MRSA, Staph, Staff, Mersa, Methicillin Resistant Staphylococcus Aureus Symptoms & Treatment

Use of very old and very new antibiotics in intensive care units in Germany

Link: Use of very old and very new antibiotics in intensive care units in Germany -- Meyer et al., 10.1093/jac/dkm394 -- Journal of Antimicrobial Chemotherapy.

The increasing problem of multidrug-resistant Gram-positive and Gram-negative bacteria causing severe infections has led to a re-evaluation of old drugs and the application of newly developed reserve antibiotics. Polymyxins and chloramphenicol were discovered in 1947. Both drugs were gradually withdrawn from clinical practice in Europe and the USA because of reports about toxicity. However, the emergence of Pseudomonas aeruginosa and Acinetobacter baumannii strains that are resistant to almost all available antibiotics has led to a revival of polymyxins given parenterally.

Care home residents very vulnerable to superbugs

Link: Infection Control Today - Hot News.

A Johns Hopkins study of adult patients admitted to the Johns Hopkins Hospital showed that patients who resided in nursing homes or other kinds of long-term care facilities at any time within the last six months were far more likely than other adult patients to carry or be infected with a drug-resistant superbug. The study, conducted over a four-month period in 2006, was intended to grasp the extent of one of the lesser known hospital superbugs, multidrug-resistant Acinetobacter (MDR-ACIN), and control its spread among the hospital’s most vulnerable adult patients. More than 1,600 were screened within 24 hours of admission to any one of five intensive care units where previous infections had been recorded. Results showed that patients who had been in nursing homes, either admitted to Hopkins directly from a long-term care facility or transferred from home or another community hospital, were 12 times more likely than other patients to be carriers of the bacterium. Rates were even higher, 22 times, among those patients who were wheelchair- or bed-bound because their legs were paralyzed. As a result of the study, the Johns Hopkins Hospital will begin this summer to test all patients who have spent time in a nursing home, looking for drug-resistant bacteria at the outset of their hospital admission, while also using isolation precautions until their test results are known.

The Invisible Enemy in Iraq - Acinetobacter

Link: Wired News: The Invisible Enemy in Iraq.

But he still had mysterious symptoms that he couldn't shake, like headaches, rashes, and intermittent fevers. His doctors gave him CT scans, laxatives, methadone, beta-blockers, Xanax, more surgery, and more antibiotics. An accurate evaluation of his case was difficult, however, because portions of his medical records never arrived from Bethesda. If they had, they would have shown a positive test for a kind of bacteria called Acinetobacter baumannii. In the taxonomy of bad bugs, acinetobacter is classified as an opportunistic pathogen. Healthy people can carry the bacteria on their skin with no ill effects - a process known as colonization. But in newborns, the elderly, burn victims, patients with depressed immune systems, and those on ventilators, acinetobacter infections can kill. The removal of Gadsden's spleen and the traumatic nature of his wounds made him a prime target.

A landmark article - click the link above for more

Acinetobactor 4 times more resistant in 10 years

Link: Infectious Disease News.

Acinetobacter is about four times more resistant to standard antibiotics than it was almost a decade ago, and incidence rates have dramatically increased in hospitals, according to research presented at the 46th Interscience Conference on Antimicrobial Agents and Chemotherapy, held here.

In 1995, multi-drug resistant (MDR) strains of Acinetobacter caused 4.5% of infections. By 2004, the rate increased to 16.7%, and the strain was resistant to three drug types in one in four cases, according to a CDC study.

“The proportion of non-susceptible Acinetobacter isolates has increased significantly,” said Roberta B. Carey, PhD, microbiologist with the CDC’s division of health care quality promotion. “Although these very resistant strains of bacteria are not considered a risk to healthy people in the community, prudent use of antimicrobial agents is important to decrease the exposure of bacteria to these life-saving drugs and decrease the pressure for the microbes to become resistant to survive.”

Acinetobacter are gram-negative bacteria found in moist environments or on the skin of healthy people, especially health care personnel.

Injured Soldiers bring back acinetobacter

Link: Independent Online Edition > Health Medical.

     Injured soldiers returning from Iraq have brought back a superbug that has been linked with outbreaks in NHS hospitals where they have been treated, a health minister has confirmed. The links between casualties brought back from Iraq and outbreaks in the NHS have caused alarm within the health service and led to renewed demands for more dedicated wards for Britain's armed forces to enable wounded soldiers to be isolated more effectively. The Health Protection Agency has urged NHS hospitals to step up their infection control measures as a result of the outbreaks of a strain of the superbug Acinetobacter baumannii which is resistant to many types of antibiotics.

Acinetobacter figures stable

Link: CDR Weekly - Bacteraemia Infection Reports.

    There is a 17.2% increase (table 1) in the total reports of Acinetobacter spp bacteraemia reported via the voluntary surveillance scheme in 2005 (1127 reports), compared to 2001 (961 reports). This increase is due in part to the inclusion, since 2002, of laboratory reports from Northern Ireland. In comparison with data collected in 2004, there was only a marginal increase (0.9%) in the number of reports of Acinetobacter spp bacteraemia in 2005.

