MRSA Staph Superbug

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Drug resistant superbug outbreak in England...

Superbug kills 90 in UK hospitals
October 12, 2007 -- More than 1,000 patients at three UK hospital contract bug, 90 cases fatal; Report cites staff not washing hands, lack of cleanlibness among other factors; Police are now looking at report with a view to pursuing prosecutions; Hospital superbug rates rocketing in the UK, increasing eight-fold since the 1990s

Nurses who didn't wash their hands and left patients lying in soiled beds were cited in an official report blaming mismanagement for the deaths of 90 people who contracted a bacterial infection in hospitals in southern England. "Significant failings" at all levels contributed to infections of more than 1,000 patients at three hospitals, the Healthcare Commission said Thursday. The patients were infected with Clostridium difficile, or C. diff, which can cause diarrhea, colitis and other intestinal problems, officials said.

"The Healthcare Commission has passed the copy of the report to us and that is being reviewed," said a spokesman for Kent Police, speaking on condition of anonymity in line with force policy. The report into the spread of the highly contagious bacterium said nurses at three hospitals run by the Maidstone and Tunbridge Wells NHS trust were often too busy to wash their hands and left patients in their own excrement. Maidstone and Tunbridge Wells NHS trust acknowledged that it had not been prepared for "an outbreak of that size and complexity" but had learned from the mistakes. The trust's Chief Executive Rose Gibb resigned last week.

Health Minister Ann Keen said the failures, which led to the deaths of patients over a 21/2-year period, must not be repeated. "Trusts must deliver clean, safe treatment to every patient, every time and where senior management and trust boards fail to act, they must be held accountable," Keen said. Investigations began after a series of complaints about cleanliness, and when the trust claimed there had been no deaths from the bug despite admitting there had been hundreds of cases.

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Spike in staph infections at schools
Oct 12, 2007 - Outbreaks, which include drug-resistant strain, more common in athletes

Schools across the country are reporting outbreaks of staph infections, particularly among athletes, and the germs include an antibiotic-resistant strain that is sometimes associated with serious skin problems and blood disorders. The infections have forced districts to call off classes, cancel sporting events and disinfect entire buildings. Several students have been hospitalized.

Many of the infections are being spread in gyms and locker rooms, where athletes — perhaps suffering from cuts or abrasions — share sports equipment. In Virginia, a Newport News high school closed its weight room Thursday to be disinfected after at least four students were infected — one with the drug-resistant strain. The drug-resistant patient, a football player, was hospitalized for three days.

On Friday, the high school in Galax, Va., postponed a football game because of an infection on its football team. School officials said they could not clean the equipment in time for the kickoff. The Centers for Disease Control and Prevention in Atlanta does not track staph infections but confirmed that the cases seem to be more widespread than in the past.

More Spike in staph infections at schools - Infectious Diseases - MSNBC.com

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Superbug possibly worse than AIDS...

Staph fatalities may exceed AIDS deaths
Wed Oct 17, 2007: More than 90,000 Americans get potentially deadly infections each year from a drug-resistant staph "superbug," the government reported in its first overall estimate of invasive disease caused by the germ.

Deaths tied to these infections may exceed those caused by AIDS, said one public health expert commenting on the new study. Tuesdays report shows just how far one form of the staph germ has spread beyond its traditional hospital setting. The overall incidence rate was about 32 invasive infections per 100,000 people. That's an "astounding" figure, said an editorial in Wednesday's Journal of the American Medical Association, which published the study.

Most drug-resistant staph cases are mild skin infections. But this study focused on invasive infections — those that enter the bloodstream or destroy flesh and can turn deadly. Researchers found that only about one-quarter involved hospitalized patients. However, more than half were in the health care system — people who had recently had surgery or were on kidney dialysis, for example. Open wounds and exposure to medical equipment are major ways the bug spreads.

In recent years, the resistant germ has become more common in hospitals and it has been spreading through prisons, gyms and locker rooms, and in poor urban neighborhoods. The new study offers the broadest look yet at the pervasiveness of the most severe infections caused by the bug, called methicillin-resistant Staphylococcus aureus, or MRSA. These bacteria can be carried by healthy people, living on their skin or in their noses.

