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Science

Antibiotic Resistant Staph Infections 663

LinuxGeek8 writes "There's a news update on a previous article about the first case of antibiotic resistant staph infections. The woman who has the infection is being kept up to 6 months in an isolation room. She is taking an antibiotic that is working, after many others did not. "In the scheme of public health threats, this has to rank close to the top," David Ropeik, director of risk communication at the Harvard Center for Risk Analysis, said of antibiotic resistance."
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Antibiotic Resistant Staph Infections

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  • by Anonymous Coward on Tuesday November 12, 2002 @06:35PM (#4654683)
    The patient, a 40-year-old Michigan man with diabetes, seems to have caught the bug off an infected catheter inserted while he was in the hospital for the amputation of a gangrenous toe

    Suddenly I realize that I am not having such a bad day after all.
    • by Anonymous Coward on Tuesday November 12, 2002 @07:01PM (#4654923)
      Yeah, living in Michigan would suck.
  • "hey mom" (Score:5, Funny)

    by Anonymous Coward on Tuesday November 12, 2002 @06:35PM (#4654684)
    thanks for making me use all that anti-bacterial soap all the time. now i'm locked up in a room for 6 months.
    • Re:"hey mom" (Score:5, Insightful)

      by duncan7 ( 247274 ) on Tuesday November 12, 2002 @06:38PM (#4654726)
      Antibacterial soap doesn't contain antibiotics, as far as I know, and certainly doesn't contain Vancomycin.

      Now, "Hey, Mom, thanks for taking me to the pediatrician for antibitoics every time I got the sniffles," is another matter, entirely.
    • obsessive-compulsive (Score:5, Informative)

      by MacAndrew ( 463832 ) on Tuesday November 12, 2002 @07:14PM (#4655020) Homepage
      Not to push you over the edge, but the antibacterial soaps are controversial; many studies show they are little more effective than regular soap [colostate.edu]. Some contend the antibacterial ingredients can cause problems all their own.

      Most bacteriocides that you'd be willing to put on your skin take a while to work, more time than you'd have the soap on. The most effective treatment is a good scrub, which physically scrapes the bacteria away -- not glamorous but effective. Most of us do a lousy job at handwashing -- it needs to be thorough and repeated during the day, as the bacteria multiply on your skin -- myself included, and I have two of those little disease vectors called "children."

      Only 40% of people wash their hands exiting public restrooms, one study showed (imagine being the data-taker); the problem there being the encouragement of the fecal-oral route of disease transmission from the non-handwasher to others. I'll let you visualize what fecal-oral involves. So be a good citizen and lather up.

      Oh, and the next time the press reports someone getting sick from beef tainted with E. coli, note that "coli" means colon, where these bacteria were discovered. These E. coli come from careless slaughtering practices and, stated frankly, mean that "there's manure in the meat." (quoting the muckraking author of the excellent Fast Food Nation)

      It's a microbe's world after all.
      • and I have two of those little disease vectors called "children."

        While I don't think you mean to blame your children, it's really not their fault.

        Last year, my kids were homeschooled, and for that entire year, nobody in my family got sick. Not one cold, not one flu, nothing.

        This year, we've had our kids back in public school, and we've already had one stomach flu and one cold work it's way through. In two short months.

        In previous years, we've had nastiness like chicken pox, measles, and. . . head lice!! All picked up from other kids at public school.

        Why do parents send their sick kids to school so they can infect other kids, and spread diseases to their parents?

        I personally blame the public school system for head lice. They could DO something about that. But with most families having BOTH parents working, kids can't take a sick day without making one of the parents take a sick day. So the parents send the kids to school in most cases, unless the kid's physically unable to prop themselves up in their desk. So mainly, I'm blaming the crappy labor standards that discourage parents from taking sick days for their kids. And I'm blaming crappy "modern industrialism" for eroding wages to the point where two adults MUST work in a family in order to maintain an average standard of living.

        Homeschooling and having my wife stay at home allowed our family incredible freedom, for vacations, etc. But my getting laid off and taking a job where I now make about 2/3 what I was making, changed that situation.
  • by Anonymous Coward
    as usual. Decimal to binary conversion errors in antibiotic design on computers caused this.
  • by i_want_you_to_throw_ ( 559379 ) on Tuesday November 12, 2002 @06:36PM (#4654697) Journal
    What doesn't help is the way that antibiotics have been indiscriminately and thoughtlessly prescribed these last several years for even the slightest ailments.

    Then there's some research suggesting that feeding antibiotics to animals isn't such a great idea either since all the nasties associated with that can be ingested later by humans. Try googling for the info [google.com]
    • by rodgerd ( 402 ) on Tuesday November 12, 2002 @06:45PM (#4654767) Homepage
      Unfortunately, patients are part of the problem - Gps are often pleasantly surprised when I don't want drugs as the automatic response to a problem, because most patients are aggressive abour demanding them, and too stupid to use them properly.
    • What doesn't help is the way that antibiotics have been indiscriminately and thoughtlessly prescribed these last several years for even the slightest ailments.

      Amen. I've actually gotten to the point where I get angry when I hear my mother-in-law tell my wife to go get some antibiotics because she has a cold. I've tried calmly explaining to her that antibiotics don't do anything to help a cold, but she's so used to years of doctors prescribing them for such that she can't get over it.

      I routinely suffer from sinusitis twice a year (when I turn on the heat and when I turn on the AC), so getting rid of infections is a big deal for me. I am not a doctor, but for the past couple years I've managed to completely avoid antibiotics. Instead, I take Echinacea and Goldenseal three times a day until the infection goes away. I've found that it's usually just about as effective as antibiotics, and since it's still my body that's doing all the work, there's no added fear of adaptation. Of course, this remedy wouldn't work if my immune system were in really bad shape.

  • DNA Theft (Score:3, Interesting)

    by Cyclopedian ( 163375 ) on Tuesday November 12, 2002 @06:36PM (#4654701) Journal
    In the article, it says that the Staph bug stole DNA from another bug already inside the woman to become resistant to vancomycin.

    For all you pathology people, is this a common method for bugs, or is it limited to a few families?