Multi-drug Resistant Acinetobacter a major issue for Iraq troops

Link: Antimicrobial Agents and Chemotherapy.

     Military medical facilities treating patients injured in Iraq and Afghanistan have identified a large number of multi-drug resistant (MDR) Acinetobacter baumannii isolates. In order to evaluate the impact of these pathogens on patient care, we analyzed the antibiotic resistance genes responsible for the MDR phenotype in Acinetobacter spp. isolates collected from patients at the Walter Reed Army Medical Center (WRAMC). Susceptibility testing, PCR amplification of the genetic determinants of resistance, and clonality were determined. Seventy-five unique patient isolates were included in this study: 53 % were bloodstream infections, 89 % were resistant to ≥ 3 classes of antibiotics and 15 % were resistant to the nine antibiotics tested. Thirty-seven percent of the isolates were recovered from patients nosocomially infected or colonized at WRAMC. Sixteen unique resistance genes or gene families and 4 mobile genetic elements were detected. MDR A. baumannnii isolates with ≥ 8 identified resistance determinants were recovered from 49 of the 75 patients. Molecular typing revealed multiple clones with 8 major clonal types being nosocomially acquired and with more than 60 % of the isolates being related to 3 pan-European types. This report gives a "snapshot" of the complex genetic background responsible for antimicrobial resistance in Acinetobacter spp. from the WRAMC. Identifying genes associated with the MDR phenotype and defining patterns of transmission serve as a starting point to devise strategies to limit the clinical impact of these serious infections.

Ions help hold back acinetobactor

Link: HighWire Press -- Medline Abstract

   OBJECTIVE: To determine effect of negative air ions on colonisation/infection with methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter species in an intensive care unit. DESIGN: Prospective single-centre cross-over study in an adult general intensive care unit. PATIENTS: 201 patients whose stay on the unit exceeded 48 hour's duration. INTERVENTION: Six negative air ionisers were installed on the unit but not operational for the first 5 months of the study (control period). Devices were then operational for the following 5.5 months. MEASUREMENTS AND RESULTS: 30 and 13 patients were colonised/infected with MRSA and Acinetobacter spp., respectively, over 10.5 months. No change in MRSA colonisation/infection was observed compared with the 5 month control period. Acinetobacter cases were reduced from 11 to 2 (p[Symbol: see text]=[Symbol: see text]0.007). CONCLUSION: Ionisers may have a role in the prevention of Acinetobacter infections.

Supersized 'island' Of Resistance Genes Discovered In An Infectious Bacterium - Insight May Help In Fight Against Hospital Infections

Link: Supersized 'island'

   Researchers have discovered a cluster of 45 genes coding for antibacterial drug resistance in the bacterium, Acinetobacter baumannii, a major cause of hospital-acquired infections worldwide. The study was reported in the open-access journal PLoS Genetics. "We expected to find resistance genes," said lead author, Pierre-Edouard Fournier, researcher at the Structural and Genomic Information Laboratory at France's National Center for Scientific Research (CNRS). "But the grouping of most of these genes within a single genomic island was totally unexpected." The resistance island--a group of resistance genes clustered close together on a chromosome--is the largest discovered to date. The research team also discovered new resistance genes. "We were surprised to discover 19 new resistance genes that escaped the scrutiny of the large number of laboratories already working on multi-drug resistant A. baumannii throughout the world. This is a demonstration of the efficiency of the whole genome approach in characterizing new pathogens," said Jean-Michel Claverie, senior author of the report and Director of the Structural and Genomic Information Laboratory at CNRS. This bacterium acquires resistance genes quickly--just thirty years ago it was completely susceptible to antibiotics and now it is resistant to a wide-range of antibiotics.

New fight as superbug hits intensive care unit

Link: CEN News :

   THE fight is on to destroy a hospital "superbug" that has hit intensive care patients.

An outbreak of infections caused by the acinetobacter bacterium has been identified in the Intensive Care and Neuro Intensive Care units at Addenbrooke's Hospital, where some of the sickest patients are cared for.

The bacterium can be dangerous in people already weakened by illness and can cause pneumonia and infections of the blood stream, skin, wounds and urinary tract.

The hospital in Cambridge said there were currently four cases of the bug and that affected patients were being cared for in isolation.

It said intensive care patients were being regularly monitored for signs of infection.

Margaret Berry, the hospital's chief nurse, said: "Acinetobacter is not uncommon in hospital intensive care units. We have identified just a small number of cases here at Addenbrooke's.

"Many strains of acinetobacter are easily treated by common antibiotics but some are more difficult to treat. This is why we are making every effort to destroy the infection. It is important to say that healthy people, healthcare workers and their families are not at risk from the infection. We are asking all staff, patients and visitors to be extra vigilant with hand hygiene."

Acinetobacter is a type of bacterium that can be found in many sources in the environment, including water and soil and can live on skin or in wounds without causing an infection.