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Doctors stumped...

Doctors Baffled by Superbug's Origins
Oct. 18, 2007 - Numerous Cases Around the Country Remain Largely Mysterious in Origin

More reports of the potentially deadly superbug are popping up around the country, just days after three teenagers died after developing the drug-resistant infection. Public health officials say they are baffled as to why the bug, known as methicillin-resistant Staphylococcus aureus, or MRSA, has spread. MRSA used to be found only inside hospitals, spread from patient to patient. Now it is infecting healthy people in their communities, homes or schools.

The Associated Press reports that officials at one North Carolina high school say at least six football players have been infected with the MRSA strain, and in West Virginia, at least seven students at three different schools have been diagnosed with MRSA. And in Richmond, Ind., health officials spent the day disinfecting the locker room of the local high school after a student apparently came down with the infection.

Three children have died from MRSA in the last week: an 11-year-old in New Hampshire and a 4-year-old in Mississippi, whose names were not released, along with 17-year-old Ashton Bonds of Virginia. A government study released this week says 90,000 people could get infected this year. For those that contract the infection, health officials say the key is to catch it early.

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Your Superbug Questions Answered!...

Your MRSA Questions Answered
Oct. 22, 2007 - The ABC News Medical Unit Responds to Your Superbug Questions

Last week "World News With Charles Gibson" reported on a drug-resistant staph infection that could be putting your family at risk. The deadly bug, called methicillin-resistant Staphylococcus aureus, or MRSA, was once only a threat in hospitals. Now MRSA has spread into communities. During the broadcast we invited you to post your questions about this "superbug" on our message boards. We sent your questions to the ABC News Medical Unit for the expert answers below.

Question: I am a phlebotomist at Mercy Hospital in Council Bluffs and this news worries me a great deal. I have three kids and three step kids. I protect myself at work, but because this infection is noncurable, I want to know how it is transmitted. I wear gloves before I touch any of the patients. However, can this spread through droplets or contact? What can I do to better protect myself and my family and all others?

Henry Masur, immediate past president, Infectious Disease Society of America: MRSA is a serious problem, but simple precautions can greatly reduce the likelihood of transmission, and it can be cured with drugs we have available now. As you know from working in a hospital, the use of gloves followed by careful hand washing will go a long way towards preventing your acquiring MRSA. This organism almost always spreads by person to person contact, or from clothes or personal items such as razors. Spread by droplet rarely happens.

Thus, if you wear gloves and wash your hands, the likelihood that you will acquire this infection in the hospital or spread it to your family, is very, very low. And remember, if skin abrasions get infected we can cure MRSA if the infection is accurately diagnosed and properly treated. We know how to manage this infection.

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Preventing staph infections...

Staph Screening Said May Wipe Out Germ
Oct 24, 2007 -- Testing all new hospital patients for a dangerous staph "superbug" could help wipe out a germ that likely kills more Americans than AIDS, consumer advocates say and early evidence suggests.

Yet few U.S. hospitals do it, and many fight efforts to require it. Jeanine Thomas, who nearly died from the drug-resistant staph bug, says the reason is simple: "Doctors don't want to be told what to do." The Chicago suburbanite's personal crusade led Illinois this year to become the first state to order testing of all high-risk hospital patients and isolation of those who carry the staph germ called MRSA.

Powerful doctor groups fought against it. The testing and isolation of patients would be too costly, they said. Many other germs plague hospitals that also require attention. Experts said a more proven approach would focus on better hand washing by hospital staff - a simple measure tough to enforce. Yet, Thomas prevailed. Similar measures passed this year in Pennsylvania and New Jersey. And Thomas' national crusade to make hospitals test for MRSA and report their infection rates gained steam last week after a Virginia teenager's death from the germ and a government report estimated it causes dangerous infections that sicken more than 90,000 Americans each year and kill nearly 19,000.

