Introduction
Doctors and nurse come in contact with this bacteria in their over crowded
clinics, surgeries and ER. Patients visiting surgery, hospitals and
clinics are said to carry bacteria in their hand and nose. The
doctors are exposed to this bacteria more often than you and so 48%
are said to be colonized with this bacteria. Managing infected
patients in their home will increase the risk of carrying bacteria
back to our family. We must make sure we
are protected.
Despite advice from microbiologists, Government in UK continue with their NHS
reforms and establish polyclinics.
As doctors & nurses we need to start thinking of ways to prevent
spreading infections to patients, protect their and our family and
children. People are often quick to point their fingers at doctors
and nurses when they get infected but are not talking about how our
life is now threatened.
Various devices and instruments are often used and are
known to be colonised with bacteria. We must take care not to
introduce infection nor get infected..........
Lost Human Face of Medicine
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CA-MRSA
Antibiotic-resistant bacteria strains are becoming increasingly
common outside of hospital settings and are posing an increasing
risk to communities and healthcare professionals.
53 million people world wide are now said to be colonized with this
bacteria, 48%-52% of healthcare workers are colonized. One in three
person are asymptomatic carriers and in USA, 60% attending ER were
found to be MRSA +ve.
Bacteria that have evolved to carry enzymes called extended spectrum
beta lactamases (ESBLs), because they are antibiotic-resistant.
Methicillin-resistant Staphylococcus aureus (MRSA)
known as Panton Valentine leukocidin (PVL) have evolved to spread
via skin-to-skin contact outside of
hospital settings. These bacteria
are often brought into clinical settings by patients and are known
to colonize in equipments like auroscope, stethoscope,
ophthalmoscope and even pens and computer key board.
In UK doctors are told not to use tie and advised to wash their
hands up to their elbows (often ignored) to reduce spread.
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Antibiotics
Possibly most worrying is that the Centers for Disease Control in
Atlanta has stated that for the first time in history those born
after the year 2000 are expected to die before their parents — a
truly frightening prospect.
Antibiotics paved the
way for doctors to develop new technologies (IVF, plastic surgery,
hip replacement, minimally invasive surgery, stents, total parentral
nutrition's, transplant surgery and cardiac surgery). Now the very
technology is threatening our existence in this universe.
Understanding this
bacteria, learning about how the resistance to antibiotic develop is
very complex. Pharmaceutical companies stopped R&D investment to
develop antibiotic in 1970s, so we need to start all over again. It
took nearly 60 years to develop Penicillin.........
Linezolid (Zyvox):
New Antibiotics MRSA has now developed
Resistance.
Pfizer withdraws new antitibiotic Dalbavancin
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Prevention
Practical procedures performed (inserting catheters, cannula,
endotracheal tubes, dialysis, naso-gastric tubes, colostomy & long
lines) in hospitals create an entry point for bacteria to enter
blood circulation. Doctors must take care not to contaminate any
instrument used to clinical diagnose a illness. This bacteria are
spreading and colonized in the hands and nose.
Avoiding contact with people who carry CA-MRSA
is very important but as doctors it will be difficult. Children who suffer with eczema, cystic fibrosis, nephrotic syndrome and arthritis are often treated with steroid. This
drug is suppress immune system making them susceptible to
bacterial infections. This makes them vulnerable and so may
predispose bacterial infections.
We plan to publish a new approach to help you diagnose illness in
children. Initial results from our clinical trial show this method
help doctors and patients to avoid contact and so may help reduce
spread of MRSA.
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Treatment
Bacteria rarely come as loners; more often they grow in crowds
and squat on surfaces where they form a community together. These
so-called bio-films develop on any surface that bacteria can attach
themselves to. The dilemma we face is that neither disinfectants and
antibiotics, nor phagocytes and our immune system can destroy these
bio-films.
The influenza pandemic of 1918 killed more people than the World
War I & II. It was cited as the most devastating epidemic in
recorded world history and was a true global disaster. We can see
this history repeating itself soon if we are not careful.
Introducing bacteria into blood or dislodging them from their
biofilm can be lethal to patients produce bacteraemia resulting in
high mortality. We need to think twice before visiting a hospital or
clinic where patients with CA-MRSA are treated...
Flow chart to help diagnose & treat CA-MRSA
Interactive slide about treatment, NEJM
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