MRSA
mikethemadbiologist | March 13, 2007Last night, I was reading some of the comments you leave here, and, in response to a post about a surgeon who thinks evolution is irrelevant to medical practice (Got Antibiotic Resistance?), fellow ScienceBlogling Mark left a comment. I'll get to the comment in a minute, but tragically, I hear stories like his far too often. Mark writes (italics original):
Mike, you've nailed exactly what pisses me off so much about Egnor. Right now, we're talking about something that's become deeply personal to me.
Since January, my father has been paralyzed from the waist down. The cause of it is MRSA. He…
mikethemadbiologist | March 7, 2007Or maybe terrifying is a better word. I just returned from the Network on Antimicrobial Resistance in Staphylococcus aureus meeting, where I learned some very interesting things about S. aureus (since I'm going to refer to MRSA, methicillin resistant S. aureus repeatedly, go check this link if you want to know more about MRSA):
1) 43% of all skin infections in the U.S. are the result of one strain of MRSA. Not 43% of staphylococcal infections. All skin infections.
2) According to the NHANES study, the number of people who carry S. aureus asymptomatically (in other words, it lives up your…
mikethemadbiologist | March 1, 2007It sure looks that way. Last night, I was talking to a colleague and he told me that several groups, including his, are seeing a very interesting pattern in commensal Escherichia coli (those E. coli that live in everyone's gut and aren't making us sick).
In humans, it appears that roughly 20% of all commensal E. coli belong to one of three clones that have a global distribution (in bacteriology, a clone is a group of very closely related strains). (an aside: In animals, there doesn't appear to be this skewed pattern. In animals, the distribution of clones appears to be more evenly…
mikethemadbiologist | February 26, 2007When I heard that Republican Senator and presidential candidate John McCain spoke at the Discovery Institute, I was disappointed but not surprised. In March, there's going to be a report released about antibiotic resistance in bacteria. A major finding of the report: roughly 40,000 people die every year from hospital-acquired antibiotic resistant bacterial infections.
The problem of antibiotic resistance is, fundamentally, a problem of evolutionary biology. Species of bacteria which had very few resistant strains (or none at all) now contain high frequencies of resistance strains (e.g…
mikethemadbiologist | February 15, 2007I've blogged before about how, for children under five, it's not the 'sexy' microbes that kill, but instead, the run of the mill ones: the bacteria that cause diarrhea and pneumonia are the culprits. One of the things I have heard a lot of recently regarding antibiotic development (and related therapies) is that we need to focus on 'non-paradigm' and non-model organisms. There's a problem with that approach:
The non-standard microbes aren't the ones causing the bulk of bacterial disease.
Oh dear.
In roaming around the International Society for Microbial Resistance website, I came across…
mikethemadbiologist | February 12, 2007Here's some very good news about MRSA (methicillin resistant Staphylococcus aureus): U.S. hospitals are beginning to implement their own versions of 'search and destroy' (italics mine):
Hospitals can stem the alarming spread of a dangerous and drug-resistant staph infection by screening new patients and keeping them quarantined, say doctors who tried this novel approach.
One model is a pilot program started in 2001 at the Pittsburgh Veterans Affairs Healthcare System, which has dramatically cut the rate of the potentially deadly germ, called methicillin-resistant Staphylococcus aureus, or…
mikethemadbiologist | January 31, 2007Methicillin resistant Staphylococcus aureus (MRSA) is a major public health threat. Currently, there are only a few antibiotics that are effective against it, and resistance is even a problem with these antibiotics. There is a potential treatment that might be effective against MRSA: heteropolymer (HP) antibody therapy.
To explain what HP antibody therapy is, I first want to give a vastly oversimplified explanation of what your immune system does when your bloodstream is infected with MRSA. The immune system, produces two molecules that attach to each other, one of which is an antibody.…
mikethemadbiologist | January 2, 2007So Michael Fumento has issued a challenge to put 'odds' on avian influenza, thinking that somehow I've stated that an avian influenza pandemic is likely (he's also accused me, a scientist, of being "anti-scientist" and "alarmist"). Well, I'm not putting odds down because I've never said that a pandemic is likely. Then again, one should hardly be surprised when a professional conservative completely distorts what one says.
In fact, in the post, I wrote:
We can argue about public health priorities (avian flu isn't my top priority personally).
One would think that was clear, but I made the…
mikethemadbiologist | December 26, 2006From the archives, I'm reposting this article about MRSA and VRSA. I've made some changes because the science and medical practice have changed.