Suddenly the little-known germ with the cumbersome name, methicillin-resistant Staphylococcus aureus, is getting lots of attention. People in health care settings, like hospitals and nursing homes, are most at risk for MRSA infections. Doctors and nurses who treat staph-infected patients and then don't carefully wash up can spread the germ to other patients. Germ-contaminated medical devices used on people having dialysis or medical procedures also can spread staph. Older patients and blacks are most at risk, according to the recent report by government researchers.

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Drug-resistant Staph becoming a crisis
Thursday, October 25, 2007 - When scientists sounded an alarm last week about the evolving presence of methicillin-resistant Staphylococcus aureus -- MRSA -- they shed new light on an old problem about a bug that has been evading destruction since the dawn of the antibiotic era.

Their conclusion: MRSA is here to stay. It is an organism that can cause mild skin infections but is capable of invading the bloodstream and causing systemic damage. For years it has been a problem in hospitals, a so-called nosocomial infection. Now it is making its way into communities, infecting people in gyms, schools and daycare centers.

MRSA is a threat because it is drug-resistant -- and hardy. But it has plenty of company among microbes -- tiny creatures with titanic drug-repelling consequences. Indeed, MRSA got its name, methicillin-resistant Staphylococcus aureus, because it is capable of defeating methicillin, penicillin's more potent cousin.

"What we have seen is Darwinism in action," said Dr. Roy Steigbigel of Stony Brook University Medical Center, referring to MRSA's drug-thwarting capacity as a prime example of survival of the fittest. The trouble with drug-resistant organisms is frightening: The medical community is running out of drugs to control them.

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Granny don't like ****-a-roaches...

Top Doc: Staph "The Cockroach Of Bacteria"
Nov. 7, 2007 - CDC Head Says MRSA Infections Can Be Avoided With Common Sense Hygiene

Drug-resistant staph infections that have made headlines in recent weeks come from what one of the nation's top doctors calls “the cockroach of bacteria” -- a bad germ that can lurk in lots of places, but not one that should trigger panic. “This isn't something just floating around in the air,” Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention, told members of Congress on Wednesday.

It takes close contact -- things like sharing towels and razors, or rolling on the wrestling mat or football field with open scrapes, or not bandaging cuts -- to become infected with the staph germ outside of a hospital, she said. Called MRSA, the staph germ is preventable largely by commonsense hygiene, Gerberding stressed.

“Soap and water is the cheapest intervention we have, and it's one of the most effective,” she told a hearing of the House Committee on Oversight and Government Reform. At issue is methicillin-resistant Staphylococcus aureus, a form of the incredibly common staph family of germs.

About one in every three people carries staph aureus in their noses. In about 1 million people, the type they carry is MRSA. “I like to think of it as the cockroach of bacteria,” Gerberding said, pointing out MRSA's ability to live on various surfaces and spread by catching a ride on an unwashed hand.

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Some FYI on staph...

Staph germ undermines body's defenses
Sun Nov 11, 2007: The aggressive antibiotic-resistant staph infection responsible for thousands of recent illnesses undermines the body's defenses by causing germ-fighting cells to explode, researchers reported Sunday. Experts say the findings may help lead to better treatments.

An estimated 90,000 people in the United States fall ill each year from methicillin-resistant Staphylococcus aureus, or MRSA. It is not clear how many die from the infection; one estimate put it at more than 18,000, which would be slightly higher than U.S. deaths from AIDS. The infection long has been associated with health care facilities, where it attacks people with reduced immune systems. But many recent cases involve an aggressive strain, community-associated MRSA, or CA-MRSA. It can cause severe infections and even death in otherwise healthy people outside of health care settings.

The CA-MRSA strain secretes a kind of peptide — a compound formed by amino acids — that causes immune cells called neutrophils to burst, eliminating a main defense against infection, according to researchers. The findings, from a team of U.S. and German researchers led by Michael Otto of the National Institute of Allergy and Infectious Diseases, appeared in Sunday's online edition of the journal Nature Medicine.

