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

Teen's Lip Piercing Leads To MRSA

Link: Teen's Lip Piercing Leads To MRSA - Health News Story - WJAC Johnstown.

A teenager thought he was being trendy when he pierced his lip. Now, he's in a hospital bed with an infection so bad doctors say it could kill him, Kansas City television station KCTV reported. Zeke Wheeler, a 15-year-old freshman at Blue Springs High School, decided three weeks ago to pierce his own lip at home. His mother, Jill Hanlin, said she found him as he was struggling to get the barbell to go all the way through his lip. "He went to the medicine cabinet, got a needle and stuck it the rest of the way through, without the needle being sterilized, of course," Hanlin said. Within days, Wheeler became achy and developed sores on his feet and hands.

Drug-resistant, sometimes lethal infections rising

Link: Drug-resistant, sometimes lethal infections rising | ajc.com.

That such a young man like Darriel Fleming would die so suddenly left his wife reeling with grief and unanswered questions. Although records show doctors reported Fleming's community-associated MRSA death to the state, his widow said she never knew the bacteria killed her husband until contacted by The Atlanta Journal-Constitution. "I'm just so frustrated," said Cynthia Fleming. "I'm just trying to come to grips with this." Hospital records, obtained by the AJC with Cynthia Fleming's authorization, show her husband's infection was caused by MRSA. She wonders whether her husband could have been saved if he had been diagnosed earlier with MRSA. Darriel Fleming, who had heart disease and was a diabetic at risk of skin problems, went to WellStar Cobb Hospital in Austell on June 17 after a painful boil grew on his stomach. In the emergency room, the doctor lanced the abscess and packed it with gauze. The doctor didn't say what it was, said Cynthia Fleming, who went to the hospital with Darriel that day. "My husband kept saying it was a spider bite. I kept saying it doesn't look like a spider bite to me," she said. Darriel Fleming was sent home with a prescription for Bactrim, an antibiotic, although no lab tests were done on the abscess to determine what organism caused it, hospital records show. About three weeks later, on July 5, Fleming developed a fever of 104 degrees. The next day, he went back to the hospital. While a chest X-ray was ordered, again the hospital didn't run any blood tests to look for an infection, hospital and insurance records show. The hospital sent him home with instructions to take Tylenol and drink fluids. Less than 24 hours later, Fleming was extremely ill and back at the emergency room. Despite being put on powerful, intravenous antibiotics, including vancomycin, Fleming's condition declined rapidly. He was put on a ventilator in the hospital's intensive care unit, but died at 3:14 a.m. on July 8. Final blood culture results, which came back after Fleming died, showed the Marietta man's bloodstream infection was caused by MRSA. A separate culture of his abdominal wound — taken less than an hour before he died — found MRSA there as well, hospital records show.

Understanding MRSA. (Mersa or Staph)

Ask an MRSA question * MRSA News * MRSA in your locality

MRSA Watch has gathered over 4500 articles on MRSA into a unique directory - see A-Z  guide in right hand column. Click on coloured text in the MRSA Basics guide below for more information on a specific subject.  The site is updated daily. Scroll down past the guide for specific information about aspects of MRSA

We also have an information packed audio introduction will help you grasp the key facts and the key issues surrounding MRSA

Simple staph aureus (SA) bacteria, (mrsa is not a virus), can be found on the bodies of up to 30% of the general population. It caused many problems before the use of antibiotics made wound recovery a safer process. Hospital acquired staph is generally resistant to several antibiotics but especially Methicillin, hence the name MRSA. This is found in about 1% of the population but in some pockets of the population this figure can be much higher.

Image from Komo News

Community Acquired MRSA (CA MRSA) is a different strain of MRSA, mainly causes skin infections and is treatable by more drugs at this time. CA MRSA (sometimes known as Mersa or Mursa) is more infectious and some strains of it are more destructive - should it become resistant to more antibiotics it could pose a considerable public health risk. Many people carry or are 'colonised' by staph bacteria but only suffer when they have another illness.

The colonisation stage carries no symptoms. Many only suffer MRSA as an infection of an existing wound. In recent times however some types of CA MRSA have begun to cause significant skin infections in otherwise healthy patients. The entry point is often a tiny cut, graze or exisiting skin condition.

How do people catch MRSA?
There are several ways it is believed to spread.

• Hand carriage - this is why hospital staff are encouraged to wash their hands after each patient.
• Contaminated surfaces - this is why clean hospital wards are vital.
• Via medical instruments - this is why many now have special coatings or have silver elements. This discourages lingering residues and/or kills external infection entering the wound
• Via airborne particles - MRSA often resides in the nasal passages and can spread with colds and flu as a secondary infection that may be dormant for some while.
• Shared items - Families or other close knit groups sharing a facility such as military personnel, a sports team or prison inmates may share hygiene items such as towels etc. This is another vector for the spread of the bacteria
• Needles - Drug users sharing needles may be passing on MRSA alongside HIV or Hepatitis C. The same could be said of tattoo artists who do not have strict hygiene regimes.
• Sexual Intimacy - the nose, groin and underarms are key colonisation areas for the bacteria. Sex workers and the habitually promiscous will be super spreaders in a society in much the same way as they are for AIDS.

