Friday, March 26, 2010

MRSA out of control in community and classrooms?

Even more reason to wash your hands often and use alcohol and/or bleach to clean surfaces that students touch--computer keyboards, desk tops, door handles, pencil sharpener, etc.

MRSA is a bacteria that is usually transmitted by contact with a contaminated surface. Many people carry and transmit MRSA with no symptoms. In certain susceptible people, MRSA can rapidly grown in a small cut and get into the blood stream causing death in a matter of hours ( sometimes less than 24 hours).

The MRSA strains of the common skin staph bacteria is not only resistant to antibiotics, but it is VERY virulent meaning it multiplies extremely rapidly and grows at an alarming rate. Just a few hours of delayed treatment can be the difference between life and death.

MRSA is a variety of a natural bacteria (staph) that grows on the skin of all human beings. Once exposed to MRSA, normal skin staph can be rapidly replaced or transformed into MRSA (The transformation occurs via a kind of bacteria sex where resistant genes are transferred.) The process of replacing or transforming existing innocuous staph on our skins is done rapidly and silently without any symptoms. An exposed person may not be aware that the MRSA strain of staph has replaced their normal staph flora until the MRSA enters a break in their skin and starts to multiply out of control. It is not only resistant to most antibiotics but also to the immune system's antibacterial defenses in susceptible people.

Heat kills MRSA. It is more susceptible to heat than your own skin cells. If your get a rapidly growing and very sore pimple, hot compresses should be applied immediately. They should be as hot as you can stand without burning.

The MRSA bacteria are very tiny compared to our own cells. Think of a earthworm compared to an elephant that will give you some idea of the size differential between MRSA bacteria and our own body cells. (MRSA is a prokaryotic cell as are all bacterial cells. Our cells are eukaryotic as are all animal cells. Eukaryotic cells are massive compared to prokaryotic cells.) An earthworm dies much sooner from a sudden rise in heat than the elephant would so the MRSA dies far quicker from heat than our own body cells.

I use a wet paper towel folded and placed in a plastic baggie, then heated in the microwave for ten or twelve seconds. The heat in the paper towel when placed on a rapidly growing pimple/boil can kill the bacteria in seconds. Then GO TO THE DOCTOR! MRSA infections are more sore and grow more rapidly and go down into the skin more deeply than any other infection you are likely to have had. If you get such an infection. First heat. Then go to the doctor. Do not delay.

Those who have had pink eye, impetigo or boils in the past are especially vulnerable to MRSA.

MRSA is the same bacteria that causes those infections, but in a "souped up" far more dangerous form.

If you have never had pink eye, impetigo, boils, or any other staph infection; you may be one of the lucky ones who has natural immunity to staph infections. Many people do. I do not. I have had many episodes of impetigo and one of pink eye.

Skin MRSA infections can be as a boil which is much more sore and goes deeper than a normal pimple. It is so sore you do not want to touch it let alone squeeze it. MRSA can also take the form of a 'red line' growing under the skin and away from the skin break.

Perhaps 50% of the population has resistance to MRSA, but at least one third are very vulnerable to MRSA and other bacterial infections. It is the luck of the genes.

Be careful out there. Even if you think you are immune, you never know. Clean surfaces with alcohol or bleach. Soap and water do not kill MRSA, they only spread it. Even alcohol may not kill it instantly. Only 10% bleach solutions are universally effective at killing all MRSA that the bleach solution comes in contact with. Alcohol is also very good if the surface is moistened and allowed to dry. It desiccates and breaks the cell walls of the bacteria. However alcohol wipes can be used too long and sections of the wipes can spread the bacteria if there is not sufficient alcohol on that section or the wipe becomes dirty giving MRSA safe areas on the alcohol wipe to survive on.

Be aware that MRSA has been found to be viable and infectious on bone dry surfaces for more than eight weeks. The most dangerous surfaces are made of plastic which provides tiny depressions in even the smoothest feeling plastic. These depressions allow the MRSA to remain viable and infectious much longer than any other surface. Plain wood is the most lethal to MRSA and MRSA does not remain infectious for more than a few days on it. But cloth even dry cloth is nearly as good for MRSA survivability as plastic. In the home the most likely place to find MRSA after the door knob and faucet handles is on the pillow case in your bed.

Some paranoia is appropriate.

Here is the article:

Community-acquired MRSA becoming more common in pediatric ICU patients
Universal screening may curb spread of MRSA

Once considered a hospital anomaly, community-acquired infections with drug-resistant strains of the bacterium Staphylococcus aureus now turn up regularly among children hospitalized in the intensive-care unit, according to research from the Johns Hopkins Children's Center.

The Johns Hopkins Children's team's findings, to be published in the April issue of the journal Emerging Infectious Diseases, underscore the benefit of screening all patients upon hospital admission and weekly screening thereafter regardless of symptoms because MRSA can be spread easily to other patients on the unit.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a virulent subset of the bacterium and impervious to the most commonly used antibiotics. Most CA-MRSA causes skin and soft-tissue infections, but in ill people or in those with weakened immune systems, it can lead to invasive, sometimes fatal, infections.

In 2007, The Johns Hopkins Hospital began screening all patients upon admission and weekly thereafter until discharge. Some states have made patient screening mandatory but the protocols vary widely from hospital to hospital and from state to state.

"MRSA has become so widespread in the community, that it's become nearly impossible to predict which patients harbor MRSA on their body," says lead investigator Aaron Milstone, M.D., M.H.S., a pediatric infectious disease specialist at Hopkins Children's.

"Point-of-admission screening in combination with other preventive steps, like isolating the patient and using contact precaution, can help curb the spread of dangerous bacterial infections to other vulnerable patients."

The new Johns Hopkins study found that 6 percent of the 1,674 children admitted to the pediatric intensive-care unit (PICU) at Hopkins Children's between 2007 and 2008 were colonized with MRSA, meaning they carried MRSA but did not have an active infection. Of the 72 children who tested positive for MRSA, 60 percent harbored the community-acquired strain and 75 percent of all MRSA carriers had no previous history or MRSA. MRSA was more common in younger children, 3 years old on average, and among African-American children. The reasons behind the age and racial disparities in MRSA colonization remain unclear, the investigators say. Patients with MRSA had longer hospital stays (eight days) than MRSA-free patients (five days) and longer PICU stays (three days) than non-colonized patients (two days).

Eight patients who were MRSA-free upon admission became colonized with MRSA while in the PICU. Of the eight, four developed clinical signs of infection, meaning that the other four would have never been identified as MRSA carriers if the hospital was not performing weekly screenings of all patients.
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The research was funded in part by the National Institutes of Health, the Thomas Wilson Sanitarium for Children in Baltimore and by the Centers for Disease Control and Prevention.
Other investigators in the study included Karen Carroll, M.D.; Tracy Ross; Alexander Shangraw; and Trish Perl, M.D., M.S.; all of Hopkins.

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