    -Cyc

  • by speculums ( 317287 ) on Tuesday November 12, 2002 @06:38PM (#4654723)
    What will they sell us once their magic potions no longer work? Maybe invent a couple more highly profitable diseases, or just classify more things as pathologies. There just isn't the same profit in prevention.
    • by runenfool ( 503 ) on Tuesday November 12, 2002 @06:44PM (#4654761)
      Well, from science fiction land I'm looking forward to nanotechnology to save the day on this one. Hopefully about the time everything under the sun becomes resistent to antibiotics we will have microscopic robots running through our blood stream wiping out invaders.

      Does that mean we will be cyborgs? Kind of I guess ... but we are going to machines sooner or later .. this sounds like a good place to start.

      I wonder how much it will cost and how much control software companies will have over us then?
  • by Maskirovka ( 255712 ) on Tuesday November 12, 2002 @06:38PM (#4654727)
    to quit washing your hands! the more bacteria resistant YOU are, the less you have to rely on artificial crutches like antibiotics.
    • by fishbowl ( 7759 ) on Tuesday November 12, 2002 @06:44PM (#4654762)
      You are probably joking, but there is some credibility to the theory that, when we started living indoors, sterilizing our environment, using lipid soaps ("antibacterial" is only new in the Marketing sense), taking antibiotics, and so on, we diminished our exposure to pathogens. Way back when, routine exposure to such things as polio and smallpox led to infant mortality rates that we would not tolerate today, but also bestowed on those who survived much more immunity to disease.

      • Dirt is good for you (Score:5, Interesting)

        by TamMan2000 ( 578899 ) on Tuesday November 12, 2002 @07:34PM (#4655149) Journal
        There is even recent research [ama-assn.org] that even suggests that children exposed to pets (and the inherent uncleanlyness) have lower incidence of asthma and allergies down the road.
      • Like allergies (Score:5, Interesting)

        by phorm ( 591458 ) on Tuesday November 12, 2002 @07:44PM (#4655272) Journal
        Sometimes this works backwards, but I used to have some really bad allergies to animals: cat fur, feathers, etc.
        After toughing it out in clean fresh air, coupled with visits to the chickens in the barn, etc, most of my animal allergies went away. I was still allergic to cats, but got rid of that after we got three of the shedding creatures.
        In reverse cases, sometimes the allergies chip away at the immune system, causing gradually increasing sickness. But in most cases I've heard of, low exposure over time builds tolerence.

        *Note: That's low exposure, stuffing a kid with allergies in a house of 50 cats is probably not recommended in the short run...
  • by Unknown Poltroon ( 31628 ) <unknown_poltroon1sp@myahoo.com> on Tuesday November 12, 2002 @06:40PM (#4654736)
    Luckily, i take my cipro once a week, so this shouldnt bother me.
  • by Anonvmous Coward ( 589068 ) on Tuesday November 12, 2002 @06:43PM (#4654754)
    And my high school collegeues made fun of my lack of social life. Ha!
  • by MongooseCN ( 139203 ) on Tuesday November 12, 2002 @06:44PM (#4654759) Homepage
    Has the bacteria really developed a resistance? Or have all the non-resistive bacteria died off and now only resistive bacteria remain?
    • Neither actually (Score:3, Informative)

      If you read the article, the resistance is attributed to theft of genetic material from another organism. So those bacteria which were most effective at stealing vancomycin resistance survived to breed, and pass on their criminal legacy.
    • by jonabbey ( 2498 ) <jonabbey@ganymeta.org> on Tuesday November 12, 2002 @06:54PM (#4654867) Homepage

      Bacteria are very unlike higher animals. Bacteria aren't restricted to darwinian evolution. They sometimes just grab genes from things they eat and incorporate them into their structure. Some bacteria even take the presence of antibiotics as a sign to spew out copies of their drug-resistant genes.. such bacteria 'remember' that those genes helped them out, and share the wealth when they are attacked. Antibiotic-resistant bacteria are an obscenely dangerous threat.

      See Bruce Sterling's excellent article, Bitter Resistance [eff.org] for far more information than you wanted to know about drug resistance in bacteria.

      • by mesocyclone ( 80188 ) on Tuesday November 12, 2002 @08:05PM (#4655433) Homepage Journal
        Bacteria aren't restricted to darwinian evolution. They sometimes just grab genes from things they eat and incorporate them into their strucure.

        This is still Darwinian Evolution. After all, Darwin didn't know about genes at all - and certainly not DNA! How the genomic change occurs is not an issue with Darwinian Evolution. Darwin's insight (others had this too, btw) was how natural selection worked to produce variations and new species.

        Genomes change for in all sorts of ways. Mutation is one. Extremely important is gene exchange - typically sexual reproduction. This is very powerful or the high costs of it (please, no bad jokes) wouldn't be tolerated by natural selection. There are other mechanisms... bacteria can simply pick up DNA that is floating around in their environment - especially plasmids. Viruses can cause germ line changes - introducing new genes or modifying existing ones.
  • by CormacJ ( 64984 ) <cormac.mcgaughey@NOSPAM.gmail.com> on Tuesday November 12, 2002 @06:45PM (#4654775) Homepage Journal
    There are many strains of antibiotic resitant bugs out there.

    I used to work in a hospital and we had a lot of patients with MRSA (Multiple Resistance to Strains of Antibiotics) related issues. These patients were kept isolated and treated until the MRSA infection was cleared then they could be operated on.

    Quite often these bugs not dangerous until a person gets sick then they can be fatal.

    This is why people should not use antibiotics for viral infections (such as the common cold) and why if you do have to use anti-biotics you should take all the pills as prescribed until they are done.
    • by chazR ( 41002 ) on Tuesday November 12, 2002 @07:48PM (#4655309) Homepage
      (Completely agree with parent post, minor correction, then rant)

      MRSA actually means Methicillin Resistant Staphylococcus Aureus.

      Now we have VRSA. Vancomycin Resistant Staphyloccocus Aureus.

      There are no "wonder drugs" in the pipeline. We're reaching the end of the road for antibiotics. It won't be sudden, but it will happen.

      Many diseases we currently think of as relatively trivial are going to become real killers again. Millions of people are going to die.

      It won't be the young, fit and healthy as much as the very young and the very old.

