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Link: RedNova News - Science - The Dawn of the Domestic Superbug
Studies from Japan suggest a strong link between caMRSA and the use of antibacterial cleaning solutions. When investigators there looked at the generational effects of exposure to the common antibacterial agent benzalkonium chloride (used in household cleaners and certain toiletries) in caMRSA strains, they found that as each new generation of bacteria evolved its resistance to the antibacterial grew stronger - as did its resistance to common antibiotics like methicillin and other beta-lactam antibiotics. As resistance grows the minimum amount of antibacterial and antibiotic needed to kill bacteria also grows, in some cases dramatically. In another Japanese study, the concentration of the antibiotic oxacillin necessary to inhibit the growth of third- generation benzalkonium chloride-resistant caMRSA organisms was 32 times greater than first-generation resistant varieties.
Link: Helsingin Sanomat - International Edition - Home.
The transfer of elderly people suffering from the rapidly spreading antibiotic-resistant MRSA staphylococcus hospital bacteria from hospitals to old people's homes has caused problems. In hospitals run by the City of Helsinki, there are currently around ten elderly patients who would be fit enough to live in a managed care facility, rather than in a hospital. However, Jaana Saarenheimo, deputy head physician of the Herttoniemi Hospital, says that they are being kept in the considerably more expensive hospital because of the bacteria. Some have been hospitalised for months, even though symptom-free carriers of the bacteria usually do not need treatment. A special section for MRSA patients was to have been opened at the Kustaankartano service centre in Helsinki, but the launch has been postponed until later in the spring because of delays in repairs. "It is quite senseless to keep the old people in hospital. Here on the hospital side we have been constantly waiting for social services to get things into shape", Saarenheimo says. "It is wrong if even a single elderly person has to suffer from it." It has been decided in Helsinki that MRSA carriers would be placed only in the city-run service centres of Kustaankartano, Roihuvuori, and Riistaviori, and not in any private facilities. Each one is to get his or her own room and toilet, which complicates the matter.
Link: HighWire Press -- Medline Abstract.
Healthcare workers (HCWs) in close contact with patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) were screened for MRSA acquisition. From 1995 to 2001, MRSA was identified from the nasopharyngeal swabs of 87 HCWs, collected one to two weeks after contact with 592 known MRSA-positive patients. These HCWs were withdrawn from work and treated with topical antibiotics/antiseptics. They were advised to disinfect their bathrooms and personal hygiene articles, and to wash bed linen and pillows. They were screened for successful eradication for up to three months. Seventy-three (84%) HCWs lost their carrier status. The eradication regimen failed in 14 cases. In 11 of these MRSA was detected only in later nasopharyngeal swabs (suspected recolonization). Screening identified nasal colonization of close household contacts in eight of these 11 cases. Environmental sampling detected contamination in seven out of eight screened home environments. When eradication treatment was applied to household contacts and when household surfaces were cleaned and disinfected, the carriage cleared in most cases within a few weeks. However, when home environments are heavily contaminated, despite adequate medical treatment, eradication took upto two years. Due to withdrawal from work, the 14 carriers without prompt and lasting eradication after the first course of treatment accounted for about 70% of all lost working days. These experiences support the hypothesis that control measures should not be restricted to antibiotic or antiseptic treatment of long-term carriers (HCWs as well as patients), but must also include cleaning and disinfection of the household.
A short introduction from Dave Roberts
This 12 minute introduction will help you grasp the key facts and the key issues surrounding drug resistant staph aureus (mersa, mursa)
