April 12, 2004

Killer Staph Is Hitting The Streets. "Drug-defying strains of the bacteria have moved way beyond hospitals." Eek! [Via Boing Boing.]
  • I clicked the link then quickly thought better of it. I have no idea what the article has to say but I pretty sure it will scare the shit out of me...
  • I clicked the link then quickly thought better of it. But did you remember to wash your hands afterwards?
  • I "experienced" an antibiotic-resistant staph infection myself in November 2001; it was not a fast-acting 'flesh-eating' bug, but over several days grew from the size of a headless pimple to a swelling in my left arm that seemed to outweigh our Thanksgiving turkey. I was hospitalized when my fever reached 103.5, given standard intravenous antibiotics for 48 hours then switched to the big gun vanomycin, which dripped into me for the next two weeks. A surgeon also carefully split open my arm to drain the wound because they never located an 'entry point' for the infection, although they seriously under-anesthetized me and my crying like a baby could be heard on three floors of the hospital. I was released to home and not allowed to return to work for three weeks (I was barely able to wobble around and do some Christmas shopping by Christmas Eve, thanks to Target's electric wheelchair-carts), during which I took regular dosages of Cipro (which was a little hard to find, because of the idiotic anthrax scare) and had a disturbing quantity of alcohol-soaked gauze packed into the un-closed opening in my arm to make sure infection did not re-establish itself. And, again, this was a second-cousin to the really bad bacteria that is going around today. Which is why, with no apologies, I beleive that THIS news story is more important to EVERYBODY than any of the "ooh scary" terrorist threats of Bin-Laden and all his cohorts. One other sidenote: upon release from the hospital, I was specifically advised NOT to use any "anti-bacterial" soap on my skin, since it was more likely to kill the 'beneficial' bacteria that usually keep these staph monsters in check than the staph themselves.
  • That's a damn scary story, wendell. I'm glad you finally recovered.
  • THIS news story is more important to EVERYBODY Well, I do think the terrorist threat is very real, but drug-resistant diseases should be given the same amount of attention, as I'm sure they will after the first epidemic. I once posted a link on WarFilter about how bioterrorism funding was hurting normal healthcare, but I can't find it now.
  • Which is why, with no apologies, I beleive that THIS news story is more important to EVERYBODY than any of the "ooh scary" terrorist threats of Bin-Laden and all his cohorts. I agree. A world without working antibiotics could get very, very scary. Your experience sounds pretty fucking scary, too, wendell. Damn. I'm glad you recovered, too.
  • To imply that a "super bug" is coming to kill us all (which is the distinct implication, if not the outright stated conclusion) is sensationalism. The risk of getting a virulent staphylococcus strain is exceedingly low- not because they were previously restricted to hospitals, but because staph infection is almost always harmless, easily dispatched by various immune mechanisms. These drug resistant bacteria are no more dangerous than the non-drug-resistant forms. The only difference is that antibiotics work poorly against them. If you are healthy with a normally functioning immune system, your chance of having a staph infection is very low. If you are undergoing a transplant, or have end stage AIDS, etc, then you are at greater risk from these; however, if you are in one of those groups you are probably frequenting hospitals anyway. The key to understanding drug resistance is to understand that these bacteria acquire resistance in the form of some specific enzyme, with the ability to synthesize it conferred by a DNA strand known as a plasmid that can be traded around, allowing for greater genetic diversity (bacteria need some method of increasing their genetic diversity, as they reproduce clonally, so the offspring are genetically identical; if the ecosystem becomes challenging, they need to find a way to gain genetic diversity so that the chance of producing a more fit strain will occur). The ability to acquire these genes is something that predates human use of antibiotics by a large margin. The reason they never got these particular genes is because, if there is no reason to have them, it puts them at a disadvantage to keep these useless things around. Since we know about washing our hands and we have some understanding today about how these infections occur, and how our immune systems work, we have many more tools against antibiotic-resistant bacteria, particularly these scary sounding resistant bacteria that are really just commensals in most people (cohabitating with no negative influences on one another). I am not saying that antibiotic resistance will not cause problems- especially among immune repressed individuals, and in certain more serious diseases like tuberculosis. However, this is controllable- by using antibiotics responsibly (not overprescribing) and by shifting the type of antibiotics used at a given time (not allowing a particular resistance phenotype gain a significant selective advantage) we can stay in control, and these nightmare scenarios would never happen (keep in mind that the first antibiotics for human use were discovered in 1928- after the plague was no longer a problem). The most effective response to this situation is not fear, ignorance and crying about the end of the world, but a rational and cooperative response from the medical community to control resistance, not overprescribe, cooperate to avoid redundant use, and ensure patient compliance to antibiotic chemotherapy. Oh, and educating the non-specialist about appropriate antibiotic use. wendell: I mean no disrespect to your experience, of course- I wish only the best for you and I am glad you have bounced back.
