MRSA in the community

  1. doctors fear epidemic of superbug that hits the healthy

    last updated thu, 31 mar 2005 00:52:33 est cbc news


    calgary - an antibiotic-resistant "superbug" that infects healthy people keeps popping up in calgary - and doctors fear the outbreak might be the start of a deadly nationwide epidemic, a cbc news investigation has learned.





    mrsa, or methicillin-resistant staphlycoccus aureus, normally thrives in hospitals, making sick people sicker - and doctors know which antibiotic will beat it. but a more powerful strain of mrsa has been spreading among healthy people who have never been in hospital, first in the united states and now in canada. standard antibiotics don't seem to slow its ravages at all.

    "community mrsa, this particular strain, appears to be more virulent," dr. john conly, who heads the department of medicine at the university of calgary, told the makers of a documentary that aired wednesday on cbc's the national.







    "so, in the case of a boil, it becomes larger, more deep-seated. it may spread into the blood stream, develop into a large abscess. in the case of a pneumonia, which is the more worrisome, it continues to spread through the lungs unabated." man's lungs destroyed in 4 days

    that's what happened to a young man early in the outbreak. his x-rays and a ct scan over four days showed how pneumonia ripped through his lungs, unchecked by the antibiotics. the mrsa destroyed his lungs from the inside and within four days of being admitted to hospital, he was dead.

    "what what happens is that the infection continues to progress because you're really not treating with anything," conly said.

    "you're basically giving something to which the bacteria are completely resistant."



    he said it has quite serious consequences for not only the public but for the treating physicians, who need to scrap the usual antibiotics for alternatives.

    mrsa initially mutated from a common bacteria called staph aureus, which can cause infections if it gets into cuts or scrapes but is easily treated with antibiotics.

    calgary hit by 15 to 30 superbug cases a month

    the calgary cluster of cases - the first significant outbreak in canada of the new community-acquired mrsa - began to appear nearly a year ago.

    forty cases had appeared by october. most but not all of the infections have been in street people, intravenous-drug users or prisoners.

    now calgary physicians are seeing 15 to 30 cases a month, sparking fear that the superbug is poised to explode.



    "there are other pockets that are starting to surface in canada now so in fact this could be the beginnings of what they've been seeing in the united states," conly said. mrsa explodes among chicago's children

    in chicago and dozens of other u.s. cities, mrsa was virtually unknown a decade ago, but now it's a growing threat.

    doctors at the university of chicago hospitals have seen so many cases they are now experts in community-acquired mrsa.

    when dr. robert daum and his colleagues first detected a 25-fold increase in childhood cases in the mid-1990s, no one could believe it.

    daum, a professor of pediatrics at chicago's children's hospital, says these days, two-thirds of the children coming in with staph aureus infections have the antibiotic-resistant strain.

    "it's very clear we are in the middle of an mrsa epidemic now," daum said.

    "both in our emergency room and our inpatient service, we are admitting patients by the flocks with this."



    these children weren't weakened by other diseases, they were healthy. baby dies within 16 hours

    everly and jim, a young chicago couple, have experienced first-hand the deadly speed of the superbug.

    one day last year, their 17-year-old son simon woke them at 6 a.m. with what everly described as "incredibly strange primal scream."

    they took the boy to a hospital emergency department, where he grew every more listless as hours passed and seemed to have trouble breathing.

    when she felt his forehead and realized it had turned as cold as ice, she summoned a doctor who said simon had to be immediately placed on an heart-and-lung machine as "his only chance" to live.

    he was pronounced dead only 16 hours after the first scream. it was two months before they learned mrsa had killed their son.

    such an extreme outcome is very rare - but not unique.

    "it was an emotional tsunami," said everly, public health consultant. "as a public-health professional, i couldn't believe my son simon had died from a bacteria, an infectious disease. and i thought no, we passed this era.