      But let's keep feeding the antibiotics to farm animals. It makes them more profitable. Got a slight viral cold? Demand antibiotics. It's your right.

      It's the tragedy of the commons again.

      Crazy question for microbiologists: Is it possible that resistance to a specific antibiotic costs an organism enough that it could no longer out-compete it's non-resistant cousins? Would it be worth infecting someone who has a resistant strain with a non-resistant strain in the hope that the non-resistant one will 'win'? Then, (if the patient still lives), treat that with antibiotics?

      Or are you going to get so much genetic transfer that it's worse than dangerous?
    • by Idarubicin ( 579475 ) on Tuesday November 12, 2002 @07:53PM (#4655347) Journal
      I used to work in a hospital and we had a lot of patients with MRSA (Multiple Resistance to Strains of Antibiotics) related issues.

      If you worked in a hospital, you obviously weren't a doctor or nurse. MRSA is Methicillin Resistant Staph(ylococcus) Aureus--a bacterial strain that is resistant to one of the antibiotic 'big guns' methicillin.

      There are few choices of antibiotics left to treat it (for example, vancomycin--though vancomycin resistant staph was observed recently, IIRC). A patient with MRSA is unlikely to survive the trauma of surgery coupled with a serious infection, because the drugs used to treat MRSA are often not friendly in their side effects.

  • by krin ( 519611 ) on Tuesday November 12, 2002 @06:47PM (#4654801) Homepage
    That we are getting soft. All these new products that have anti-bactereal stuff in them aren't helping us, in the long run anyway. It's sad when you see kids afraid of dirt, or people who have to wipe down every little thing before they feel it's clean. Yes, I'm wash myself.. but I don't feel the need to buy every product that 'Kills 99.9% of germs FAST!' I rarely kid a cold, and when I do my body fights it off without the use of twenty different products. Tylenol, and some good chicken soup are all I need. And yet they say the flu is getting worse by the year. We're soft, we need to toughen up. Go play in the mud.
    • Just like how our medical methods are really making our gene pool a bit murkey. Since even the children with life-threatening defects live and reproduce, this weakness gets spread to all their offspring... weakening the gene pool even more.

      On one hand, advanced medical science can cure the world... on the other... it can make everybody so weak that they would die from a untreated cold in a matter of hours...

      maybe genetic engineering can restore the strength that the human race once had...
  • by duncan7 ( 247274 ) on Tuesday November 12, 2002 @06:49PM (#4654817)
    Many health professionals hope that following this summer's discovery of vancomycin-resistant staph aureus in the metro woman's foot, Americans will be scared enough to accept limited use of antibiotics.

    Not bloody likely. Though maybe if more doctors took the approach that was taken at the Olympic Village in Salt Lake City [idsociety.org], the over-use of anti-biotics might start to decline. Not many doctors have that kind of captive audience, though.

    It's not a matter of scaring people away from antibiotics, it's a matter of giving them something that actually might work, instead of just giving them something to get them out of the office...
  • A grain of salt (Score:5, Interesting)

    by MacAndrew ( 463832 ) on Tuesday November 12, 2002 @06:49PM (#4654823) Homepage
    This spectre of super-bacteria (another writer correctly notes that antibiotics have nothing to do with viral infections) has been over-hyped by the press. There have been occasional examples of astonishingly resistant variations on common bacteria, but almost all have arisen in hospital settings with other complications present. They aren't whipping through the community, in other words. There are also special interests, such as the anti-antibiotics in animal feed people (a cause I tend to believe in), which have disingenuously used the problem to boost their cause, lacking any causal connection.

    There is good evidence anitbiotics are overprescribed and, much worse, misused by the public (always always finish your course of antibiotic correctly, the last mile really is important even though you may feel fine -- it sounds preachy but it's true). But this is a different issue; the super-bacteria appear in hospital setting where doctors are doing their utmost to fight infection. Vancomycin is still pretty nuclear stuff.

    I wish I had a good cite handy, but I can't dredge one up offhand; do take a look if you're interested, at NIH and CDC for starters. IMHO the superbacteria are kind of like the killer bees, long heralded but never quite arriving in force. I don't mean to make light of the potential trouble; it's just not here yet, and won't for a while, and it pales in contrast to staggering public health problems we have like HIV and smoking and unaffordable prescriptions and even West Nile virus. When you hear reports in terms of infections per 100,000 people, as opposed to isolated case studies, take heed. For now it merely makes for good copy, over and over.

    "I'm not a doctor but I play one onlin." :) Actually, I minored in biology and immunology, FWIW.
    • Re:A grain of salt (Score:4, Interesting)

      by jonabbey ( 2498 ) <jonabbey@ganymeta.org> on Tuesday November 12, 2002 @07:01PM (#4654925) Homepage

      Well, that's the hope, that somehow the antibiotic-resistant genes will prove detrimental to the bacteria in the absence of the specific antibiotic. If a vancomycin-resistant staph bug is 10% less efficient at metabolism or replication, then there might be a degree to which the problem becomes self-limiting. This is also the idea behind letting older antibiotics 'rest' for awhile, in the hope that, in the absence of the antibiotics, the wild population will mutate back to the more efficient non-resistant configuration.

      I suspect that's not a terribly sturdy reed to pin one's hopes on, though. I'd again recommend Bruce Sterling's Bitter Resistance [eff.org] column for more on this.

  • by Blimey85 ( 609949 ) on Tuesday November 12, 2002 @06:49PM (#4654826)
    Yes I know that AIDS is a virus and not a bacteria but there have been cases of other things becoming airborne such as certain strains of Ebola. My fear is that somehow AIDS will become airborne.

    I think the main problem with infections and diseases becoming more resistant to treatment lies partly in a lot of people failing to use the medicine for the required amount of time. I had a skin fungus that kept coming back because everytime I cound't see it anymore, I would quit spraying the medicine on it. After a few times of this, the medicine was no longer effective and I had to get some much stronger (and much more costly) medicine to combat the problem. Using antibiotics for a short while until the problem is apparently gone and then stopping, may allow whatever it is that is being treated to adapt to the treatments. Then it gets spread to someone else and the process repeats itself until eventually, we have no way to stop even common ailments.

