July 21, 2002

8:17 PM

We're back![2] A new resistant strain of staph has been documented in a Michigan Man. Agricultural and medical abuse of antibiotics has quickly lead us to the point where only very expensive and rarely used antibiotics can treat some new antibiotic resistant strains of staph (and acne). On the bright side you can get your antibiotics by drinking some river water.
posted by srboisvert (11 comments total)

I can feel my knee jerking already.

General consensus on just how much worry us worriers should set up for?
posted by precocious at 8:24 PM on July 21, 2002

Damn. Setting OCD to "freakout"...
posted by donkeyschlong at 8:52 PM on July 21, 2002

Crap. Now I won't even leave a good looking corpse.
posted by Kikkoman at 9:33 PM on July 21, 2002

Staph infections, themselves, are still relatively rare. And it's good, or bad, depending, that the worst strains are typically only contracted in a medical setting; and we're still in the single digits of cases, no more. This makes it trickier to treat infections, but by no means impossible.

And "overuse" is a poorly chosen term. Sloppy use is much more accurate -- infections where the treatment, whether it be as simple as penicillin or as killer as vancomycin, is only taken by the patient until they feel better. This often leaves in their body the very bacteria that were strongest against that antibiotic, and simple Mendelian genetics leads to a hybrid that is resistant. This is why one should always when prescribed antibiotics finish the entire treatment.
posted by dhartung at 9:54 PM on July 21, 2002

Oh, well good to know I've done my part in assisting staph in becoming Uber Bacteria.
posted by precocious at 9:58 PM on July 21, 2002

Staph infections are common from impetigo to stys. Most staph will die when treated with cheap, common antibiotics.

Patient compliance is another issue. When I write an Rx, it reads for example, "1 pill twice a day until gone". I always write "until gone." I also underscore it with the patient. Do they listen, probably not....
posted by shagoth at 9:58 PM on July 21, 2002

mendelian genetics perhaps in a fraction of cases; normally, horizontal transfer of a transposon or plasmid confering the apparatus to render the bug impervious to the antibiotic. But finishing the entire course is v.imp, as well as reducing sloppy prescription by clinicians.
posted by johnnyboy at 2:11 AM on July 22, 2002

[voice of dude from dr. strangelove]There they go again, messing with our precious bodily fluids. [/vodfds]
posted by adampsyche at 5:31 AM on July 22, 2002

My brother in law got staph during a routine knee operation. He went to the emergency room twice and to his doctor in the three days after the operation complaining of an infection only to have them tell him that the puss was normal and send him home. When it was finally properly diagnosed, by a *resident* in the ER it was far along and to make matters worse the antibiotics didn't really work. No one said that the infection was resistant but they did put him on one of the resistant-fighting antibiotics and that worked Lot of permanent damage to the tendons in his knee -- bottom line: he cannot run/ play sports most likely for the rest of his life. very scary stuff. He has since been told that he was lucky -- far worse things could have happened.
posted by n9 at 6:21 AM on July 22, 2002

A good fact sheet on VRSA, including this ominous scenario:

Although there is no way to predict exactly when VRSA will appear or how rapidly it will spread, researchers can make reasonable estimates using a parallel case: the evolution of vancomycin-resistant enterococci (VRE). Enterococci are harmful bacteria closely related to staphylococci. Until the late 1980s, most enterococci were susceptible to vancomycin. The first case of VRE was reported in 1986 in Europe and then another in 1988 in the United States. Then, between 1989 and 1993, the number of VRE cases in hospital patients increased 20-fold. In New York City in 1993, 97 percent of clinical labs had found at least one strain of VRE. By 1994, 61 percent of hospitals nationwide had reported cases of VRE.

Plus, the CDC has an entire section devoted to drug-resistant microbes.

A perspective on rare/common: ~2 million staph infections annually, of some 20M surgeries and 40M overnight hospitalizations. Those with increased risk factors such as suppressed immune systems stand in some cases a 25-fold increase in risk. It's rare outside hospital settings; apparently it can be frequently found in the human nose, for instance, but is only problematic if it enters the bloodstream through a wound. (I couldn't find numbers for these, though.)
posted by dhartung at 8:41 AM on July 22, 2002

staph is very common yellow fluids in your throat, eyes (pinkeye) or ears are signs of staph infection. In fact the staph lives naturally on your skin even when your healthy. Staph can infect lots of things but when it gets into your blood its a real problem like during surgery. You can have chronic low-grade staph infections that never go away like a constant sore throat or ear infections.
posted by stbalbach at 12:24 PM on July 22, 2002