  • What I find interesting are that the drugs being developed aren't helpful in a community setting--and these particular settings (the atheletes, prisoners, i.e. any group where things are shared) are where we hear about the outbreaks of the "superbug". But as jjray said, these strains are basically harmless to the person with a functioning immune system. Antibiotic-resistent strains of staph such as MRSA normally in hospital settings have been found on perfectly healthy pre-schoolers.
  • Wait, I thought all soap is anti-bacterial (just as rubbing alcohol is anti-bacterial), and the label was just marketing? Are they actually adding an extra ingredient? And if so, why is it important, as it's not the same kind of antibiotic that they put INSIDE us, so who cares about resistance to soap?
  • Oh, and JESUS TAPDANCING CHRIST wendell, glad you're alive. Fuck.
  • Daniel, soap by itself doesn't kill bacteria. Instead, it helps dislodge soil that can harbor bacteria. (If the bugs aren't on you, they can't bite you.) That's usually quite enough. Isopropyl (rubbing) and ethyl alcohols work by attacking the bacterial cell wall. Unlike common soap, they are true antimicrobial agents. There is no known bacterial mechanism of resistance against them other than sporulation. Furthermore, they evaporate after use, so there's little mechanism by which bacteria could evolve resistance through continual exposure to a subtherapeutic dose. The agent in "antibacterial" soaps is usually triclosan (and relatives). Resistance to triclosan, once considered impossible, is in fact possible, and could create a clade of germs immune to other antibiotics using triclosan's mechanism of attack.
  • Finally, a cheap, reliable source of Staphylococci!
  • wendell, where the hell did the infection come from? did you work or volunteer in a hospital? lordy. glad you're still with us.
  • Good grief, Wendell. Hope you're all right now, and that it never happens again *KNOCK ON WOOD* Would you now have increased resistance to the staph, or are you still as vulnerable as any of us?
  • And, if indeed you gained resistance, wendell, would you share it to someone who joins your cult after a healthy donation? *hints at ways to make lotsa money*
  • While jjray has a point about not overreacting to this problem, it is true that more and more community acquired infections are due to drug-resistant bacteria, and some of theses can be quite serious. Overuse and inappropriate use of antibiotics is almost certainly to blame, and it is very difficult to limit the use of these drugs. They are overprescribed in this country because patients want a quick fix and it is easier to write a prescription than to explain that an antibiotic is often unneccessary. The use of antibiotics in livestock feed adds to the problem, and finally, in many countries, antibiotics are sold over the counter which leads to inappropriate and unneccessary use. This is a problem that is going to get worse before it gets better, and although MRSA gets most of the press, drug resistant tuberculosis and other infections are much more troubling and are also becoming more common.
  • Oh goody. Another thing to be afraid of.
  • well, this is just evolution at work, folks. gene frequencies change with every generation, mutations that may confer resistance can pop up occasionally. the faster the generation time, the faster evolution can occur, especially given a strong selective pressure like a drug that KILLS anything that can't resist it. that's some severe, severe selection. sort of like a disease that immediately kills all people it contacts unless they are albinos. it wouldn't be very damn long before all remaining humans were albinos, would it? unfortunately for us, the generation time of a bacterium is something like 20 minutes. exponential growth. if it isn't dead in 20 minutes, it made a copy of itself and now there's two resistant bacteria. in 40 minutes you have 4, then 8, then 16, then 32, then 64, and pretty soon hundreds of thousands of them, all waiting to infect the next person to come along, and unable to be affected by antibiotics. they adjust to the antibiotic, mutate and reproduce far, far faster than we can come up with new ways to kill them. the good thing is that antibiotic resistance confers a cost on the bacterium. generally a gene that gives resistance also makes it harder for the bacteria to do X, so ordinarily having this gene around isn't that helpful and may even be harmful, same way sickle cell anemia isn't helpful at all unless you're exposed to malaria regularly, in which case it keeps you from dying due to mosquito bites. in absence of the pressure that makes carrying the gene worthwhile (that is, take away the antibiotic) bacteria will tend to lose the gene, as the ones without it will be better able to survive in a world without antibiotics. rather than bulking up on multi-antibiotic cocktails, we ought to do what jjray said - rotate what is used, don't over-use it, and as goetter mentioned stick to soap or alcohol to clean yourself up unless you're already immunocompromised. if we cut down on the amount of antibiotics out there, they will start working better again. i do like the idea of using our own immune systems to attack these bacteria, though - that's what out immune systems are for, so maybe this staphVAX will be a good thing...
