Category: Methicillin-resistant Staphylococcus aureus

MRSA’s Image Problem is Killing Us

MRSA is a worldwide problem. In the U.S. alone at least 19,000 people die every year because of it. 100,000 more become infected with a disfiguring, disabling, life-altering MRSA-caused disease. And studies in the U.S. and Canada show the problem increased 17-fold over an 11 year period beginning in 1995. Yet neither government nor the public seems concerned. Why is that?

Daniel Kahneman is a 77 year old Israeli psychologist. He won the Nobel Prize in Economics in 2002 for explaining the wayward thinking that is behind poor economic decision making. He was presented with the American Psychological

an Israeli-American psychologist and winner of the 2002 Nobel Memorial Prize in Economic Sciences.

Association’s Award for Outstanding Lifetime Contributions to Psychology in 2007. And his life’s work was turned into his 2011 New York Times best-selling book Thinking, Fast and Slow.

Our problem, says Kahneman, is that we “think” too emotionally and quickly and as a result we get important things wrong: often times it is the fear factor at work. That explains why we are afraid of certain kinds of well publicized but low probability risk but indifferent to more objectively dangerous but less probable ones. Murder, accidents, and terrorism get headlines. Diabetes and asthma don’t. So you are more likely to be afraid of the first 3 despite them being far less likely to affect you. Studies show that people judge deaths by accidents to be more than 300 times more likely than deaths by diabetes, but the true ratio is 1:4. And while death by disease is 18 times more likely than accidental death people judge the two as being about equally likely.

Kahneman calls this the “availability heuristic.” It means that we assess the relative importance of issues by the ease with which we can think of examples of them. Therefore the more dramatic an event, the more vivid the imagery associated with it, the more it’s attached to celebrity, and the more it’s replayed in the media, the easier we can retrieve examples from our memory. The most recent example of this is Asiana Flight 214 that crash-landed in San Francisco this past Saturday morning killing 2 and seriously injuring dozens more. Such a remarkable event, easily retrieved from the memory bin, is what causes us to grossly exaggerate the frequency and dangerousness of events – like travelling by air.  Importantly, it’s not just the public that falls prey to this kind of  thinking, our government decision makers do too, and perhaps no more so than in the context of terrorism.

We are more likely to drown in a bathtub than we are to die from a terrorist attack. However, since 9/11, life in the United States has been turned upside down, including the way in which the federal government allocates funds in an effort to deal with this perceived risk. There was a shift of tens of millions of dollars of federal research money since 2001 away from pathogens that cause major public health problems to obscure germs that the government fears might be used in a bioterrorist attack. So much so that according to a 2005 report in the New York Times,  758 scientists including 2 Nobel Prize winners petitioned the U.S. Government’s National Institutes of Health  saying grants for research that cause anthrax and 5 other diseases that are rare or non-existent in the U.S. have increased 15-fold since 2001. Over the same period grants to study bacteria not associated with bioterrorism including those associated with tuberculosis and syphilis have decreased 27 per cent. One of the petitioners, Sidney Altman, a scientist at Yale, who won the Nobel Prize in chemistry in 1989, said that while a risk of bioterrorist attack existed he considered it “a very minor factor” among all the risks faced by the nation.

Communities like MRSASurvivors need our support to change the MRSA image problem

So given all of this, what chance does MRSA and its cousin pathogens have of capturing public imagination and government health care dollars? On the face of it not a lot, however, there is an important precedent in the history of infectious disease that suggests otherwise.

In 1981 another then unknown disease was making its way into the United States: HIV/AIDS. The Centers for Disease Control dubiously labelled it the “4H disease” because it affected Haitians, homosexuals, heroin users, and hemophiliacs. The stigma resulted in horrific behavior towards a suspected carrier: they’d be subject to compulsory testing, mandatory quarantines, and violence. If you had it you were scared to tell anyone, health care workers quit their jobs rather than risk infection while treating someone who had it, and government treatment programs and research dollars were virtually non-existent. The word AIDS became a code word for any shameful malady. And if you got it, you died. Yet today, HIV/AIDS is no longer a death sentence. People have it and lead full lives. There is much more public understanding and acceptance, and there’s government support for programming and research.