The Chicago Tribune reports that three children died from toxic shock syndrome caused by methicillin resistant Staphylococcus aureus ("MRSA"). Toxic shock syndrome is not typically associated with MRSA. What's worse is that these infections were "community-acquired" (CA-MRSA) In other words, the kids were not infected in the hospital-many staph infections are hospital acquired due to puncturing the skin barrier (e.g., catheters, IVs, surgery).…
mikethemadbiologist | December 19, 2006...or at least, I was mentioned in Cell. Currently, we have very few new antibiotics in the pipeline, particularly for Gram-negative bacteria such as Acinetobacter. One of the things I'm involved with is a project to develop a not-for-profit screening library to find new antibiotics. From Cell:
Resistance of microbial pathogens to an increasing number of antibiotics is a serious problem. In the US alone, 90,000 people die every year from infections acquired while in the hospital. According to the Infectious Disease Society of America (IDSA), 70% of these deaths have been attributed to…
mikethemadbiologist | December 15, 2006I was recently at a conference (pdf file) where one speaker (Dr. Thomas O'Brien) suggested 'VRSA hospital insurance' to prevent the spread of vancomycin resistant Staphylococcus aureus outbreaks ('VRSA'). Before I get into the plan, let's talk about VRSA.
VRSA are staphylococci which are not only resistant to vancomycin, which is one of the last effective drugs against methicillin resistant Staphylococcus aureus ('MRSA'), but are also resistant to most (or usually) all other available antibiotics. While tigecycline can be used to treat some infections (skin and abdomindal), it is not used…
mikethemadbiologist | November 14, 2006...then what we think makes community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) so infectious might be wrong. A to-be published article in the Journal of Infectious Diseases (Dec. 15) asks "Is Panton-Valentine Leukocidin the major virulence determinant in community-associated methicillin-resistant Staphylococcus aureus disease?" Before everyone wanders off due to boredom, let me translate: we don't really understand how CA-MRSA can kill you.
The study, conducted by Jovanka Voyich and colleagues, examined the assumption that the Panton-Valentine Leukocidin toxin ('…
mikethemadbiologist | November 4, 2006Occasionally, Congress does something right. In this case, they are making research to develop new antibiotics a priority:
A key Senate committee is supporting more antibiotic research and development and more research into the mechanisms of resistance at the National Institute of Allergy and
Infectious Diseases (NIAID).
As a result of the efforts of IDSA and others to raise awareness about the need for effective drugs to treat resistant infections, the Senate Appropriations Committee has included language in its report for the bill funding NIAID urging the agency to "move aggressively to…
mikethemadbiologist | October 26, 2006I have discussed the "search and destroy" strategy for controlling and reducing methicillin resistant Staphylococcus aureus (MRSA) before. Search-and-destroy involves the screening of every patient and hospital worker for MRSA.
Patients with MRSA are isolated to prevent spread to other patients. In the Netherlands, hospital workers with MRSA are sent home with pay, and are treated with muriopicin nasal drops (MRSA usually lives up your nose). In addition, the workers' family is screened along with any pets, and those that have MRSA are also treated. Because of this program, the…
mikethemadbiologist | September 20, 2006Geneticists often use the phrase wild type to describe the dominant allele--genetic variant--of a gene. In microbiology, we typically assume that the wild type of a bacterium is sensitive to antibiotics, and that the rare mutants (and recombinants) are antibiotic resistant.
My colleague, Susan Foster, at the end of a seminar she presented to clinicians in Southern California, asked her audience to anonymously write down the percentage of methicillin-resistant Staphylococcus aureus (MRSA) at their hospitals.
The result?
The median percentage of methicillin resistance was 60% (the average was…
mikethemadbiologist | August 11, 2006Since I'm off to Woods Hole to give a lecture about antibiotic resistance, I thought this interview from the old site with Dr. Henrik C. Wegener about antibiotics and agriculture would be appropriate.
In looking through some things at work, I came across this interview with Henrik C. Wegener, Ph.D., Director of the WHO Collaborating Centre for Antimicrobial Research and Foodborne Pathogens and the Danish Institute for Food and Veterinary Research about antibiotics and agriculture. It's from 2004, but it's still pretty good (it's interesting how, on the internet, once something gets past two…
mikethemadbiologist | August 9, 2006Joseph beat me to it: there's a Nature article about platensimycin, an antibiotic that inhibits lipid biosynthesis in Gram positive bacteria. While it's not in human trials yet, it's always good to have another antibiotic that's effective against MRSA and VRE. Now, if it only worked against Acinetobacter...
mikethemadbiologist | July 28, 2006From the archives, comes this post about the health crisis no one cares about (except for the Mad Biologist. We are very caring): the 90,000 deaths per year from infections people get while in the hospital. And this number is probably an underestimate.
Bacterial infections aren't sexy: no one walks, bikes, hops, pogo sticks for the cure. There are no ribbons, no bumper stickers, and no hot celebrities (damn!). Yet, according to the CDC, bacterial infections acquired in hospitals kill at least 90,000 people per year in the U.S. Granted some of those who died would have died from something…
mikethemadbiologist | July 17, 2006The carnival o'the wee beasties known as Animalcules is up at Science Matters. I have a post about MRSA and drug use in this edition. There's also a good post about drug resistance in the HIV virus.
While I'm advertising things microbial, revere at Effect Measure has a good post on patenting microbes and other organisms. He's right: it's stupid.