  • Wowzers, is there anything you don't know, CLF? although wouldn't it be more like 1,2,4,16,256,65536...?
  • As a nurse my advice to all... if you wish to avoid infections, wash your hands, wash your hands, wash your hands. If you have children, and they have a runny nose, don't insist your physician write a prescription for antibiotics, unless there are clear signs of bacterial infection. Like green sputum, or green nasal drainage, etc. Best and first line of defense against infections....handwashing.
  • I've heard that phage treatment is coming back in as a way of fighting bacterial infection. It certainly sounded more promising than that great piece of biological pest control, the cane toad.
  • 'Flesh-eating' bacteria are on the rise Gee, that sounds like good news!
  • So why don't you support our troops?
  • Cool.
  • 52 out of 53 dead! dems some shakey odds
  • So why don't you support our troops? Simple cowardice. Maybe if I cooperate, the superbugs will spare me.
  • I've been rather quiet lately, and partly due to a couple health issues - - one of which may be an MRSA . I'm about to start one of the "big guns" myself, Bactrim, and hopefully start to see some progress. The current infection is in my chin area - - and likely happened while shaving. I had to go to the Emergency Room last weekend, and they didn't do squat. Swollen, painful and quite unnerving (the only upside is that I have doctor's orders to "not shave"). My dermatologist has been rather perplexed by it, and the earlier round of antibiotics has not had much of an effect. I'll start the new medication tonight - - have to run over to the pharmacy in a moment - - and I must admit that this has made me quite nervous.
  • Uh, I meant to say "which may be a MRSA infection".
  • Hang in there, SMT, and please keep us posted on how things are working. *reserves unlimited allotment of thread room for future SMT posts*
  • Dang! Get better, please. We needs ya!
  • good wishes to smt!
  • Shit! I hope you're okay, smt. Keep us informed.
  • Get well soon smt!
  • NO SICK!
  • Thanks for the kind words, All. I'm out the door to the dermatologist for a biopsy from my chin. Slight improvement - - but not what I was hoping for after three weeks of this! Still not confirmed if it is MRSA, but the biopsy should clear that up. My dermatologist happens to teach at NYC Medical Center, and presented my case to the residents there last week. She said that they all agreed that I have a difficult and stubborn infection to get rid of. *sigh* Not surprising, I have suddenly found myself washing my hands a lot more than I did before.
  • Report please, SMT. We're rootin' for ya.
  • Our Decrepit Food Factories MRSA: Revenge of the Pigs.
  • And while we're at it, 'C. diff' is set to challenge MRSA as the next "superbug".
  • Remind me to avoid the hospitals here in NYC. Going to labs for bloodwork is bad enough - it amazes me at how dirty many of them are. *cringes* Drug companies are looking for blockbuster therapies that must be taken daily for decades, drugs like Lipitor, for high cholesterol, or Zyprexa, for psychiatric disorders, used by millions of people and generating many billions of dollars each year. Antibiotics are used to treat infections, and are therefore prescribed only for days or weeks. (The exception is the use of antibiotics in livestock, which is both a profit-driver and a potential cause of antibiotic resistance.) Tah-dah!
  • Freaky! In a good way!
  • In fact, getting the total US death toll number is rather difficult to do, because hospitals don’t want to report these deaths and have actively lobbied against state laws requiring them to do so. Because corporate health care has your interests at heart! *snort*
  • Just great. Let's pump MORE antibiotics into our farm animals. We can make teh Supr-MERSA!!
  • that poor little pig. I am sorry you taste so good and that I eat your agri-biz anti-bio fed franken-carcasss mr pig. so cute....but so delicious...
  • *points shaking finger at Medusa* BACON-ZOMBIE!!
  • I know, I am a baaaaad person
  • Cute now, but later--still a pig.
  • Just great. Let's pump MORE antibiotics into our farm animals. We can make teh Supr-MERSA!! Okey dokey: FDA Withdraws Proposal To Limit Livestock Antibiotic Use, Raising Public Health Concerns
  • Yeah, the FDA is totally useless. Hey, pizza is a vegetable!