    • by primenerd ( 100899 ) on Tuesday November 12, 2002 @06:58PM (#4654904)
      Viruses such as HIV can swap genes, but only if two strains infect the same cell. This is why new influenza often comes to us from China, where swine, bird and human all live in close proximity and exchange viruses.
      The chief engine of genetic change in viruses is caused by antigen drift via mutation. This is due to the error-prone nature of virus replication.
      However, drug resistance is found in viruses. AIDS has shown resistance to some of the early retrotranscriptase inhibitors (AZT), not due to gene-swapping, but good old fashioned natural selection.

    • AIDs is already airborne. The problem is, you apparent need a LOT of HIV virus in your system to get infected, and you simply can't get that much through airborne sources. Most of us have already come into contact with very low numbers of dangerous virii and not been affected because our imune system managed to wipe them out before they propagated to higher numbers.
  • by myowntrueself ( 607117 ) on Tuesday November 12, 2002 @06:49PM (#4654827)
    How are they gonna explain this in classrooms in Alabama? (or wherever the heck it is that evolution is banned in classrooms)

    "Well kids you see God just recently gave the staph bacteria a gracious gift; antibiotic resistance. Of course staph didn't *evolve* this resistance since theres no such thing as evolution, children.
    We just have to wonder at Gods great plan where he makes these changes in living things just to make life harder for us God fearing folk. Praise the lord.
    Ok now children all lne up for your lobotomy operations; you won't be needing independent thought with God looking after things."

    • by xenoweeno ( 246136 ) on Tuesday November 12, 2002 @06:54PM (#4654872)
      In the creationist's mind, this is an example of "microevolution" and not "macroevolution". The latter of these two is the one that Goes Against God's Plan(TM), etc. They'll go along with staph becoming antibiotic-reistant, but not with staph mutating into an entirely different creature.

      This ignores that micro and macro are in reality the same thing to educated people, of course.
      • How much education counts?

        You are correct on micro/macro.

        And, it's not that it's "Against God's Plan" -- it's that it simply is conjecture that didn't happen.

        The better example is the dog born with 5 legs. Some would say this could be a transitional form that if things were right could lead to a new breed of super dog. We see a dog flopping around looking embarrassed because it has a serious problem.

        The main issue is that there should be tranisitional forms all around us -- and that evolution should be observed. Peppered moths are nursery stories and have little correspondance to anything. I could throw away all my yellow sheets of paper, but that wouldn't make my white paper turn into monkeys.

        Mutations and diseases are not part of God's Plan. They are the result of choosing another plan.

  • by jblsys ( 25647 ) on Tuesday November 12, 2002 @06:54PM (#4654874)
    The Russians have been working for years on alternatives to antibiotics. Phages are viruses that target bacteria and have been shown to be successful in targeting what would otherwise be very resistant strains. http://www.phages.org/PhageHistory.html
    • I remember seeing a Horizon that dealt with bacteriophages some time ago. It highlighted the fact that most of the research was being done in Russia and the conditions the researchers worked in were appalling. Power cuts could easily wipe out a colony of very promising phages.

      In particular one thing I remember was that for some types of phage, you had to feed them, I think raw meat was a good choice. The viruses actually ate the meat. Phages have the advantage of being as adaptable as the bacteria however.

      What about nanotech? I wonder if by the point that antibiotic resistant bacteria becomes a problem whether we'll have sufficiently advanced nanotechnology to make our own killer molecules.

    • Unfortunately, bacteria can become resistant to bacteriophages as well. Occasionally a bacteria has a mutation in the receptor protein that the phage normally binds to during infection. Still, if I had a vancomycin resistant infection, I'd want to give phage treatment a try...
  • by CableModemSniper ( 556285 ) <.moc.liamg. .ta. .odlapacnagol.> on Tuesday November 12, 2002 @06:55PM (#4654877) Homepage Journal
    That we've licked staph, along comes some guy with $6Mil. "We can rebuild it. We have the technology. We can make it better, faster, stronger."
  • Not the first time. (Score:5, Interesting)

    by xenoweeno ( 246136 ) on Tuesday November 12, 2002 @06:58PM (#4654899)
    Not only is this not the first time, but antibiotic-resistant strains are already resisting [smh.com.au] brand new classes of antibiotics designed to beat them when all others fail.

    All I'm sayin' is that I'm funneling down the vitamin C like Pez. :-|
  • phage therapy (Score:5, Informative)

    by soundofthemoon ( 623369 ) on Tuesday November 12, 2002 @06:58PM (#4654902)
    There have been rumblings in the news for over a decade that profligate use of anitbiotics in both medical care and factory farming would lead to just this sort of problem. After years of warnings, no one should be surprised by this development. DNA swapping among bacteria species is a well-known phenomenon, and I read years ago that biologists were concerned this very thing would happen.

    What's the alternative? Virtually every species of bacteria has one or more virus species that have evolved to prey on it. These bacteriophage (or phage for short) can sometimes be used as treatment for bacterial infection. They were supposedly the Next Big Thing about a century ago, before antibiotics stole the show. Now there is renewed interest in this approach. There was also a recent development of a technique using only a phage-produced enzyme to fight bacterial infections.

    Google "phage therapy" or "phage enzyme" for some good reading on the subject.
    • Re:phage therapy (Score:3, Insightful)

      by mesocyclone ( 80188 )
      There is a good overview article on phage therapy in last week's Science magazine.

      Phages therapy still faces the development of resistance. Natural selection is a very powerful process, and various forms of gene exchange among bacteria makes it happen quite quickly.

      Phages also are likely to be attacked by the human immune system (they are, after all, foreign viruses). Thus a lot of phages that work well in vitro don't do well in vivo.

      However, they are an additional weapon against bacteria, and there are now some western companies that are combining the long Soviet experience with them with western venture capital and well equipped laboratories.

      At some point, on might suppose that bacteria would run out of resistance strategies. Most changes to cause resistance come at some cost - which is why resistance genes will often fade away without the presence of antibiotics. Add up enough of these changes and you may produce bacteria that are not very viable. OTOH you may produce bugzilla!

