[Homestead] Getting out of hospital alive, Golden Staph, necrotizing fasciitis,

Tvoivozhd tvoivozd at infionline.net
Thu Sep 30 00:31:33 EDT 2004


Better sanitizing methods adopted---with a glaring exception---did ou 
ever see a doctor or nurse ever clean a stethoscope? I never have, the 
sound transmitting head is by preference placed on bare skin, head 
reeled in and the whole now non-sterile head removed, non-sterile 
ear-pieces removed, to dangle around the doctor or nurses neck---next!

Doctors worry as drug-resistant staph infects more healthy people

By LINDA A. JOHNSON
Associated Press
Published on: 09/29/04

TRENTON, N.J. — Flesh-eating bacteria cases, fatal pneumonia and 
life-threatening heart infections suddenly are popping up around the 
country, striking healthy people and stunning their doctors.

The cause? Staph, a bacteria better known for causing skin boils easily 
treated with standard antibiotic pills.

EMAIL THIS <http://www.ajc.com/news/content/health/0904/30superbugs.html#>
PRINT THIS <http://www.ajc.com/news/content/health/0904/30superbugs.html#>
MOST POPULAR <http://www.ajc.com/news/content/health/0904/30superbugs.html#>

	
*Related*
• Infectious Diseases Society of America <http://www.idsociety.org>
• More health news <http://www.ajc.com/health/content/health/index.html>

------------------------------------------------------------------------
*Ways to prevent the spread of staph super bugs*

Antibiotic-resistant staph infections, usually involving the skin, are 
showing up more often among healthy people. Here are some prevention tips:

• Wash hands thoroughly and often with soap and water.

• Keep cuts and abrasions clean and covered with a bandage until healed.

• Avoid contact with other people's wounds or material contaminated by 
wounds.

• Do not share items such as razors, soap, ointments and balms, towels 
or wash cloths, clothing or uniforms.

• If participating in contact sports, cover cuts, scrapes and other 
wounds with a bandage. Shower with soap immediately after each practice 
or game. Wipe down all nonwashable equipment (mats, head protectors, 
gymnastics equipment, etc.) with alcohol or antibiotic solution after 
each person uses it.

• If caring for someone with an infection at home, wash hands with soap 
after each physical contact and before going outside. Only use towels 
for drying hands once. Change and launder linens frequently, right away 
if they are soiled.

• When contact with body fluids is expected, wear disposable gloves and 
wash hands after removing them.

• See a physician promptly if you have a suspicious skin sore or boil.

Sources: U.S. Centers for Disease Control and Prevention, physician 
interviews.

No more, say infectious disease experts, who increasingly are seeing 
these "super bugs" — strains of Staphylococcus aureus unfazed by the 
entire penicillin family and other first-line drugs.

Until a few years ago, these drug-resistant infections were unheard of 
except in hospital patients, prison inmates and the chronically ill. 
Now, resistant strains are infecting healthy children, athletes and 
others with no connection to a hospital.

"This is a new bug," said Dr. John Bartlett, who chairs the committee on 
antibiotic resistance at the Infectious Diseases Society of America. 
"It's a different strain than in the hospital ... more dangerous than 
other staph.

"Primary care physicians and ER doctors, they don't all know (about 
this) and should," he said.

Bartlett, a professor at Johns Hopkins University School of Medicine, 
treated three young Baltimore area women this year who got pneumonia 
from this community-acquired resistant staph. All had to be put on 
breathing machines, and one died, he said.

The infections will be a hot topic at the society's annual meeting this 
week in Boston. The group has been warning that drug companies aren't 
developing enough new antibiotics to avert a crisis.

Among the case reports to be discussed:

• In Los Angeles, doctors at UCLA Medical Center treated 14 people with 
necrotizing fasciitis, informally known as "flesh-eating bacteria," over 
a 14-month stretch through April. Three needed reconstructive surgery 
and 10 spent time in intensive care.

"This is about as serious an infectious disease emergency as you can 
get," said Dr. Loren G. Miller. "We don't know how these people got the 
infection — there doesn't seem to be a common thread."

• In Corpus Christi, Texas, doctors at Driscoll Children's Hospital saw 
fewer than 10 cases a year of community-acquired resistant staph 
infections in the 1990s, then saw 459 in 2003, with 90 percent in 
healthy children. Half were admitted to the hospital to get intravenous 
antibiotics; a few developed life-threatening lung and heart infections 
or toxic shock syndrome.

• A Centers for Disease Control and Prevention study shows another new 
twist: The resistant staph strain caused pneumonia in 17 people, killing 
five, during last year's flu season. Only one had any risk factors for 
the infection.

"Nobody dreamt when we were in medical school that this would ever enter 
the community," said Dr. Rajendra Kapila of University of Medicine and 
Dentistry of New Jersey in Newark.

He has treated several patients with the infections at University 
Hospital there, including an itinerant golf caddie who kept getting 
abscesses on his neck until he landed in the hospital two years ago. 
Kapila linked the infections to abrasions from the man's golf bag strap.

In August, a man in his 40s with severe back pain turned out to have 
such a severe staph infection in his spinal cord he was paralyzed 
permanently, Kapila said.

Dr. John Segreti, an infectious disease specialist at Rush University 
Medical Center in Chicago, estimates about 1 in 10 patients, some with 
prior health problems, die from the infections.

Dr. Dan Jernigan, a CDC epidemiologist, said athletes, children and 
military recruits are at higher risk. They're more likely to have cuts 
and scrapes, and share close quarters, as well as towels and soap. 
Another factor is overuse of antibiotics, which tends to kill weak 
bacteria and help hardier ones develop resistance.

"Clinicians will have to think differently about skin infections," 
Jernigan said. "We treat most skin infections without ever testing them."

Testing will tell whether a strain is antibiotic-resistant, but the 
tests are expensive.

There are no national statistics on these infections, but health 
authorities are debating requiring doctors to report them.

CDC has reported on numerous infection clusters, including Colorado 
fencing club members, college football players in Pennsylvania and Los 
Angeles, and high school wrestlers in Indiana, and dozens of Pacific 
Islanders in Hawaii. Many patients were hospitalized, including most of 
the athletes. At least two outbreaks have occurred among Native Alaskans 
since 1996, with many cases linked to steam baths.

In New Jersey, infection clusters were reported in 2003 and earlier this 
year involving two high schools and members of one family.

In Stafford, Texas, Janet Johnson's 13-year-old son Nicholas had such a 
severe infection — apparently after a minor football injury last October 
— that he was hospitalized for 5 1/2 weeks and nearly died. The staph 
infected his lungs, blood and bones, destroying hearing in one ear and 
making it difficult to walk.

"He was like a stroke victim," she said, but he's doing much better now 
thanks to extensive physical therapy, repeated surgeries and continuing 
use of antibiotics.







More information about the Homestead mailing list