The influenza pandemic of 1918 killed more people than the World War I and II was a true global disaster. These bacteria are not a danger to our patients but health care workers are also at risk. We have seen reports of bacteria developing resistance to new antibiotics very rapidly. The so-called biofilms develop on any surface can attach themselves to our skin. The dilemma we face is that neither disinfectants, antibiotics  nor our immune system can destroy these bacteria....we are now entering danger zone.....

 
  • Introduction
  • CA-MRSA
  • Antibiotics
  • Prevention
  • Treatment

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

Do No Harm

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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.

Doctors are living in an illusion expecting to get a miracle treatment to fight these infection. Based on the R&D work, we think it is unlikely to get a treatment that works.....

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.

Best way to prevent this infection killing you is to avoid coming in contact. So please keep away from healthcare settings and hospitals if you think you are not an emergency

"To Wash or Not To Wash" This is a worrying development

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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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