    "i started to think about families 50, 100 years ago who actually had many, many kids on purpose because it was assumed you have at least one child die." the quest to find the cure

    the tricky bit is figuring out which drugs will work to treat mrsa - and the stakes are high. before antibiotics, 90 per cent of people who got invasive staph infections died.

    it takes precious time in a microbiology lab to learn exactly which antibiotic will kill a given bacteria infecting a patient.






    everly and jim agonize daily over how their healthy child became infected - and why he died so fast. everly believes society has to kick its antibiotic habit or face a hard truth:

    "the overprescription of antibiotics, and the use of antibiotics in animal feed, and use of antibiotics in all the cleaning products have created an environment whereby the weaker bacteria are dying off, leaving the stronger bacteria to be even stronger," she said.

    daum, who's tracked the growing epidemic in chicago children for a decade, believes staph aureus will always find a way to outwit antibiotics.



    "staph is a very complicated pathogen ... because it has multiple systems for doing the same thing and it's not going to cough up its secrets easily to a vaccine approach. "so this is going to be a difficult vaccine to make."

    http://www.cbc.ca/story/canada/natio...ug-050330.html
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  2. 15 Comments

  3. by   SmilingBluEyes
    This has been a LONG time coming, sadly. Truly frightening isn't it.
  4. by   Morning-glory
    It really gives me the creaps to read about this. I had a patient with an infected hip post surgery. It was awful. At the same time that I started the dressing, I realized that my belly button had just herniated. I just bent over and felt it "give". I had had laproscopic surgery 2 weeks earlier and my belly button hadn't healed properly. All of a sudden I had visions of getting MRSA in it. I did have a dressing over it and I was wearing the isolation gown and mask, but all of a sudden I didn't feel protected enough. MRSA is scary in the hospital. I had never heard of it out in the community. It can do really horrible damage to wounds. This woman's wound looked like yellow brains with yellow oozing slime coming out of it. She was in isolation for months.

    So needless to say I took another 2 weeks off for my belly button to heal.
  5. by   dlchap78
    I work in Kentucky and have already heard of a teenager that contracted CAMRSA after borrowing shin gaurds from a friend. It started out looking like a recluse bite and ended up after several months to be a major infection up to his thighs that he had to have debrided. Also, my mom works as a correctional facility nurse in IN and they had many prisoners turn up with what they thought were recluse bites. The "bites" grew out MRSA...
    Interesting, huh? Makes you think twice before using antibacterial hand gels. We are going to have some BAD BUGS out there!!!
  6. by   hockeymom
    I am very familiar with this problem. The fact that people are contracting it independent of the hospital is so frightening. A very risky population is athletes, especially those who wear protective equipment. The MRSA (and mold, fungus, yeast) thrive inside the foam and padding of hockey and football equipment. I live in Michigan and my 3 sons play hockey. Last year my husband and I started a new business that offers a proactive solution by thoroughly washing away and sanitizing all kinds of sport and safety equipment without damaging the gear or polluting the environment. It removes all traces of MRSA. We have been slowly growing, but our biggest hurdle is making non-medical people understand the seriousness of the public health problem and that one cannot rely upon an antibiotic to help should you or your child contract MRSA. They just don't seem to get it... maybe it's denial. My nursing background does help convince people that this is a real problem that is going to get worse before it gets better. We are YEARS away from a new antibiotic becoming available that will work ( 15 years is the average length of time that it takes a drug to go from initial concept to going on the market), so our best protection is through prevention. Check out our website: www.getcleangear.com for some very useful information. There are links to our parent company as well as other media reports about MRSA that have been in papers and on national TV.
  7. by   redshiloh
    OK does anyone know what the treatment is? My boyfriend was treated for 'recluse bites' x2 before and has since then had these terrible lumps all over his body. And of course now I have one too, in a really bad location I might add. I also feel bad, so I figure the infection is going systemic.
    I am taking Bactrim(leftover med). I don't get to see my doc til Wednesday.
  8. by   pickledpepperRN
    Quote from redshiloh
    OK does anyone know what the treatment is? My boyfriend was treated for 'recluse bites' x2 before and has since then had these terrible lumps all over his body. And of course now I have one too, in a really bad location I might add. I also feel bad, so I figure the infection is going systemic.
    I am taking Bactrim(leftover med). I don't get to see my doc til Wednesday.
    Can you go to urgent care? Or the ER?
  9. by   DNRme
    Quote from redshiloh
    OK does anyone know what the treatment is? My boyfriend was treated for 'recluse bites' x2 before and has since then had these terrible lumps all over his body. And of course now I have one too, in a really bad location I might add. I also feel bad, so I figure the infection is going systemic.
    I am taking Bactrim(leftover med). I don't get to see my doc til Wednesday.
    Please tell me you did not say you are taking leftover antibx!!! This is a big reason these critters are able to become drug resistant. Don't we all, as nurses know that?
    Two staff members in the OR where I work (1 RN and 1 MD) turned up with MRSA over the last 6 mos. They were told by employee health it was not a workman's comp. issue because they could not prove it was contracted at work and it's becoming more and more common in the community.
  10. by   Gennaver
    Quote from redshiloh
    OK does anyone know what the treatment is? My boyfriend was treated for 'recluse bites' x2 before and has since then had these terrible lumps all over his body. And of course now I have one too, in a really bad location I might add. I also feel bad, so I figure the infection is going systemic.
    I am taking Bactrim(leftover med). I don't get to see my doc til Wednesday.
    Hi redshilo,

