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xx Superbugs - important
« Thread started on: Mar 19th, 2007, 08:21am »

I have taken the liberty of posting this here as I figure the information could be vital to saving a life. If the powers that be deletehuh? this there is not much I can do except try to get this information out to you.

Monday March 19 2007

Superbugs get out of hospital as antibiotic armoury runs dry

CanWest News Service

Monday, March 19, 2007

It began with what looked like a pimple below her bottom lip.

Then the cramps started below Angela Weil's left ribs, the pain so sharp she couldn't sit in the waiting room at her doctor's office and had to lie flat on a bed in the back.

"Get her to the hospital," the doctor told her mother.

In a matter of months, Weil would be fighting a blood poisoning that can rapidly lead to septic shock and death, and she'd undergo emergency surgery for an abscess of the spleen that had slowly leaked 400 millilitres - nearly two cups - of pus into her abdomen. She'd lose 40 pounds and spend the day of her high school graduation vomiting, crying and writhing in pain.

In January 2006, Weil contracted drug-resistant staphylococcus aureus, a bacterium that's a major cause of hospital-acquired infections - except she hadn't been hospitalized.

The Ottawa-area teen had been caught in a rapidly emerging public health threat in Canada, the spread of drug-resistant superbugs into the community.

No one knows exactly how the infection entered her body. A cut or puncture in the skin is the most common route.

"The doctor asked her, 'Do you share needles? Do you do this, do you do that?' " Louise Davis, Angela's mother, recounted. Angela had been working at a pet store, cleaning birdcages. She would come home at night with scratches on her arms.

The first sign something was wrong was a tiny, blister-like bump on her chin. Impetigo. Within days, round, crusty, fluid-filled lesions had spread over her entire chin. The bacteria travelled through her bloodstream, attacking her spleen. When the surgeon cut into her, the fist-sized organ was dark purple, fractured and bleeding.

Weil developed septicemia, a bloodstream infection that can be rapidly fatal. "She would have been dead in a couple of days had we not brought her in," her mother said.

Weil lost one litre of blood, required two blood transfusions and spent 10 days heavily medicated in hospital while doctors tried one antibiotic after another to clear the infection sweeping through her body.

In August came a blocked urethra; a stent was inserted to help drain urine from the bladder to the kidney. Then an ultrasound taken after the stent was removed showed a "spot" on Weil's liver. One month later, there were four tumours. The results of a MRI won't be known until the doctor returns from vacation next week.

"I have no friends any more - they've all gone off to college or moved," said Weil, who is now on antidepressants and sleeping pills. "I can't leave home."

"This is too much for an 18-year-old to take," her mother said. "They should be going out with boyfriends and enjoying friends. My daughter is losing her will."

As our antibiotic armoury disintegrates, drug-resistant superbugs entrenched in hospitals are moving out into the community and infecting otherwise healthy people.

Community-acquired methicillin-resistant s. aureus, or

CA-MRSA, is emerging in daycares, schools and cruise ships. Nearly 500 cases have spread across Alberta and outbreaks have occurred in British Columbia, Saskatchewan, Manitoba and Ontario.

The infection - a rapidly dividing organism that lives on skin or in noses and secretes enzymes that break down tissue - can enter the body through a nick with gardening shears or a burst pimple.

It's striking pregnant and nursing mothers. Children and adults are contracting fatal pneumonia.

"These superbugs have made their way into the day-to-day lives of regular people," warned George Zhanel, professor of medical microbiology at the University of Manitoba. "They're just out there on the streets."

Drug-resistant staph isn't the only microbe of concern. C. difficile, the diarrhea-causing bacterium implicated in the deaths of 2,000 Quebecers since 2004, appears to be increasing in the community as well.

So, too, does its severity.

The disease usually occurs when antibiotics taken for an infection alter the normal balance of good "gut flora," or bacteria in the intestine and colon. Researchers say that risk can last for weeks to months after taking antibiotics. But the organism is also striking otherwise healthy people who have not been treated with antibiotics. Researchers are warning that people who take heartburn drugs appear to be in danger of contracting

C. difficile.

And the superbug "hit list" keeps growing: E. coli, a major cause of wound, urinary and gastrointestinal tract infections, is rapidly turning resistant to a growing number of drugs. One in 20 E. coli infections in intensive care units is virtually untreatable.

Pseudomonas aeruginosa, an organism that causes life-threatening pneumonia and post-surgery infections, is also becoming multi-drug resistant.

There are multi-resistant strains of tuberculosis, "the most deadly organism on the planet," said Robert Hancock,

director of microbial diseases research at the University of British Columbia and a Canada Research Chair.

Infectious disease experts are urging front-line doctors to treat C. difficile and other suspected drug-resistant infections as aggressively as they would a heart attack. They say patients should be monitored carefully and fast decisions made if their health deteriorates.