While only 14 percent of serious MRSA infections are the community associated kind, they have drawn attention in recent months with a spate of reports in schools, including the death of a 17-year-old Virginia high school student. Both hospital-associated and community-associated MRSA contained genes for the peptides. But their production was much higher in the CA-MRSA, the researchers said.

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MRSA research at U. of Idaho making headway...

Developing kryptonite for Superbugs
November 8, 2007 - University of Idaho researchers are crossing academic and geographical bounds to develop more effective defenses against Staphylococcus aureus bacteria and other deadly pathogens.

One of the goals of that effort is to create much faster and more accurate identification of strains resistant to the antibiotic methicillin, formally known as methicillin-resistant Staphylococcus aureus, or MRSA. Breakthrough detection technologies are already in hand in University of Idaho labs. Nanoelectronic biosensors at the university’s Center for Advanced Microelectronics and Biomolecular Research (CAMBR) recently have cut detection time for staph from the industry standard of up to three days down to three hours.

Researchers now are focused on tweaking the device so that it can provide a complete toxin profile of staph that will quickly reveal the virulence of infections. To accomplish that goal, researchers from the university’s Center of Biomedical Research Excellence (COBRE) are partnering with CAMBR scientists. Eventually, it is hoped that even the hard-to-identify MRSA bacteria will be detected quickly using some iteration of the nanotechnology.

MRSA’s resistance to antibiotics has earned it “superbug” status. It is responsible for more 94,000 infections and 16,000 deaths annually in the U.S. alone, according to recent Center for Disease Control reports. Those numbers indicate it is a greater health threat to Americans than the AIDS virus. The spiking MRSA death toll recently reported by the Center for Disease Control presents formidable motivation to move infectious disease research ahead, and to get life saving nanotechnologies into the marketplace. University of Idaho scientists are focused on both goals.

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Stepping up the fight against MRSA...

Hospitals marshal resources to wipe out MRSA
3 Dec. 2007 : A recent federal report on the growth of "superbugs" - deadly bacteria resistant against most antibiotics - has renewed public attention to how hospitals are faring in their decades-long war.

Hospitals across the USA have been stepping up their fight against all types of infections, especially superbugs that have been found to be more common and more deadly than previously believed. Among the methods some hospitals are employing:

•Using secret observers to check on whether doctors and nurses are washing their hands.

•Swabbing the nose of every patient to check for the presence of certain bugs.

•Installing alcohol sanitizer dispensers in hallways and outside patient rooms to make it easier for staff and visitors to clean their hands.

•Testing the surfaces of bed rails, countertops and health equipment for bacteria.

In October, a federal report estimated that nearly 19,000 people died in the USA in 2005 after being infected with a virulent drug-resistant bacterium called methicillin-resistant staphylococcus aureus, or MRSA — more than the number killed by HIV/AIDS. A study released on Thursday in the journal Emerging Infectious Diseases found that hospitalizations related to MRSA nearly doubled between 1999 and 2005, from 127,000 to almost 280,000.

"It's a battle for us, a big battle," says Nina Shik, infection control manager at the University of Kansas Medical Center in Kansas City. The hospital had an MRSA outbreak in its burn unit in 2005. The culprit was found to be pillows, which had small holes in them that enabled the bacteria to pass from patient to patient. When the hospital changed the type of pillow, the infection rate dropped.

Secret observers mobilized

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Potential new defense against superbugs...

Replacing Antibiotics: The Next Generation In Bacterial Inhibitors Could Revolutionize Medicine
27 December 2007 - Over the course of the 20th Century, doctors waged war against infectious bacterial illness with the best new weapon they had: antibiotics. But the emergence of dangerous, multi-drug resistant strains of tuberculosis and other killer infections means that in the 21st century antibiotics are losing ground against bacterial disease.