  • by Cipster ( 623378 ) on Tuesday November 12, 2002 @07:03PM (#4654952)
    I have actually worked in S. aureus research and it is a very scary bug. Some of the strains we had collected were resistant to 12 different antibiotics and even Arsenic. The main reason S. aureus becomes so easily resistant to new antibiotics is because it easily picks up circular strands of DNA called plasmids which carry resistance genes on them. The most likely source of the resistance gene is not cattle but other bacteria present in the hospitals. Enterococcus, a cousin of S. aureus which lives in a person's gut is highly resistant to Vancomycin and it was expected that sooner or later this will be passed to S. aureus. There have been cases of this happening in Japan a few years ago. The best place to pick up a nasty germ is in the hospital since most patiets there are on antibiotics so the only bugs around are highly resistant to a wide range of drugs.
  • by md2b ( 314289 ) on Tuesday November 12, 2002 @07:07PM (#4654978)
    VRSA (vanc. resistant s. aureus) is some scary schtuff. S. Aureus is one of the most virulent organisms we as humans get infected with; aside from the whole being sick in general, it can cause septic shock (death if you're not in a hospital at the time) and VERY rapid failure of your heart valves (called acute bacterial endocarditis). Vanc was once the last line of drugs. If it failed, we had no treatment. Since then, two more classes of ABs have been invented, and we deliberately avoid their general use so they'll be useful in just such situations; some doctors, sadly, don't use this guideline near as much as they need to. Sadly, S. Aureus is also a bacteria which is astoundingly well adapted to take up genetic change. These little buggers actually have "bacteria sex" and share their antibiotic resistance.

    Here's some suggestions to help you avoid these problems:
    1) Most MDR (multidrug resistant) bugs are found in hospitals (med word: nosocomial). You're relatively safe from this stuff when you're out in the community.
    2) TAKE ALL OF YOUR ANTIBIOTICS AS PRESCRIBED. Taking just enough to feel better is the worst idea ever - all the bugs left have now been genetically selected for greater resistance.
    3) If the doc says you don't need an antibiotic, don't push too hard - ABs can cause serious side effects and drug resistance in YOU. Remeber - a normal health human has 10x more bacteria than they do human cells - most bacteria are there to help!!!
    • One issue that I haven't seen mentioned in this thread is the spread of resistance in cultures where antibiotics are frequently used without prescriptions or medical advice.

      In many third world countries, antibiotics are available by the pill. People take them until they feel better or can't afford any more.

      Without significant education (and perhaps changes in incentives), this will lead to widespread resistance, without invoking first worlder's ignoring their doctors' adivce or agricultural use of antibiotics.

      In addition, certain subcultures in the US have similar problems. One of the scariest bugs out there (far scarier than MRSA) is multi-drug resistant tuberculosis. TB is common among street people, due to their lifestyle. Unfortunately, the same psychopathologies that lead to them being homeless also lead to failure to follow proper antibiotic treatment regimes. For this reason, states are now starting to reinstate the process of forced treatment - in confinement if necessary.

      If you have TB and you don't follow the treatment protocols, you can be confined to a treatment facility until the TB is cleared (which may be never if it is highly resistant).

      Making this even worse is that many of the street people are also heroin addicts, and contract AIDS. Then we have a paradise for the TB - weakened immune system in a person who doesn't adhere to proper antibiotic use.

      It is also spreading very rapidly in Russian prisons, btw, and is also a major killer in the third world.

      The reason TB is so scary is that it is a very serious disease (often fatal) in a healthy person, and it is spread through the air. You can catch it on a bus or walking down the street. Most TB is resistant to some antibiotics, but curable by a (nasty) cocktail of other antibiotics.

      Before the development of Streptomycin, TB was common in the United States. Many people spent the last months or years of their shortened lives in TB Sanitoria, often experiencing all sorts of ghastly treatment.
  • SA (Score:5, Interesting)

    by zogger ( 617870 ) on Tuesday November 12, 2002 @07:10PM (#4654998) Homepage Journal
    --long time ago I had an SA infection, it is TRULY sucky, incredibly hard to get rid of. took me six months or so to beat it. At the time I was put on erythomycin (sp).

    With that said, past few years been using colloidal silver on external wounds/infections, works quite well. I was skeptical at first until I tried it. Still using it when needed. Much better than any store bought/prescription antibio cream I ever tried. The only bummer is, it's very inexpensive. You can make it yourself easily or buy it cheaply pre-made, variety of places. People have this ingrained almost religious belief that stuff has to cost a lot of money and come from the medical deity to be effective. (Almost like the almost religious belief that software has to come from an expensive closed source place to be any good). You don't get that "full" satisfaction of paying mucho dinero for it so you know it'll work, like big pharmco products.

    Yes, I know there are some issues with taking it orally by the 55 gallon drum, I'm not recommending that at all, but for some reason those silver particles will sure kill the cooties. No idea if effective or not on SA, but given that the medcos are stumped, well????

    Not to be construed as medical advice, closed track, illegal where void and like that there.
  • by lirkbald ( 119477 ) on Tuesday November 12, 2002 @07:15PM (#4655028)
    Several have commented that you should finish the prescribed course of antibiotics. Very true.

    The other point I've seen is that you should take your doctor's advice- some people will demand the doctor prescribe antibiotics for any little cold or sniffle they get. This, of course, won't do a bit of good, since colds and flus are caused by viruses, and antibiotics only work on bacteria.

    So the prescription won't do any good, but it won't harm the patient either- so the doctor gives in and writes the prescription, just to get the patient to shut up. (okay, so it's partially the doctor's fault too)

    But the antibiotics in the system will give the body's native bacterial flora a chance to develop resistance, and those little bugs have a nasty way of passing genes back and forth... (if you don't believe me Google for bacterial conjugation)
  • by Anonymous Coward on Tuesday November 12, 2002 @07:18PM (#4655055)
    Is there any REAL reason that Triclosan [cambridgesoft.com]
    (VERY common antibacterial agent/cancerogenic) has to appear in...

    toothpaste [colgatetotal.com],
    mouthwash,
    cleansers,
    soaps,
    toothbrushes,
    dishwashing detergents,
    hand lotions,
    Anti-Bacterial Toilet Seat Lifter, [cyberbabymall.com]
    Anti-Bacterial Chew Toys!? [4t.com]

    Apparently the germs don't care about the new products we've tried to make "clean" with Triclosan.....
    because they've already beaten it. [pslgroup.com]

    Oh, and what do the experts think?

