MRSA (Mersa, Staph) Questions

Acupuncture - MRSA Caution Needed

Link: HighWire Press -- Medline Abstract.

We performed an infection control audit of the medical practitioner's premises and practices and administered MRSA decolonization therapy to the medical practitioner. Results. @nbsp; Eight cases of invasive MRSA infection were identified. Seven cases occurred as a cluster in May 2004; another case (identified retrospectively) occurred approximately 15 months earlier in February 2003. The primary sites of infection were the neck, shoulder, lower back, and hip: 5 patients had septic arthritis and bursitis, and 3 had pyomyositis; 3 patients had bacteremia, including 1 patient with possible endocarditis. The medical practitioner was found to be colonized with the same MRSA clone [ST22-MRSA-IV (EMRSA-15)] at 2 time points: shortly after the first case of infection in March 2003 and again in May 2004. After the medical practitioner's premises and practices were audited and he himself received MRSA decolonization therapy, no further cases were identified. Conclusions. @nbsp; This outbreak most likely resulted from a breakdown in sterile technique during percutaneous needle procedures, resulting in the transmission of MRSA from the medical practitioner to the patients. This report demonstrates the importance of surveillance and molecular typing in the identification and control of outbreaks of MRSA infection.

MRSA rare in Turkey

Link: HighWire Press -- Medline Abstract.

The nasal swabs were obtained from 4,050 children during a 4 month period in Ankara. In vitro antimicrobial susceptibility testing to 1 mug oxacillin and 30 mug cefoxitin was determined by a disk diffusion method. We found that the 1,001 of 4,050 (24.7%) children were colonized with S. aureus. Three S. aureus strains were resistant to oxacillin and cefoxitin. The rate of MRSA among all children was 0.07%. The MRSA strains revealed three different PFGE pattern. All MRSA isolates by harbored the SCCmec type IV element, but not the PVL gene. The two MRSA isolate belonged to sequence type (ST) 30, whereas the other one was a unique type. The results of this study demonstrated that S. aureus nasal carriage rate was consistent with previous studies. However, MRSA carriage rate was low. This study also indicated that the ST30-type IV without PVL gene MRSA clone may be expected to spread in Turkish community.

Physicians Report MRSA Superbug Cases On The Rise

Link: Physicians Report MRSA Superbug Cases On The Rise, According To Study By GfK Market Measures.

Supporting reports of MRSA's increasing prevalence, which over the past year garnered the public's attention as stories of the MRSA "superbug" made national news headlines, almost 90 percent of physicians participating in GfK's study confirm that the prevalence of community-acquired MRSA infections is increasing. The research revealed that almost one in five hospitalized patients treated with an injectable antibiotic is suspected of having a MRSA infection. Although adults show the greatest prevalence of MRSA cases, emergency room physicians are seeing a notable proportion of MRSA in college-aged patients. While hospital-acquired MRSA infections have not shown as dramatic a rise as community-acquired MRSA cases, with 60 percent of physicians reporting an increase, culture testing for MRSA in the hospital setting has increased, according to almost 80 percent of physicians. In addition to more widespread testing, to better manage the spread of MRSA in the hospital setting, physicians report that hospitals are focused on isolation procedures, hand-washing protocols and screening/surveillance of certain patient types.

Smokers willbe more vulnerable to MRSA complications

Link: Cigarette Smoke Makes Flu, Other Viral Infections Worse.

A new study by researchers at Yale School of Medicine could explain why the cold and flu virus symptoms that are often mild and transient in non-smokers can seriously sicken smokers. Published in the Journal of Clinical Investigation, the study also identified the mechanism by which viruses and cigarette smoke interact to increase lung inflammation and damage. Until recently, scientists haven't been able to explain why smokers have more exaggerated responses to viral infections. Smokers have been more likely than non-smokers to die during previous influenza epidemics and are more prone to chronic obstructive pulmonary disease (COPD). Furthermore, children who are exposed to second-hand smoke have more severe responses when infected with respiratory synctial virus. The prevailing view has been that cigarette smoke decreases anti-viral responses. But the Yale researchers — lead author Jack A. Elias, MD, the Waldermar Von Zedtwitz Professor of Medicine and chair of internal medicine at Yale School of Medicine, and first author Min-Jong Kang, MD, associate research scientist — found the opposite to be true. Their experiments showed that the immune systems of mice exposed to cigarette smoke from as little as two cigarettes a day for two weeks overreacted when they were also exposed to a mimic of the flu virus. The mice's immune systems cleared the virus normally but the exaggerated inflammation caused increased levels of tissue damage.

How MRSA lingers in a hospital

Link: HighWire Press -- Medline Abstract.