Other experts are calling for such measures as mandatory hand-washing stations at daycares and nursing homes, and more private rooms and private bathrooms in hospitals.

More urgently, new drugs are badly needed, "but when you look at the antibiotic discovery pipeline, the cupboard is bare - this is really quite scary," Hancock said.

He said the amount of money spent on basic research is minimal; the ratio of U.S. grant funding for AIDS compared with drug resistance is seven to one.

"About 10,000 people die every year in North America from AIDS; about 90,000 die from an antibiotic-resistant infection," Hancock said.

"We just don't have many people left in the world who do basic research in antibiotics.

"If you run out of antibiotics, you can't do major surgeries, you can't do radiation therapies, you can't have premature babies or sextuplets like we've had in Vancouver."

Outside Manitoba and Quebec, MRSA is not a reportable illness. "So contacts are not being systematically traced," said Mark Loeb, professor of pathology and molecular medicine at McMaster University in Hamilton, Ont.

C. difficile is the canary of infection, meaning it can be a sign of less-than-optimal infection control. The primary means of transmission is from the hands of health-care workers to patients.

McMaster University researchers recently stationed nine university students outside patients' rooms to record how often doctors, nurses and other health-care workers washed their hands.

"Roughly, it's about 30 per cent," Loeb said. "Only 30 per cent of the time do health-care workers wash their hands. When you ask them, they say they forgot or the hand product is irritating to their skin or they don't know it's important."

"What's the best way to kill these bugs? Soap and water. We've got to be pushing basic hygiene," Zhanel said.

- - -

Community-acquired MRSA

What is MRSA?

Staphylococcus aureus is a bacterium commonly found on the skin or in the nose. About 25 to 30 per cent of the population is colonized in the nose with staph bacteria (meaning bacteria are present but not causing infection). Methicillin-resistant s. aureus (MRSA) is not killed by the usual antibiotics. Staph causes infections when it enters the skin through a cut or sore. People who have been in a health-care facility are more at risk.

What is community-acquired MRSA (CA-MRSA):

A type of MRSA infection contracted by someone who hasn't recently been in a hospital, clinic or other health-care setting. Infections have been reported in toddlers in daycare to high school, college and professional-level athletes.

What are the symptoms?

Usually a skin infection such as a boil or abscess. It can start with a pimple or cyst and can be mistaken for a spider bite. The infected area will be red, swollen, warm and sometimes painful, and there may be pus or other drainage. Symptoms of a more serious infection include rash, shortness of breath, fever, chills, chest pain, fatigue, malaise (generally feeling unwell) and headache.

How is it treated?

Most often by drainage and good wound care. Antibiotics are sometimes needed.

Serious staph infections may include cellulites, toxic shock syndrome, pneumonia and blood poisoning. Organ failure and death may result from untreated MRSA infections. Call your doctor if a wound seems to get worse rather than healing or if any other symptoms of staph infection are present.

How can I prevent the spread of


Cover all wounds with clean bandages. Wash hands often, especially after visiting someone in a hospital or long-term care facility. Don't share personal items. If you share sports equipment, clean it first with an antiseptic solution.

Sources: Mount Sinai Hospital, Toronto; U.S. National Institutes of Health; U.S. Centres for Disease Control

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xx Re: Superbugs - important
« Reply #1 on: Mar 19th, 2007, 08:22am »

C. difficile

What is it?

Clostridium difficile (C. difficile) is a bacterium that causes diarrhea and more serious intestinal conditions such as colitis. Treatment with antibiotics increases the chances of developing C. difficile diarrhea because antibiotics alter the normal levels of good bacteria in the intestine and colon. C. difficile can thrive and produce toxins that can cause an infection. The elderly and people who take antibiotics for prolonged periods are at greater risk. Drugs that suppress stomach acid, such as heartburn medications, also increase the risk for C. difficile infections.

What are the symptoms?

Watery diarrhea, fever, loss of appetite, nausea and abdominal pain or tenderness. More severe symptoms include diarrhea containing blood and mucus. In rare cases, it can be fatal. Diarrhea can also lead to serious complications such as dehydration.

How is it spread?

Infected individuals shed spores in stool that can be spread from person to person. Spores can be transported on the hands of health-care workers who have direct contact with infected patients or contaminated bedpans, toilets, floors, etc.

What should I do to prevent the spread of C. difficile?

If you are infected, you can spread the disease to others. Wash your hands with soap and water often, especially after using the washroom and before eating. Clean surfaces in bathrooms and other areas on a regular basis with household detergent/disinfectants. See your doctor if you think you have C. difficile disease.

Sources: Public Health Agency of Canada; U.S. Centres for Disease Control

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