    Center for Disease Control's view of things [cdc.gov]

    ST. JUDE RESEARCH TEAM [131.104.232.9]
    DISCOVERS A TRICLOSAN-RESISTANT ENZYME IN PATHOGENIC BACTERIA

    "A Swedish study [nyteknik.se] found triclosan in
    "the breast milk of three out of five lactating women tested..." [theage.com.au]

    Yet more... [mpt.org]

    I for one, will be exercising my immune system with daily exposure to germs. Do your part, get dirty.
  • by Wolfier ( 94144 ) on Tuesday November 12, 2002 @07:28PM (#4655110)
    Can bacteria be tricked to exchange DNA with genetically-engineered bacteria that is designed to be vulnerable to everything?

    If we contaminate their system enough would the resistant population decrease?
  • by salimma ( 115327 ) on Tuesday November 12, 2002 @08:07PM (#4655456) Homepage Journal
    The hospital that my father works in has had similar cases in the past: infections that would only respond to the latest antibiotics.

    This is rather worrying, especially when you think that the main cause of all this resistance buildup is GPs prescribing antibiotics copiously (at the behest of patients, true, but what's wrong with giving placebos? Probably will get them lawsuits for misleading the patients, hmm) and commercial farming where antibiotics are used liberally to stock up the animals..
  • by FireHorse ( 2235 ) on Tuesday November 12, 2002 @08:14PM (#4655512)

    The latest all natural fad being used as an anti-microbial is "Grapefruit Seed Extract" (commonly called GSE).

    I discovered it when it was recommended to me for a nasty GI virus that wouldn't go away by normal starvation. Killed the sucker right off. As a nursing student I will be trying to bring this into any hospital I eventually work for.

    Hopefully, and I don't see why not, it will work against antibiotic resistant bacteria and viruses.

    A good overview [chisuk.org.uk]

    Here's a good summary from another site:

    Grapefruit seed extract is derived from the bioflavonoids found in the seed and pulp. Its anti-germicide action has shown a growth-inhibiting effect on bacteria, fungi, parasites, and viruses in several in vitro studies. The effectiveness of grapefruit seeds was discovered accidentally by a doctor, who noticed that the seeds did not decompose in his compost file. Further examination revealed that the grapefruit seeds killed any microorganism that tried to decompose it. Laboratory studies have shown it to be effective in inhibiting bacteria such as Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Mycobacterium tuberculosis. Grapefruit seed extract has been formulated by a number of manufacturers for various uses, including an internal bactericide, water disinfectant, skin cleanser, and first-aid spray. Grapefruit seed extract is also a treatment for house pets and livestock that may be susceptible to bacterial infections from a variety of sources.

    • I don't know about this guy's compost pile, but I can tell you from my various attempts to sprout grapefruit seeds, that they do indeed rot (quite nastily) if conditions are too wet and the seed "drowns". OTOH, *NO* seed decomposes so long as it is still alive. So there's nothing unique about grapefruit seeds in this respect.

      However, you might look into apple seeds. When I was a kid, I discovered that a peeled and crushed apple seed held against a canker sore for 10 minutes would cause very rapid healing in 90% of cases. Maybe a cyanide compound of some sort, killing a specific pathogen, I dunno (never bothered to pursue it, no idea if anyone's researched it).

    • I discovered it when it was recommended to me for a nasty GI virus that wouldn't go away by normal starvation. Killed the sucker right off. As a nursing student I will be trying to bring this into any hospital I eventually work for.

      Please don't. I'm serious.

      As someone with medical training, you should KNOW that most diseases go away by themselves and there's no substitute for double-blind, placebo controlled studies to ascertain the efficacy of a given treatment. Please don't rip off poor people in their time of need by sending them to GNC to pay lots of money for various things that just don't work, and in some cases kill.

      Note that no links to peer-reviewed articles exist on the link you provide. Just assertions who all curiously use the commercial name of the product. Look at the broad range of things it claims to cure...missing only "the vapors" and "consumption" to be pure snake oil.

      A quick check of the FDA, however, reveals that these makers haven't bothered to put it to the test of actually trying to show it cures people instead of making outrageous claims:

      first letter [fda.gov]

      a href="http://www.fda.gov/cder/warn/cyber/cyber2002 .htm"> second letter

      And since the stuff you'll be foisting off on suffering, desperate people is unregulated, you won't even know that the brand they buy actually contains the advertised product, nor that it's safe.

      Hell, I don't know exactly why switching everyone in the middle east to purple robes wouldn't bring peace, except that nobody's shown even a correlation between purple-robe-wearing and sudden elimination of religious fanaticism (though it'd be fun to try on Pat Robertson in a study). Similarly, since no one has actually shown that the concoction you ingested (if it actually contained what its maker claims it did) had anything to do with your improvement. It's not as if all your white blood cells up and died, leaving it as the only thing between you and death.

      Please, go to pharmacy school if not getting a full MD before prescribing drugs, because that's exactly what you'll be doing if you recommend it to anyone.

      And that's just plain wrong.

  • by SysKoll ( 48967 ) on Tuesday November 12, 2002 @09:25PM (#4655879)

    Vancomycin-resistant staph is really bad news. Vancomycin was the last line of defense among antibiotics that have been tested. Its successors are very recent and might have side effects that haven't been detected yet. Not to mention that they are very expensive.

    That's one more reason why it's a bad idea to use antibiotic resistance genes as selection markers in genetically modified organisms (GMOs). The process goes like this: A researcher wants to splice, say, a sheep's wool-producing skin gene into common corn so that the GM corn will have wooly fibers (cheaper wool, great!). The researcher prepares thousand of modified cell cultures. The gene splicing has succeeded in only a small percentage of them. How does he select the cells with the spliced gene? Easy: He also splices another gene, coding for antibioresistance (ABR), and looks for its signature in the Petri dishes, using standard reagents.

