not mean they are "dirty" places. People in the hospital are generally sick - immune compromised and more readily acceptable to disease. Sometimes the most innocent act can cause the spread of the disease, like a new housekeeper doesn't realize they can't use the same mop in a patient with VRE and a patient with non-VRE.

Spreading panic about MRSA is useless. It is a staph infection that is resistant to one antibiotic. One antibiotic that "used to be" the gold standard for treating staph. Now, there are better and less toxic antibiotics that will treat this infection. And, there are MANY MANY people who are colonized with it (myself being one). I have tested positive for MRSA since 1995 and I have never been sick from it nor have I ever passed it to anyone.

It is a fact of nature now, we need to learn from it and make changes now with our practices for VRE and VRSA before they too become like MRSA.

Interesting, thanks for the info Madie. We just have to keep developing new antibiotics it sounds like. I heard something about one coming from the mud on the ocean floor in the bahamas recently.

Animals are not given Vanco.Of course not. What is your point here, exactly?

And I think the 5% number is way low too. Nearly every nursing home used to tests their incomming residents for it and deny them if they had it. Now, it is assumed everyone has it. In fact, most places do not isolate for MRSA any longer - its that rampant.If in fact everyone has it, you're right, isolation is pointless; but the article not only said that it was 5%, but that that figure was about 10 times more than the authors had expected.

Is your "almost 100%" figure just your guess or speculation, or is it something that has been tested and proven? Is it in all hospital settings?VRE and VRSA - now those are something we can do something about. I agree that stringent isolation and infection control devices need to enacted at every health care facility to ensure no spread of these diseases occur.What antibiotic(s) is MRSA most commonly treated with?

The way I see it, if I live an exceptionally filthy and toxic life, and stay healthy, then obviously my body is too toxic for even the most virulent strains of bacteria.

Pass the Jack Daniels and the cancer sticks, please.

Of course not. What is your point here, exactly?

Well, one of the wives antibiotic abuse tales about how VRE and VRSA were produced is that it is from giving antibiotics to animals over the years.

I don't say old wives. Because this theory is still being taught.

What antibiotic(s) is MRSA most commonly treated with?

Vanco.

If in fact everyone has it, you're right, isolation is pointless;
The point is to slow the inevitable. Isolation does work is slowing disease spread.

Is your "almost 100%" figure just your guess or speculation, or is it something that has been tested and proven?

Two of the hospitals where I did clinicals have the policy that all patients from nursing or rest homes are considered MRSA positive, until tested negative.

Depends on the hospital. At St. Joseph's virtually every patient I worked with was getting Vanco. At my hospital, you usually don't get Vanco unless you have MRSA.

Wash your hands.

And stay out of hospitals if you can.

Well, one of the wives antibiotic abuse tales about how VRE and VRSA were produced is that it is from giving antibiotics to animals over the years.I was talking about MRSA though. That's what the thread is about.Vanco.And the more MRSA cases are treated that way, the faster the bacteria will evolve protection against the last antibiotic available. Which is a reason to try to contain MRSA, and not just say, the hell with it.And stay out of hospitals if you can.This was my original point.

It is not going to evolve.

It already has.


VRE's spread is going to be slow, it is an anaerobic bacteria. It lives in your gut. It is not normally a surface or fomite bug. But it can easily pass via the fecal oral route, of course.

VRSA is going to spread just like MRSA did, most likely slower because isolation precautions are already in place. VRSA is aerobic, of course. And the precautions get more stringent every year. Hospitals now have dedicated staff to slow nosicomials and resistant bugs, even if it's one infection control nurse; they did not have those 20 or 10 years ago.

Got to get the docs to wash their hands too. Most of the old school docs are vectors.

Which is a reason to try to contain MRSA, and not just say, the hell with it.

Well, if it seemed like I meant that, I apologize.

It just is nothing to get alarmed or panicked about.

I appologize as well, I did not mean to say that everyone should just accept they will have MRSA some day and just not do anything about it. I simply meant that it is not something to panic about.

I also agree 100% with the washing the hands thing. I have personally sat for 2 hours in the nurses station in my ICU and watched as nearly every physician, intern, resident, attending, med students, and even some therapists, walk out of a patient's room without washing their hands or at least using the sanitizer.

It is AMAZING!! If you don't touch anything in the room, fine I am OK with you not washing. But if you even touch the chart and nursing papers then you at the very least need to use the hand sanitizer!! That is why there is one outside every freaking room!

I have confronted physician's about it and usually get some flack if I unintentionally embarrassed them. However, they always go to the sink when they are done telling me why they shouldn't have to. I also make sure that in Code situations - everyone has on their protective gear when they walk in the room, and if they don't they leave.

I think with me being the manager, my staff sees me doing these things and it makes them more comfortable to do the same. I have heard some of my staff be very strict but polite when telling physicians to either put on their PPE or wash their hands. Makes me feel all warm and fuzzy inside :) (and no that's not the MRSA ><)