How is it treated?
There are 3 key treatment regimes that are commonly used.

• For those who are colonised - a nasal treatment and a skin wash. This is often the strategy when MRSA is rare or prior to an operation as a means of preventing infection. Where MRSA is common some doctors will not suggest decolonisation as many will be recolonised within months within the local community. Some deep seated - throat and intestine - colonisation may require drug treatment.
• For those who have a potential or active bloodstream infection - drugs such as Vancomycin, Linezolid or Daptomycin.
• For those with infected wounds - special honey, silver bandages, garlic preparations and tea tree oil are all believed to be effective in killing MRSA in a wound. Many who have the skin infections common with CA MRSA simply need incision and drainage of the infected area and good hygiene while it heals. Antibiotics are not always needed.

How can it be prevented
The media often focus on clean hospitals and clean hands as a key to combating MRSA. Others believe that this will only cut cases by 30% and that a diverse strategy is vital and will include:

• Clean Wards - especially surfaces and keyboards.
• Staff Screening - are they super carriers?
• Patient Screening - so that they can be decolonised and to avoid self infection.
• Hospital Equipment - because it can take the infection deep into a wound.
• Air Hygiene - to help prevent nasal colonisation
• Hand Hygiene - to prevent transport from patient to patient via staff hands
  
• Antibiotic Restraint - because resistance grows from over prescription
• The Food Chain - is resistance also provoked by over use in the animals that we eat?
• Patient Isolation - this helps lessen the potential risk of airborne infection
• Lifestyle Choices - needle injected drugs and multiple sexual partners help spread chronic illnesses that emerge slowly.

What can I do

• Stay informed - this site and several others can help you do this. The A-Z guide in the right hand column will give you in depth information on over 50 aspects of MRSA from over 4000 articles, news items and academic papers.
  
• Ask others via our MRSA Watch forum
• Act locally by becoming involved in patient advocacy or patient/hospital forums
• Seek justice - do you need to take legal action because of neligence or do we all need to speak up for communities who are being hit by CA MRSA but are underinsured and often powerless.

MRSA Headlines

How CA MRSA Complicates Everything

Link: HighWire Press -- Medline Abstract.

Septic cavernous sinus thrombosis is an uncommon clinical syndrome with a high morbidity and mortality. The commonest bacterial pathogen is Staphylococcus aureus. We describe the study of a patient with cavernous sinus thrombosis and meningitis caused by community-acquired methicillin-resistant S. aureus (CA-MRSA) infection. The isolate was genotyped as the ST93 (Queensland) clone of CA-MRSA and carried the Panton-Valentine leucocidin genes. Cure was obtained following prolonged antimicrobial therapy with vancomycin, rifampicin, cotrimoxazole and linezolid. Given the high morbidity and mortality of cavernous sinus thrombosis and the worldwide recent emergence of CA-MRSA, clinicians treating patients with this infection should consider early empirical coverage for CA-MRSA with an antimicrobial agent, such as vancomycin or linezolid, particularly in the presence of suspected facial staphylococcal skin infections. If vancomycin is used, we emphasize that high doses may be required to achieve even low levels in the cerebrospinal fluid.

School Waits 2 Weeks for Death Notice of MRSA Contagious Child

Link: School Waits 2 Weeks for Death Notice of Contagious Child|ABC 7 News.

Parents of students at Bunker Hill Elementary are outraged that the school notified them almost two weeks after a student, who had an extremely contagious disease, died. Parents already knew 11-year-old Dionshae Robinson had died, what they didn't know and just recently found out was the little girl was diagnosed with MRSA, a deadly and extremely contagious anti-biotic resistant staff infection. The school sent out a notice from the Health Department home to parent Monday. 

29% of Australian MRSA community variant

Link: HighWire Press -- Medline Abstract.

The Australian Group on Antimicrobial Resistance studied the epidemiology and outcomes of Staphylococcus aureus bacteraemia in selected Australian hospitals in 2005-06. Seventeen hospital-based laboratories collected basic demographic, susceptibility and patient outcome data on all cases of S. aureus bacteraemia for 5 to 24 months during the study period. There were 1,511 cases of bacteraemia documented, of which 66% occurred in males and 32% originated from vascular access devices. Bacteraemia had a community onset in 60% of cases, although 31% of these were health-care associated. Overall, 57% of episodes were health-care related. Methicillin-resistant Staphylococcus aureus (MRSA) was the responsible pathogen in 24% of instances; of these 53% were of the typical multi-resistant hospital type, and 29% were of the community-associated type. Seven per cent of all staphylococcal bacteraemias were caused by community-associated MRSA strain types, attesting to the growing size of this problem in Australia. Outcomes were available for 51% of cases and in those the all-cause mortality at 7 days or discharge (whichever came earlier) was 11.2%. Age was strongly associated with mortality; the rate for patients aged more than 60 years was 18%. Sepsis originating from intravascular access devices had a lower mortality rate of 5%. S. aureus bacteraemia is a common community and hospital infection with a significant mortality. A nationally co-ordinated program documenting the incidence and outcomes of this disease would likely lead to measures designed to reduce the incidence and improve outcomes of this disease.