    Then when the wooly corn is marketed, all its cells carry the same ABR gene. Eat the corn, and the bacteria in your guts get a chance to acquire the ABR gene from exposure to it. Then you get sick. The doctor prescribes antibiotics. All the E. Coli in your guts are killed, except the infinitesimal fraction that acquired this ANR gene. Then the surviving fraction repopulates your intestine. All your E. Coli population is now ABR. They will transmit the gene to some pathogene sooner or later.

    Understand me, I don't really think that GMO are evil. Some GMO are actually very good ideas. The problem is that implementation of the idea with selection through ABR is very dangerous. Look it up for yourself. [google.com]

    -- SysKoll
  • by freejung ( 624389 ) <webmaster@freenaturepictures.com> on Tuesday November 12, 2002 @09:48PM (#4655986) Homepage Journal
    I live in the tropics, and I and many others in this area have recently contracted a highly antibiotic-resistant strain of staph. It responds to antibiotics to some extent in some people, but in others antibiotics seem to have little effect. I know a guy who has had it for a year or more, his leg is half gone, he's been in and out of the hospital several times and he can't seem to get rid of it.

    I and many others have cured ourselves without antibiotics, and I want to tell you how. This by no means qualifies as official medical information, it's just what happened.

    Disclaimer: I am not a doctor and this is not a scientific analysis. This is just my story. It worked for me. If you have staph you should seek medical attention immediately. It's no joke, and even the doctors may not be able to help you.

    OK, if you have a weak stomach, stop reading now.

    First I should explain how staph attacks you, typically. Usually what happens is that you get a nick on your lower leg, and it just won't heal. Soon you have a festering infection which grows rapidly. It's amazingly efficient and agressive. It eats a sizable hole in your leg, and then starts to spread. You start getting pimples on other parts of your body which quickly grow and soon your are covered with round, dime or quarter-sized oozing festering holes. It's pretty horrifying. If you don't do something about it, you will end up with serious problems.

    I was infected for a couple of months, but I recovered without antibiotics, and many others have by using similar techniques. I have thought about the whole experience a lot, and I think I can identify the core elements of a successful staph cure. These elements can be divided into two main categories. First, you must have some kind of internal defense to prevent the spread of the staph through the bloodstream and the intercellular fluid. In the usual cure this is done by antibiotics, but these are losing their effectiveness. But fortunately your body comes equipped with an immune system for this purpose, but you must do everything you can to strengthen it and give it the advantage over the bacteria. Secondly, you must have some sort of external attack. This is the really horrible part. The staph burrows under the dead flesh it kills, making it extremely difficult to attack from the outside.

    Internal Defense

    • NO SUGAR!!! You must avoid sugar, starch if possible, fat, alcohol and cigarettes at all costs. Your life may actually depend on this, so don't try to cheat. This is the staph diet, and the staph will rigorously enforce it. Staph appears to feed on the sugar in the intercellular fluid, mostly in the fatty tissue just under the skin. When your blood sugar goes up, it goes crazy. One night I couldn't stand the sugar cravings any more and I ate 6 banannas. The next morning I woke up with 20 new sores starting. When I did finally get rid of it, it was only when I stopped eating sugar completely. Everyone who has had staph agrees on this. Avoiding sugar is the only way to stop getting new sores.
    • Bolster your immune system. Do anything you can to do this. Get lots of rest, drink lots of fluids, eat vitamin C and other antioxidants, do anything you can think of to strengthen your body's defense. Alcohol and tobacco weaken your immune system, and must be avoided. There are a number of local herbs which people say help, I can't really give evidence on these one way or another and besides they probably don't grow where you live.
    • Consider taking antibiotics anyway. I didn't, but sometimes they help somewhat even if they don't completely kill the staph. The resistant strain seems to have a higher survival rate, but it does still kill some of them. But taking antibiotics does not exempt you from the other elements of the cure, so don't even think about slacking off. Curing staph is a full time job, and you must give it your whole attention.

    External attack

    This can be divided into two phases. In the first phase, the staph colony is expanding into the flesh around it, and your attack must be very aggressive. In the second phase, your body has isolated the colony and built a membranous wall around it. Then the treatment must be very gentle.

    Phase one; Expanders:

    • This is the really horrible part, so brace yourself. The staph burrows under the dead flesh it kills, leaving a hard, tough gray scab. This material is incredibly strong, we should be using it in high tech aircraft design or something, it's amazing. This stuff must be removed by any means necessary. This is not fun. Some people take the leaves of a certain plant, boil them, take a handful and scrub the wounds hard until the scabs come off. This is horribly painful, and takes a long time because the leaves are soft. Some use a scrubby, brillo pad, or steel wool. This is even more painful, but is much faster. However, it does a lot of peripheral damage, which then gets infected. Personally, I used a razor blade, and just gouged that shit out of there. This is also horribly painful and takes a long time and is really really disgusting (the worst part is the smell of your own rotting flesh), but it is very precise and it works nicely. You must do this at least once a day, preferably twice or even three times. The staph grows fast.
    • Disinfectant. Once you have removed the dead flesh as completely as possible (you will know you have done this because when you get down to the living flesh it starts to bleed profusely, and it really starts to hurt like hell), you must disinfect the area thoroughly to kill as much of the colony as possible. This is just a numbers game. Exponential growth is a bitch. Some use hot water with a lot of salt, but I prefer hydrogen peroxide and chlorine, which are highly toxic and quite effective. Iodine for some reason seems to have little effect. Washing afterwards with antibacterial soap is also a good idea.

    During this phase, I think the wounds should be left open. This is to encourage them to ooze pus, which is actually a good thing because it establishes an outward flow of fluid and slows the staph down. The objective of this phase is to slow the growth of the colony enough for your body to build a membranous wall around it, isolating the infection from the intercellular fluid and allowing the healing process to begin.

    Phase 2; Contractors:

    You will know you have entered this phase when you stop finding so much dead flesh, and the colony slows its growth. At this point you build a wall around the infection, and within a couple of days the remaining dead flesh outside the wall should come off easily, without extensive scrubbing. Now you must change your approach:

    • Scrub the wounds gently with boiled Coralito leaves or a soft cloth. The idea is to remove the loose organic matter without damaging the wall.
    • Continue to disinfect after each scrub.
    • Cover the wound. The absolute best way to do this is to take this one kind of leaves called Coralito or Red Top, toast them to a fine powder over a low heat, and apply this powder to the wound after disinfecting. This hurts like hell for some reason but is very effective in drawing out the fluid and protecting the wound. In this phase the wound will ooze a lot. That's OK, even though it's pretty nasty.