    I am a very soon to be nursing student who has worked in hospitals, (in Chicago) and in health care for 15+ years.

    Wow, I am surprised that you not only have left over antibiotic, (don't the directions usually say to "take until complete") but that you are taking them willy nilly like this.

    Please don't take this as chastizing, I figured that you are like so many people who really don't (or didn't) take those antibiotic directions seriously enough. My husband is the same and I have been telling him for years that there is a reason antibiotics are prescribed and how they work.

    I read another poster suggested you go to an urgent care or er, hopefully you will be okay!! Please let us know what happens with both your boyfriend and yourself. You are now a great advocate to whoever thought your boyfriend had recluse bites, hmmm, wonder if they did a culture or blood test or what?

    Good luck!!
    Gen
  11. by   redshiloh
    Hey cool it on the leftover meds. What my post is asking is does anyone know if there is a treatment for this problem. REALLY do not need a lecture right now.
  12. by   Gennaver
    Quote from redshiloh
    Hey cool it on the leftover meds. What my post is asking is does anyone know if there is a treatment for this problem. REALLY do not need a lecture right now.

    editing to end the instant messages
    Gen
  13. by   mir4777
    It is scary, and I can say working in a small pediatric ward in southern California, that we've seen at least 5 kids w/ MRSA since I started working here 9 months ago. It starts as what looks like a bug bite and quickly goes to a large abscess. We've seen them all over the body and Clindamycin is about the only drug that it is really susceptible to. God help us as it begins to hit our community more and more.
  14. by   VivaLasViejas
    We are seeing MRSA everywhere these days, in fact I'm surprised that there isn't more of it. In the small city where I live, there is a huge meth problem, and these folks do a lot of 'skin-popping' which leads to abscesses (often attributed mistakenly to spider bites), and then pass MRSA on to their families, friends, sources, and other people in the community. If I've seen one 'spider bite' case this past year, I've seen 50, and these are almost always in young adults and teenagers.

    I'm even more suprised that there aren't more healthcare workers with MRSA. Despite the use of standard precautions, I think there are probably a lot of undiagnosed cases out there; who knows, maybe even you or I have it and just don't know it yet. Scary thought, huh?

    That's why I don't take antibiotics every time I get sick (even though I'm on my third go-round with bronchitis since the beginning of the year), and why I educate my friends, family, and patients to avoid them as much as possible. Most ailments are self-limiting anyway---they go away in a week if you treat them, and they go away in seven days if you don't. The other things I tell people about are the need to finish the entire prescription, even when one is feeling better, and NEVER to take old antibiotics, or worse, someone else's prescription. Why risk the possibility that the antibiotic you're given when you REALLY need it won't work?

    OK, I know, I'm preaching to the choir. But seriously.........it's really frightening to realize that we are growing super-bugs that are resistant to every type of antibiotic we've got. It's only a matter of time until we run out of ammunition, and Lord help us then! :uhoh21:

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