Wednesday, October 24, 2007

MRSA panic


There is so much apathy in the country these days about a number of issues. Unfortunately, the only way most people learn about pertinent issues is during a crisis situation (image credit), or during a tragedy. This is evident now through the California wildfire situation. I admit that I really did know much about the specifics of how wildfires happen until recently reading about them.

The same can be said of MRSA. I think it's reasonable to say that most of the public didn't know what MRSA was until recently, especially before the tragic death of that Virginia teen.

Now, it seems to be everywhere in the media. And, our office is getting calls about this every day. In today's Newsday, an associate professor at NYU School of Medicine outlines what's probably been happening in doctor's offices across the country.
But thanks to widespread media coverage of the CDC report, people are worried. Last week many of my patients called me with fresh concerns over their usual pimples and boils, and a frightened neighbor refused to shake my hand, pointing out that because I worked in a hospital I might be in contact with the superbug.

Such hypervigilance will do nothing to eradicate MRSA. Quite the contrary, in fact. Excessive concerns over rare bacteria lead patients to pressure physicians for antibiotics to treat the slightest sniffle or scratch. Though more than 90 percent of upper respiratory infections are viral and don't respond to antibiotics, and though most skin bumps go away on their own, physicians are nevertheless quick to overprescribe oral antibiotics. This bad habit leads to more impervious bacteria, which develop resistance to existing treatment.
This is an interesting national article, and I encourage you to check it out. But, when it comes down to it, all politics is local, right? People really don't learn all the ins and outs of an issue until it hits home. Here is the beginning of an article from one of our local papers today:
Niles — A McKinley High School football player has contracted a drug-resistant staph bacteria infection, sparking city health and school district officials to take precautionary measures. ‘‘We are taking precautions,’’ Niles schools Superintendent Rocco Adduci said.

City Health Commissioner and school physician Dr. William Eddy said it takes 48 to 72 hours to determine that a staph infection is Methicillin-resistant Staphylococcus Aureus (MRSA). The confirmation of the Niles case was made Tuesday.
But, what I really enjoyed was the end of this local article. It is so pragmatic. It makes total sense. It's definitely what this community needs right now. And, of course, the quote is not from a doctor, but from a nurse and mother. I couldn't have said it better myself.
Still, infections can happen, according to parent Cindy Rosenberger of Niles. Although she’s a nurse in a local hospital and taught her kids how to wash their hands and prevent infection, three of her children — one of them an athlete in the schools — have come down with staph infections over the years. ‘‘It’s definitely a concern,’’ she said. ‘‘You hear of schools where there are staph infections, where kids may have died.’’

When her children had staph infections, Rosenberger watched for signs of illness, such as fever and chills, and also made sure they finished the prescriptions their doctor gave them. ‘‘Kids want to take one or two of the doses, and then when the symptoms go away, they don’t want to take any more,’’ she said. ‘‘I always make sure they finish them.’’
Update (1pm): Niles player has MRSA infection

7 comments:

Bond said...

'finish the prescription...i do not care if you feel better' the voice of my mom in my head

OHN said...

Having nearly lost my husband (a big healthy guy) to MRSA after a routine arthroscopy, I can tell you first hand the nightmare that can ensue. It took weeks of IV therapy (Vancomycin-the only one hubby was not allergic to), I had to do dressings for awhile then when the hardware needed to be removed he had to heal by secondary intention...and the drama goes on and on. It is very frightening but you are so right that sometimes we are our own worst enemy by demanding antibiotics for all infections. I don't know what the answer is but knowing that schools have become a very real avenue for these bugs to multiply is frightening to a parent of any student but especially an athlete.

Travis said...

Ditto what Bond said.

Scott said...

Hmmm . . . Mersa. Well, you are a doctor. In the west. Have you ever heard of bacteriophage therapy? Apparently they have been using it in Russia since before the mighty Pennicilin was harnessed. Supposedly they have viruses that attack Mersa, VRE, and any other malicious bacteria out there. But for whatever reason (ahem! big pharmacy is still making big dollars off of making all bacteria resistant) we are not using bacteriophages over here.

I am really interested to know what you think about this.

Mauigirl said...

Very interesting, Scott. I recently posted about MRSA on my own blog, Medicana, and in the course of the research, found that Methicillin resistant bacteria started showing up only 2 years after the drug was introduced (which was 1959). I have heard about bacteriophage therapy and will have to read up on it. We've certainly had enough time to look into it since the early 1960's, haven't we! It's interesting (read: sad) the way Big Money in the United States drives everything, including what treatments may be developed or used.

medrecgal said...

Believe it or not, reading articles like this that have been spreading over the blogosphere and the rest of the net has not been surprising. I survived a nasty tangle with this MRSA critter in March; it scared the hell out of my doctors & got me a nice 9 day stint in the hospital, complete with a trip to the OR to clean out the abscess (complete with partial necrosis)that had formed. I was on vancomycin for a few days IV, and then had a month's worth of doxycycline.

The upside only happened at the last office visit I had with the surgeon; researching this superbug helped him change his thinking in regards to who's at risk for MRSA. He was still in the days where they thought only people with compromised immune systems got MRSA; that's no longer the case today, unfortunately. Of course, now I'm completely paranoid and it seems like I'm always washing my hands. But if it keeps me out of the hospital, I'll live with it!

PsychoToddler said...

Just found your blog through Medscape!

Anyway, re: MRSA, it's funny. I was watching the NBC Nightly Entertainment show..er News, when they had a "Special Report" about the new superbug infecting the nation...MSRA!

At first my wife and I (she's a nurse, I'm an MD) thought the TV doc had a dyslexic moment, but he kept saying MSRA, and even the graphic said "MSRA".

Now, I'd been seeing my share of MRSA in the clinic, but this new MSRA thing really started worrying me. I started to question whether there was some new superbug out there that I hadn't heard of.

Halfway through the broadcast, the news anchor broke in with a correction due to the bombardment by emails over the error.

My question is this: This so-called medical authority, who gets on TV night after night to tell America what to panic over, how out of touch is he if he couldn't get the name of a bacterium which any doctor who's stepped foot in a hospital in the past 15 years is intimately familiar with?