There are several reasons for the turn-around but one event in particular drew the attention of University of Central Florida social scientist Philip Pollock: In 1991 Magic Johnson told the world he was HIV-positive. What had been stigmatized as largely a “gay disease” now had a very different face. Pollock wanted to know if Magic Johnson’s public acknowledgement mattered. This fit nicely into Pollock’s interest in how you go about changing the public’s perception of issues. What he found was that immediately after the announcement and again 10 months later the public “constructed” their view of AIDS more positively, and that included a 15-point increase in support of AIDS spending. Pollock says that intense, public, value-laden communications, or “critical moments,” are of key importance in changing public awareness and opinion of issues.

This is exactly what Kahneman is saying. The flip side of dramatic personal testimony constantly played out in the media is marshalling statistics about obscure-sounding Latin-named pathogens. No matter how strong the numbers are the public and our representatives in government can’t “hear” them: that’s just human nature, says Kahneman. As he puts it, “the world in our heads is not a precise replica of reality.” In other words, it’s not just the pathogens that we have to confront it’s also the flawed way in which we think about them.

It’s only a matter of life and death.

When the future becomes the past: MRSA and microbial resistance

Let’s step into a time machine for a moment. Acquire some plutonium, unlock the Delorean, rev it up to 88 miles per hour and we’re good to go.  Destination: 1770.

The late 18th century was a pretty great place. Nations were being thought up and defended, women piled their hair into fantastic curly creations complete with white powder and men could sport walking sticks without looking like a try-hard hipster.

Sounds great right?

Unfortunately, it was also a time when the result of contracting a minor cold was often death.

Back to the future… (get it?).

This is the scenario (albeit somewhat exaggerated) that awaits us as a society if we do not tackle the problem of antibiotic resistance, according to the top health official in the UK.

Sallie Davies, chief medical officer for England, called for a global fight against microbial, or antibiotic, resistance, as well as a push to fill a drug “discovery void” to treat mutating superbug infections like MRSA, the National Post reported Wednesday.

According to the same report, new antibiotics are few and far between, and only a handful have been marketed in the past few decades. This means that when a new strain of resistant bacteria emerges, there is very little we can do to treat against it.

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New Era In Infection Control: Universal Decolonization Replaces Universal Screening

Vancouver General Hospital, a global leader in infection control, has implemented our MRSAid Photodisinfection System as part of its standard perioperative program to reduce surgical site infections (SSIs). Under this new program, all patients prior to major elective surgeries and emergency surgeries wherever possible will undertake this proactive new infection control measure. With very high patient compliance rates (98%) and no resistance generation, universal decolonization with MRSAid has demonstrated significant SSI reductions as well as ease of integration into the perioperative surgical workflow.

Unlike antibiotics, photodisinfection does not generate bacterial resistance. It is therefore possible to decolonize everyone rather than the select few patients with the most dangerous pathogens. This universal decolonization program eliminates both Staph and MRSA from the nose, ground zero for bacterial colonization. Studies have demonstrated that by eliminating bacteria in the nose prior to surgery results in significant reductions in surgical site infections. Data released by Vancouver General Hospital showed that the use of MRSAid with chlorhexidine body wipes reduced surgical site infections by 39%.

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MRSA Rampage: Two Stories of Infection In The Community And Hospital

Mentioning MRSA to someone outside of the medical field often elicits a blank stare or a vague look of confusion and mistrust.  In fact, going so far as to mention Methicillin Resistant Staphylococcus Aureus (MRSA) is usually enough to end a conversation completely.  For the most part, the destructive, life-altering scope of MRSA isn’t known to the general public—nor is the risk of acquiring MRSA in the hospital.  Knowing many patients and health care workers, I’ve seen prognoses that have varied from life-threatening and permanently disabling, to non-deadly, but career ending.  This is the story of two acquaintances of mine: one who contracted MRSA in the community at large, and another who contracted MRSA while at the hospital.