    Gradually the wound will begin to shrink. You must stick with the treatment rigorously and stick to the diet mercelessly. The cases that go on and on are the ones where the person simply cannot force themself to avoid sugar, alcohol and cigarettes, and just keep getting new infections.

    Also, a note about clenliness. It's really important. You must clean and disinfect your entire environment completely all the time, especially your clothes and bedding. Do lots of laundry, take lots of showers, use chlorine liberally.

    Well, that about covers it. After two months of this horrible daily torture, I finally got a grip on my sugar consumption, cured my last big sore, and recovered. I have big scars on my legs to tell the tale, but I'm actually grateful for the experience. It builds a hell of a lot of will power, which is useful stuff.

    Good luck, and may the Force be with you.

  • by Cef ( 28324 ) on Tuesday November 12, 2002 @09:53PM (#4656012)
    So many people take anti-biotics for everything, and don't complete their prescribed courses, that people forget the other tried and true methods of helping your body and immune system fight a cold.

    1. Inhalation of steam and an antiseptic agent.
    Eucalyptus oil or Tea Tree oil in water, then heated/boiled is a great way to kill off bugs in the air. Very good for throat/nasal infections. Scented burners are good value for this.
    2. Acidic foods/liquids.
    This includes oranges, lemons, apples, grapefruit and tomato, including juices of those. Vinegar, particularly cider and malt vinegar, can be good if used as a mouth wash/gargle or ingested (if you can). Salt is also a good thing to ingest when ill, but as always, too much is bad for you. Yes, I am advocating salt'n'vinegar potato chips here. *grin*
    3. Mouth washes.
    Cider and malt vinegar work well, as does salt water. Iodine throat wash (commonly found under the "Betadine" brand) is also very good, but don't swallow it. Listerine and other mouth washes (for teeth care/plaque) are also good value. And brush your teeth too.
    4. Suppliments/herbal treatments.
    Echinacea, and other herbal suppliments can help, though be warned that some may have bad or deadly side affects for some people. Ginger is used lots in Chinese medicine, and is apparently quite good for helping someone overcome a cold, but some people are allergic to it. Vitamin suppliments are also good if you haven't been eating right, or can't keep a lot of food down.
    5. Fluids.
    The kidneys are a primary place for a virus to be flushed from the human body. Don't drink too much though, as it is possible to kill yourself from taking too much fluids.
    6. Regular wash/shower.
    Sweat is another way for fluids to leave the body, and regular washing helps remove some viruses.

    This is not a definitive list. But I'm hoping someone out there might find it useful. There are a lot of NATURAL ways to fight a cold. The goal is to help out the body. If that is by helping to remove the virus or most of the things the body fights against on a regular basis (air-born contaminants, throat bourne virii, etc), then you body will have more resources to chuck at other areas. Just think of the whole thing as a resource based game, where you are the resource. Remember though that too much of something can be bad though, so balance things out.

  • A few facts (Score:5, Informative)

    by mrpastry ( 625320 ) on Tuesday November 12, 2002 @10:01PM (#4656057)
    This story is a big deal because until recently vancomycin has been the one antibiotic microbiologists could reliably fall back on to treat MRSA. Resistance to all other antibiotics has been seen in S.aureus . It's also a big deal because Staphylococcus aureus (the SA in MRSA) is a pretty aggressive bug, unlike say VRE, which, though also effectively untreatable in some cases due to drug-resistance, are pertty weedy bugs that only affect a few very ill patients.

    MRSA strains with intermediate resistance to vancomycin have been seen in many parts of the world since 1996, and patients certainly have died as as result of vancomycin treatment failure. However, these perhaps weren't so scary as the resistance mechanism was a very thick cell wall which made these strains very slow growing and not so viable in the absence of vancomycin.

    What's new is that MRSA strains have now emerged with high-level vancomycin-resistance and this happened by acquistion of the vancomycin-resistance gene (vanA) from VRE. That this was possible was shown in the lab in 1992, but the first time it's been seen in patients was this year. The two reports of Vancomycin-resistant MRSA in the U.S. can be found in the CDC's newsletter:

    MMWR Morb Mortal Wkly Rep 2002 Oct 11;51(40):902

    MMWR Morb Mortal Wkly Rep 2002 Jul 5;51(26):565-7

    How scary is it? Until recently MRSA has been almost exclusively a hospital pathogen, so it's pretty scary if you're a hospital patient with a lot of tubes sticking into you which alow the bugs to get in and cause infections, but if you're well it's not a big threat (doctors and nurses can carry MRSA, but generally they don't develop infections despite a lot of exposure). There have been reports recently of strains of MRSA that do spread well in the community, and that can cause serious infections amongst essentially healthy people. However, these have not been multiply-resistant strains, and really these are no worse than virulent strains of normal S. aureus which have been round for millions of years. The message is, if you're well, don't rush out and buy cipro (this will only helps MSRA as the bugs are resistant to it), and if you're ill, keep away from hospitals.

    Just to rebut a few other comments: over-prescribing of antibiotics probably is very important for encouraging drug-resistantce, but even correct of use of antibiotics will lead to some resistance. Use of antibiotics in animal feed can't really be blamed in this case, as drugs of the same class as vancomycin (glycopeptides) have not been used in animal feed in the US, though they have in Europe. They've probably played a significant role in VRE transmission in humans in some European countries, but in the U.S. hospital prescribing of this and other antibiotics have probably been the driving force.

  • by ez76 ( 322080 ) <slashdot@@@e76...us> on Tuesday November 12, 2002 @10:31PM (#4656228) Homepage
    From Psalm 23:

    "Thy rod and thy staph shall come for thee."

    Clearly, the rod is the bacillus bacterium responsible for Anthrax, and the staph is the aureus.

What is research but a blind date with knowledge? -- Will Harvey

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