MLST demonstrated that the international ST228 was the most frequent (67%) clone. The pvl gene was negative in all isolates and the SCCmec corresponded to types I (97%) and IV (3%). Strong mutators were not detected, but a considerable number were considered weak mutators. Conclusions Distinct microbiological and molecular features were detected among CF-MRSA isolates, probably due to adaptation to specific conditions in CF patients. Prevalence of MRSA increased among these patients, most of them colonized with a multiresistant biofilm-forming clone belonging to ST228-SSCmecI, suggesting cross-transmission or a common source.

10% of HIV patients MRSA positive

Link: HighWire Press -- Medline Abstract.

Fifteen of 146 (10.3%) patients had MRSA nasal colonization; 1 also had axillary colonization. Twelve of 15 isolates were staphylococcal cassette chromosomemec type IV, and 8 of 14 were USA300 or USA400 genotype. MRSA colonization was associated with lower CD4 cell count, not receiving current or recent antibiotics, history of prior MRSA or methicillin-susceptible Staphylococcus aureus infection (P < 0.05 for all), and a trend toward history of hospitalization or emergency department visit in the past year (P = 0.064). Current use of trimethoprim-sulfamethoxazole was protective for colonization: 0 of 29 trimethoprim-sulfamethoxazole recipients were colonized versus 15 of 117 nonrecipients, P = 0.04. In a multivariate logistic regression model, prior infection with either methicillin-susceptible S. aureus (odds ratio = 32.4, 95% confidence interval 3.04 to 345.42) or MRSA (odds ratio = 9.71, 95% confidence interval 2.20 to 43.01), not receiving current or recent antibiotics (odds ratio = 0.026, 95% confidence interval 0.002 to 0.412), and lower CD4 count (odds ratio 0.996, 95% confidence interval 0.992 to 0.999) were associated with MRSA colonization. DISCUSSION:: The prevalence of MRSA nasal colonization was relatively high compared with prior studies; axillary colonization was rare. Prior staphylococcal infection (methicillin-susceptible S. aureus or MRSA), not receiving antibiotics, and lower CD4 count were associated with MRSA nasal colonization. Trimethoprim-sulfamethoxazole seemed to be protective of MRSA colonization.

MRSA replacing SA?

Link: News: ‘Superbug’ infections tracking higher at RGH | infections, hospital, increased : Portales News-Tribune.

Roosevelt General Hospital staff members are increasingly concerned about the rise of methicillin-resistant Staphylococcus aureus, or MRSA infections, at the hospital. Director of Patient Care Gayle Richerson told RGH board members Tuesday at their regular meeting that the percentage of staph infections that turn out to be the MRSA strain rose from 43 percent in 2004-2005 to nearly 58 percent in 2006-07. The total number of staph infections has also increased significantly increased. The so-called “superbug,” essentially a regular staph infection that’s resistant to first-line antibiotics, causes 94,000 severe infections each year with 19,000 deaths, according to a recent federal estimate. Of these infections nationwide, about 86 percent are healthcare-associated and 14 percent are community-associated, according to the Center for Disease Control.

Every MRSA case costs NHS an extra £9,000

Link: Every MRSA case costs NHS an extra £9,000 - Telegraph.

Every case of MRSA costs the National Health Service an extra £9,000, experts say. The cost of keeping patients in hospital to treat them for the superbug adds up to more than £45 million lost to the NHS annually. The figure comes on top of the costs of the patients' original condition. The statistics, published at a conference at the Royal College of Physicians in London on fighting superbugs, were calculated by Marsh, the financial risk management company, whose clients include some NHS trusts.

8% MRSA Increase in USA

Link: Number Of Patients Treated With An Antibiotic For MRSA Within U.S. Acute Care Hospitals Increased 8 Percent From 2006 To 2007.

Arlington Medical Resources (AMR), a provider of premier market intelligence for the pharmaceutical and diagnostic imaging industries, finds that the number of patients treated with an antibiotic associated with a positive culture for MRSA within U.S. acute care hospitals has increased from 2006 to 2007 by 8 percent. However, the average number of days of inpatient therapy per patient treated with an antibiotic associated with a positive culture for MRSA decreased by 10 percent.

Ward closed by MRSA reopens

Link: Ward closed by MRSA reopens | Otago Daily Times Online.

Dunedin Hospital's ward 8B opened yesterday afternoon after being closed to new admissions since Monday because of an outbreak of an antibiotic-resistant bacteria. Two patients and three nurses have been found to have methicillin-resistant Staphylococcus aureus (MRSA) but no more cases have shown up in test results in the past two days. More than 150 patients and staff associated with the ward have been tested for MRSA. Although about 20 results remain outstanding, infection prevention and control charge nurse manager Jo Stodart said if one or two more cases showed up in the final test results, the hospital would be able to manage the situation without having to close wards.