Down on her luck, living in a small, government subsidized apartment, my first acquaintance was forced to share her space with several other near-homeless individuals.  Crowded in a tiny room, many of her roommates were poorly fed and suffered from mental illness.  As is the case in many situations of extreme poverty, drug abuse and poor hygiene were rampant—as were skin infections.  Such close-knit quarters were a breeding ground for CA-MRSA, or Community Acquired MRSA.  Community Acquired MRSA differs, in that it’s a) often more aggressive b) less resistant to antibiotics than its hospital counterpart.

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Are MRSA Vaccines The Only Solution To Preventing Superbug Infections?

In an attempt to find new ways to prevent cases of MRSA, researchers have been working to develop a new vaccine. Several pharmaceutical companies have attempted to create vaccines for MRSA in the past, but such endeavors have not been successful. The main reason for this is that it is not known what makes individuals immune to the disease. Current research into a MRSA vaccine is in the very early stages, and even if a successful vaccine was developed, it would take years to receive approval.

We often blog about the importance of preventing surgical site infections. An effective vaccine to combat MRSA would be a major milestone in the fight against antibiotic resistance. This is because powerful antibiotics are used to treat active MRSA infections, and each time such therapies are used, the more likely it becomes for the bacteria to develop resistance. Thus, the most optimal treatment would be to prevent MRSA before it occurs. If a successful vaccine was to be developed, it would likely be given prior to surgical procedures, and in those with compromised immune systems. But, why wait years for a MRSA vaccine to be developed when there are simple solutions available right now? Read More

What We Can Learn From A 12 Year Old’s Tragic Death

Chances are you have recently heard of the tragic death of 12-year-old Rory Staunton, who went septic after receiving a cut during basketball practice in April. Rory’s story demonstrates the alarming trend of failure to recognize the symptoms of sepsis until it is too late. While Rory’s untimely death is real tragedy, there are several things we can learn from it, and also many ways we can all help to ensure that his death was not entirely in vain.

Sepsis, also known as blood-poisoning, is the body’s response to infection or injury, which is often deadly if left untreated. An estimated 200,000 people die annually in the United States as a result of sepsis, although most sepsis resources argue that the number of deaths is far higher, as many sepsis deaths are blamed on other causes. Here is another example of something that kills more people each year than AIDS, yet few people have ever even heard of it.

We need to first understand the context of Roy’s final days to understand how we can prevent similar circumstances from happening to others. The day after receiving the cut, Rory was taken to his pediatrician’s office with a 104-degree fever, and several symptoms mimicking the flu. There were however some symptoms of sepsis there as well, including Rory’s blotchy skin. Rory was sent to the emergency room by his pediatrician, where he was released just two hours later being diagnosed with the flu.

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MRSA Infections and How Athletes are at Risk

Methicillin-resistant Staphylococcus aureus (MRSA), is quickly becoming a widespread threat to athletes in all sports. MRSA is a bacterium that has developed resistance to most common antibiotics and usually colonizes the nose. This antibiotic resistant bacteria has crossed over into the athletic world. MRSA is quickly becoming a widespread threat to athletes in all sports.  Bacterial infections in athletes are quite common, and they inhibit their ability to compete and perform at their best. The fact that MRSA has become increasingly resistant to antibiotics creates a serious problem for both athletes and doctors since effective treatment options will be further limited.

Many of the first MRSA infections in athletes were reported in football.  Many college teams have had major difficulties controlling the spread of the bacteria, which is usually through person to person contact. The New England Journal of Medicine published a study that linked MRSA in athletes to the abrasions caused by artificial turf [1]. In addition, the State Department of Health in Texas did three studies and found that football players were 16 times more likely to be infected than the national average [2]. Sport players in football, wrestling, and soccer are among at highest risk of spreading the bacteria due to the constant bumping, hitting and direct contact with teammates and opponents. These sports also have more exposed skin and open wounds when practicing or competing.  Wounds such as turf burn abrasions, fingernail scratches or a small open blister allow the bacteria to cause an infection.  In addition, direct contact with contaminated towels or equipment can further spread the bacteria.  Once an infection develops in an athlete, it can quickly spread through the team and to opponents. Read More

Tattoos Are A Source of MRSA Infection Too

The allure of getting all inked up is ever present as permanent tats are flaunted on the arms of bikers and sailors to that of yogi masters and sorority girls. However, the idea of a painful, oozing, serious, and even sometimes fatal skin infection is not. It is possible to sustain a MRSA infection after getting a tattoo. Even though it is rare, infection is possible when there is a break in the actual skin –Streptococcus and Staphylococcus are the two types of bacteria that can cause skin infections.

