Apart from the creation of superbugs, overuse of antibiotics has negative consequences including killing many of our beneficial bacteria. In the grand scheme of things, little is known about the bacteria we live with, and how they individually as a species, and collectively in combinations forming biofilms, get affected by various exposures to our antibiotics. Insufficient research is being conducted to help us find the answers.
Some research has suggested that antibiotic use may play a role in conditions that lead to obesity, Type 1 Diabetes, inflammatory bowel disease, allergies and even asthma, a common chronic airway disorder. Patient populations suffering from all of these chronic diseases appear to be increasing in prevalence, but very little is being done to understand if anything in contributing to all of these conditions as a group instead of just individually.
In agriculture, antibiotics have been used as “growth promoters” enabling farmers to increase their livestock yield, as their animals can gain more weight with less food. The influence of these antibiotics on the livestock we eat is likely to have some impact on our own bodies but this field has not yet been adequately investigated primarily due to lack of financial motivation. In Europe, where usage of antibiotics in livestock as growth promoters has been banned, it was determined that the same dollars spent on extra food resulted in the same growth as yielded by the additional antibiotics.
Given that antibiotics are a critical part of our medicinal arsenal, it is not likely that antibiotics will be replaced any time soon. However, it is important to start asking the questions and dedicate more resources to learning more about how the antibiotics we use directly and indirectly are truly affecting us. Once we learn more about this impact, then we can start to make progress in influencing the development of new alternatives and better approaches to antibiotic usage.
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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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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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 »
As antibiotic resistance becomes an increasing issue, researchers are busy investigating natural alternatives to fight deadly infections. Researchers in Liverpool for example, investigated the effects of using honey as an antibacterial agent for post-operative wound care in the fight against MRSA. Patients that had honey applied to their wounds had 36% fewer incidences of infection, and spent around 25% less time in the hospital compared to those who were not administered honey.
Lead researcher, Dr. Val Robson, explained that honey has antibacterial properties because of its high sugar content, presence of hydrogen peroxide, and low water content. Robson has since dubbed the honey utilized in this study “Medihoney.”
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When we think of antibiotic misuse, we often think of how it contributes to big name superbugs such as C. diff and MRSA. But what often goes overlooked is how antibiotic misuse affects the many microbes that are beneficial to our health. While the Human Microbiome Project is a step in the right direction towards learning more about combating horrible diseases like C. diff, it is also a huge advancement in terms of understanding which microbes truly benefit us—and which ones we may have been too quick to label as hazardous to our health.
Take for example the germ H. pylori. During the 1980s, it was discovered that H. pylori was a causative agent for peptic ulcers. While this major discovery resulted in the treatment of such individuals by aiming to eradicate H. pylori microbes from the stomach, researchers are now discovering possible adverse implications of this.
Before I begin discussing how the Human Microbiome Project has already impacted our knowledge of H. pylori, I want to make it clear that I am not by any means suggesting that this particular microbe is not hazardous to our health. In other words, I’m not suggesting you go and ingest H. pylori as Barry Marshall did in order to validate his theory about H. pylori and peptic ulcers. Read more »
Lipstick? Check. Wallet? Check. Car keys? Check. Deadly bacteria???
Sometimes, we carry around more than we think in our bags; such is the case for hundreds of mobile clinicians in the UK and around the globe. Studies show that 55% of nurses’ medical bags that have been used to deliver community care – that is, at home medical care – in the UK are never cleaned. A mere 6% are said to be cleaned weekly. And yet, a nurse visits an average of 17 patients a day, the majority being for wound care. Plug all these stats in, and it is not surprising to hear that one third of all medical bags are said to carry the MRSA bug. There doesn’t exist any official cleaning standards for nurses` bags, and as a result, traditional bags are often outdated, unsafe, simple rucksacks made from absorbent material. They’re full of pockets, buttons, zippers, and folds that are difficult to clean and that can serve as perfect housing and free public transit for bacteria, particularly MRSA.
My grandmother, a community nurse in her day and a hand sanitizer-aholic, recounts that even in being conscientious of cleaning her bag regularly it was nearly impossible to get every surface, for all the snaps and crevices prevented thoroughness. She could sterilize until the cows came home, but the deepest corner of the side pocket, or the underside of the zipper, or the crease in the fabric were forever vulnerable to bacteria.
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There are a number of studies that have demonstrated conclusively that eliminating a large percentage of the bacteria in the nose of a patient just prior to a major surgery can reduce the number of surgical site infections (SSIs). The main culprit seems to be Staphylococcus aureus which thrives in the warm, moist undisturbed environment in the nose. Whether it is the highly antibiotic resistant form of S. aureus, MRSA (a known superbug) or the antibiotic susceptible version MSSA, these species of bacteria are responsible for the majority of surgical site infections.
While MSSA is responsible for a greater number of SSIs, MRSA is responsible for the deadly and very costly infections. Some MRSA infections can cost up to $100,000. On average however, SSIs cost anywhere between $11,000 – $35,000, add on average an extra 8 hospital days, and can result in 5 times higher readmission rates. Whichever way one looks at it, SSIs are a huge burden on the medical systems around the world. Some estimates put this cost as much as $10 billion annually in the US alone.
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Over the coming year, the world will learn more about our MRSAid™ photodisinfection technology and its ability to prevent surgical site infections. The last patients in the year long quality improvement program at Vancouver General Hospital (VGH) will be treated next month, giving us a chance to look retrospectively at how surgical site infections were affected at this major hospital. This program, involving over 5,000 patients at VGH, sought to reduce infections in all patients undergoing cardio, vascular, neurological, thoracic, breast, spinal and orthopaedic surgeries. Data from this analysis is expected in the late fall and results are expected to be announced at Infection Control Conferences in 2013.
People who carry MRSA or MSSA are at much greater risk of self infection when they are immunocompromised and weakened after surgery. Up to 30% of patients are simply unable to defend themselves from the tenacious bacteria called Staphylococcus aureus which lie dormant in the nose, waiting for opportunities to invade the body. Eliminating the bacteria carried in the nose prior to surgery has been proven to reduce the rate of surgical site infections. From a number of other studies (including Bode et al “Preventing SSIs In Nasal Carriers of Staph”), we have learned that eliminating both MRSA and MSSA from the nose prior to surgery reduces surgical site infections (SSIs) by up to 56% and total healthcare-associated infections (HAIs) by up to 79% in non-surgical admissions.
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We’ve blogged in the past about MRSA being found on grocery meat in Detroit. Now, the same problem is occurring in Iowa, Minnesota, and New Jersey. A a recent study published this past January revealed that 64% of pork samples from grocery stores in these areas were contaminated with Staphylococcus aureus. Of these, more than 6% tested positive for MRSA, the drug-resistant strain of Staph.
Tara Smith, an epidemiologist at the University of Iowa and one of the study’s contributing authors notes the uncertainty of the source of contamination. The molecular typing from these samples are shown as a combination of both “human” and “pig” strains. This suggests that the bacteria may be from both the farm and the people who handle the products.
As most of you know, methicillin-resistant Staphylococcus aureus is one of the most deadly and resistant strains of Staph bacteria. According to the Centers for Disease and Control and Prevention, more than 90,000 people develop a serious MRSA infection every year and up to 20% of the infected population die. Of those that survive, many face incredibly difficult recovery periods that often involve more medication and surgery. Read more »