CA MRSA emerging worldwide

Link: HighWire Press -- Medline Abstract.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) isolates producing the Panton-Valentine leukocidin (PVL) have been reported worldwide. We describe the molecular characteristics of PVL-positive CA-MRSA strains isolated in Madrid, Spain, and analyze the clinical features of patients infected with these isolates. From 2004 to 2007, we collected 13 PVL-positive MRSA isolates from patients attending to the emergency department. The isolates were genotyped by pulsed-field gel electrophoresis, SCCmec typing, agr polymorphism, and multilocus sequence typing. Susceptibility to 29 antimicrobials was determined by the broth microdilution and by the E-test methods. The isolates belonged to 3 genotypes: ST8-SCCmec IVc (n = 11), ST5-SCCmec IVa (n = 1), and ST80-SCCmec IVc (n = 1). The corresponding agr types were I, II, and III, respectively. Five isolates were resistant to tetracycline and doxycycline, and 1 was resistant to fusidic acid (ST80). The isolates were from children (n = 9) and adults (n = 4), and were associated with skin and soft tissue infections (n = 9), otitis (n = 1), and bacteremia (n = 1). Nine patients were from South America. Our results indicate the transcontinental importation and recent emergence in Spain of PVL-positive CA-MRSA strains belonging to 3 distinct lineages, including 1 predominant (ST8-SCCmec IVc).

MRSA Emerging in Denmark

Link: HighWire Press -- Medline Abstract.

In Copenhagen, methicillin-resistant Staphylococcus aureus (MRSA) accounted for <15 isolates per year during 1980-2002. However, since 2003 an epidemic increase has been observed, with 33 MRSA cases in 2003 and 110 in 2004. We analyzed these 143 cases epidemiologically and characterized isolates by pulsed-field gel electrophoresis, Staphylococcus protein A (spa) typing, multilocus sequence typing, staphylococcal chromosome cassette (SCC) mec typing, and detection of Panton-Valentine leukocidin (PVL) genes. Seventy-one percent of cases were community-onset MRSA (CO-MRSA); of these, 36% had no identified risk factors. We identified 29 spa types (t) and 16 sequence types (STs) belonging to 8 clonal complexes and 3 ST singletons. The most common clonal types were t024/ST8-IV, t019/ST30-IV, t044/ST80-IV, and t008/ST8-IV (USA300). A total of 86% of isolates harbored SCCmec IV, and 44% had PVL. Skin and soft tissue infections dominated. CO-MRSA with diverse genetic backgrounds is rapidly emerging in a low MRSA prevalence area.

Staph infection USA 300 crisis traced to single strain

Link: MyrtleBeachOnline.com | 02/21/2008 | Staph infection crisis traced to single strain.

DeLeo's research, the first study to compare DNA fingerprints of the microbe from various parts of the country, traces the origins of community-acquired MRSA and resolves a heated scientific debate. His findings rule out the previously held notion that multiple strains of MRSA emerged randomly with similar characteristics. MRSA was once a hospital-acquired organism. Now, that it is spreading in communities, the bacteria are being brought into hospitals from the outside.

MRSA Strikes Siouxland Toddler

Link: News::MRSA Strikes Siouxland Toddler.

Meet one-year-old Isabella Nilles. She's happy and healthy now, but just a couple of months ago she was battling MRSA. It was just before Christmas and Isabella developed her first diaper rash. Mom and Dad, Amy and Chris, didn't think much of it. Isabella was teething and running a low-grade fever. So the diaper rash didn't seem alarming... but, Amy Nilles says, "Over a couple of days, there was one spot on her diaper rash that looked like it was getting worse." Christmas Eve Isabella's temperature climbed prompting a trip to the hospital. By they time they got there... she had a 104 degree fever. And that little spot that kept getting worse had dramatically grown in just a couple of days. Amy says, "The spot on her bottom had gone from about the size of a quarter to all the way up to her bikini line all the way down her bottom. I mean her skin was red. It was inflamed. It was hard." Doctors did cultures and other tests to figure out what was... but Isabella and her parents were sent home. Two days later they found out it was MRSA. Amy says, "It was bad. It was really, really scary. She could die." Isabella spent 8 days in the hospital. Doctors had to lance the sore to drain it, and give her IV antibiotics. When she went home, more antibiotics for a month. Where did a one-year-old pick up such a dangerous virus? Her daycare. The provider was unaware another child was a carrier and had an open wound.