According to the U.S. Centers for Disease and Control (CDC), there have been 44 cases reported thus far that show a correlation between MRSA infections and tattoos. This data was taken from 2004 and 2005, and it is likely there are even more cases that have gone unreported. The cases that were examined showed that the tattoos had been done by 13 different tatoo artists across the U.S that lacked standard sterilization technique. Just about every single person who sustained a MRSA infection was healthy and did not possess any risk factors that would make them attractive candidates for MRSA infection.

Just about anyone who gets a tattoo is at risk for contracting an infection, this is even more so when dealing with dangerous superbugs such as MRSA. MRSA is able to colonize the body of a carrier while showing no signs of poor health. In many cases, the carrier may not be aware that they have spread the bacteria through skin to skin contact, especially when it involves the surface of skin being broken. Read More

Somebody else’s problem: Staff perceptions of MRSA

It has become increasingly clear that MRSA is a significant health challenge for the present and the future. Not only does it kill more people each year than AIDS in the US, but it is also a significant source of unnecessary patient pain and suffering. In Britain, the National Health Service has recorded a spike in contamination and infection rates, going from 2% in 1990, to 43% in 2002.

One of places currently undergoing major transitions in order to adapt to the growing problem of MRSA is the hospital environment. Here, the key element is the staff responsible for day-to-day operations concerning MRSA, namely, the health personnel. Previous studies done in this area have tended to ascribe the high incidence of MRSA infection in hospitals to a lack of staff knowledge on the subject. However, this theory has proved insufficient.

In a 2011 study, Elizabeth Morrow, Peter Griffiths, G. Gopal Rao, and Debbie Flaxman examined the relationship between infection control and the attitudes of hospital staff. More specifically, attitudes that tended to attribute the causes of MRSA to forces outside the hospital (such as senior care centers, communities, etc) or to incontrollable conditions within the hospital itself. Read More

MRSAid™ Supports World MRSA Day – Get Active, Get Involved, Make A Difference!

The rapidly escalating human suffering and loss of life from MRSA in the United States and in other countries needs to be recognized and an immediate international response for prevention, awareness and education is imperative. – MRSA Survivors Network, Jeanine Thomas

World MRSA Day takes place this Saturday, October 1. The third annual world MRSA Day kickoff event and Global MRSA Summit will be held at Loyola University Stritch School of Medicine in Maywood, Illinois.

October has been coined World MRSA Awareness Month in hopes that the title would generate substantial awareness on the global crisis.  Challenging the status of global inaction and educating the public on the current MRSA situation are the main objectives for the special date, and the theme for the year of 2011 is “The MRSA Epidemic: A Call to Action.”  Jeanine Thomas, the founder and president of MRSA Survivor’s Network created World MRSA day in 2009 and stands as its official organizer.  Another goal of World MRSA Day is to raise awareness about MRSA on a global scale, while reaching out to MRSA survivors, communities, governments, and healthcare professionals for their ability to educate others and prevent the spread of this superbug.

It is necessary to draw attention to the rising prevalence and serious implications of MRSA.  A study released this year shows the rise of MRSA infections in the U.S. from 2.9 million to 4.2 million throughout the period of 2009 – 2015.  Over the same time period, skin infection treatment days are slated to rise from 20 million to 30 million, with an annual toll of $9.5 billion for the U.S.  The number of deaths resulting from MRSA have now become greater than the deaths caused by HIV / AIDS per year in the United States. Despite these startling facts, there has been little discussion or significant acknowledgement from American health officials on the MRSA problem. Read More

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