Now, researchers from Weill Cornell Medical College in New York City say exciting new molecular targets -- so-called "virulence factors" that bacteria use to thrive once they are in the host -- present an alternative, potent means of stopping TB, leprosy and other bacterial illness. "We have developed the first inhibitor of a key small molecule from Mycobacterium tuberculosis and Mycobacterium leprae (which causes leprosy) utilized to subvert human host's defenses and damage and invade human host's cells during infection," explains study senior author Dr. Luis Quadri, Associate Professor of Microbiology and Immunology at Weill Cornell.

"With this work, we now have proof of principle for the inhibition of this virulence factor in bacteria cultured in the lab. Our next step is to explore whether this inhibitor can stop these pathogens from multiplying in a mouse host, curtailing infection," Dr. Quadri says. The findings -- published online today in Chemistry and Biology and appearing in the journal's Jan. 26 print edition -- highlight what Dr. Quadri has called a "paradigm shift" in infectious disease research.

"We are moving beyond antimicrobials such as antibiotics, which kill the bacterium directly, to anti-infectives, that may have no effect against the pathogen in the test tube but which do compromise its ability to infect and spread in the host," he explains. "We believe that the expansion of the drug armamentarium to include such anti-infective drugs could help the fight against multi-drug resistant infection that has become such a challenge today."

According to World Health Organization data, TB remains one of the world's top-ten leading causes of death, killing nearly two million people each year. Multi-drug resistant strains of M. tuberculosis -- as well as even more dangerous, extensive-drug-resistant (XDR) strains of the bug -- are emerging each year. "Obviously, we are going to require more than the traditional antimicrobial approach to turn this situation around," Dr. Quadri says.

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Another air passenger with drug-resistant form of TB...

Sunnyvale woman being treated for dangerous strain of TB
Dec 28, 2007 — Authorities are releasing more information about a Santa Clara County woman who flew into San Francisco International Airport while sick with a dangerous strain of tuberculosis.

The U.S. Centers for Disease Control and Prevention says the 30-year old Sunnyvale woman boarded an American Airlines flight in New Delhi, India on Dec. 13. The flight stopped in Chicago, before continuing on to San Francisco.

Officials with the CDC are working on tracking down 44 people who sat within two rows of the woman on the flight. The woman -- who is not being named by authorities -- is being treated in isolation at Stanford Hospital.

A Santa Clara County health official says because the disease is still in its early stages, doctors don't know what her prognosis is.

http://www.mercurynews.com/news/ci_7...nclick_check=1

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E. Coli a new superbug?...

Resistant E. Coli bacteria may become new 'superbug'
Wednesday, February 20, 2008 - E. coli bacteria resistant to commonly used antibiotics may soon start spreading in hospitals and pose problems similar to the MRSA "superbug," an article in The Lancet Infectious Diseases journal found.

Difficult-to-treat Escherichia coli bacteria, which often cause urinary tract infections, have become "widely prevalent" in communities in Europe and Canada, Johann Pitout and Kevin Laupland from the University of Calgary said in a review. The bacteria are likely being carried into hospitals, they said. Public health institutions are already fighting MRSA, or meticillin-resistant Staphylococcus aureus, common bacteria that don't respond to standard antibiotics. MRSA affects about 2 million Americans annually and costs some US$20 billion a year to treat, according to the U.S. Centers for Disease Control and Prevention. A 2006 report from the Infectious Diseases Society of America listed E. coli as one of the six drug-resistant microbes for which new medicines are "urgently needed."

"Because of the increasing importance of multi-resistant E. coli in the community, clinicians should be aware of the potential of treatment failures associated with serious infections caused by these bacteria," Pitout and Laupland said. There have been reports of resistant bacteria from countries including the U.K., Spain, Italy, Greece and Canada, the researchers said. Though the bacteria commonly cause urinary tract infections, there have also been reports of bloodstream infections caused by resistant E. coli strains.

"These infections are currently rare, but it is possible that, in the near future, clinicians will be regularly confronted with hospital types of bacteria causing infections in patients from the community, a scenario very similar to that of community- acquired MRSA" the researchers said. Drug-resistant germs such as MRSA have emerged because of overuse of standard treatments such as penicillin, oxacillin and amoxicillin, leading drugmakers to try to develop new antibiotics.

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