More on MRSA....new study

Hillbilly · #1 01-21-2008, 02:29 PM

there is an article in today's NYT® that reports that the MRSAUSA300 is a major health threat.

After Linking New Strain of Staph to Gay Men, University Scrambles to Clarify
By JESSE McKINLEY

SAN FRANCISCO — In a matter of days, it jumped from a routine press release to a medical controversy.

On Monday, a team of researchers led by doctors from the University of California at San Francisco announced that gay men were “many times more likely than others” to acquire a new strain of drug-resistant staphylococcus, a nasty, fast-spreading and potential lethal bacteria known as MRSA USA300. And sure enough, the study, published online in the Annals of Internal Medicine, was quickly picked up by reporters round the world and across the Internet, including a London tabloid which dubbed the disease “the new H.I.V.”

Since this is a copyrighted article, I cannot produce it here...go to
http://www.nytimes.com/2008/01/20/us...gewanted=print

For the complete article.

HOW is this related to the DR?
1) We talked about it in relation to DrChrisMD and her spider bites. Cobraboy mentioned a bout of this from contaminated gym equipment, and we have gyms here.
2) There is sizable homosexual population in the DR that do read these pages and should know about the risks.

HB

margaret · #2 01-21-2008, 05:47 PM

Difficult-to-Treat Staphylococcal Infections in Men Who Have Sex with Men -- , -- Annals of Internal Medicine

If you listen to the interview with one of the authors, towards the end of the interview he suggests hygiene (soap and water) as the key to preventing the spread of this bacteria.

Annals of Internal Medicine - Home

Doctors who are treating hard to treat skin infections will need to consider the "contact sport" of the patient and do a culture.

This is all due to the over prescribing of anitibiotics by physicians and patients who stop taking them once they feel better. These bugs are smarter than we are, they keep evolving.

KeithF · #3 01-22-2008, 12:06 AM

Quote:

Originally Posted by Hillbilly

t
http://www.nytimes.com/2008/01/20/us...gewanted=print

"One of the major sore points for some critics..."

Was that really the best turn of phrase?

I was talking to Dominican about two years ago, trying to explain about MRSA. They had just bought some 'over the counter' antibiotics that would be prescription only in the UK. They bought four days supply because 'they knew' that would clear their sore throat up. And it did. They didn't know that this was a perfect environment for the infection to become resistant.

Our fault in the 'developed world' for over prescribing in the first place but then for not trying harder to educate people in the rest of the world. We got MRSA first, but you guys are going to be least prepared for dealing with it.

PS It is cultured by otherwise healthy people, mainly in the nose and arm-pits. In the UK we are finally introducing "deep cleaning" to try and combat it. About four years ago the way to deal with MRSA was to 'stop routine screening'... if you stop looking for something, you stop finding it... I kid ye not.

cobraboy · #4 01-22-2008, 08:37 AM

Beyond the actual disease, the problem with MRSA coming to the DR is that EVERY method of treating it is incredibly expensive, far, far beyond the ability of most Dominicans to pay for it, and prolly so much that health insurance plans may be reluctant to pay for it.

The only oral medication for it, Zyvox, cost me $2200 for a two week regimine. The other drugs are IV only and cost as much as $1000 a day; eveinif 1/3 the cost in the DR, that is still seriously expensive. Even the generic Zyvox was nearly $1000, and the efficacy is unknown.

It's some bad mojo, folks.

KeithF · #5 01-22-2008, 09:30 AM

What you have got going for you is lots of fresh air & sunshine and an 'outside' culture. MRSA lives on healthy people but clears from them quite easily in fresh air. Also soap & water are cheap, prevention rather than cure.

The problems begin when it gets into wounds or people who are otherwise vulnerable get it. And there you are correct, it's hard to shift and costs a lot.

I always knew gyms were an unhealthy idea anyway, when did you last hear of someone getting MRSA from a beach bar? Same with hospitals, people die there all the time. If I get ill, take me to the supermarket, I've never heard of anyone dying in a supermarket.

cobraboy · #6 01-22-2008, 10:16 AM

Quote:

Originally Posted by KeithF

What you have got going for you is lots of fresh air & sunshine and an 'outside' culture. MRSA lives on healthy people but clears from them quite easily in fresh air. Also soap & water are cheap, prevention rather than cure.

The problems begin when it gets into wounds or people who are otherwise vulnerable get it. And there you are correct, it's hard to shift and costs a lot.

I'm not sure research backs this up. Most folks have immunity to common staph, but not MRSA because it has genetically changed. The MRSA bacteria lives in the nostrils. It looks for a skin opening. When it gets there, it takes the body of a healthy person a while to build a defense. By then it can go nuts.

Gyms and athletic team locker rooms are generally populated by the healthiest among us, and those are places where it is beginning to run rampant.

On the positive side of the DR MRSA balance sheet, folks there have not been innundated by antibiotics all their lives, so possibly staph strains there have not become methicillin resistant.

Hillbilly · #7 01-22-2008, 10:19 AM

I can appreciate KeithF's sense of humor...as well as his anecdote regarding the over the counter sale and inadequate use of antibiotics. This is a land where the antibiotic resistant strain of TB has found its home!!.

However, those costs quoted by Cobraboy are truly incredible.

Let's hope that the use of soap and water gets a big play....

HB

I did not see this go up just before mine:

"On the positive side of the DR MRSA balance sheet, folks there have not been innundated by antibiotics all their lives, so possibly staph strains there have not become methicillin resistant.

And I have to disagree heartily! Here every Tom, Dick and Pedro go to Pharmacies to get antibiotics for coughs, colds and anything that they feel pooly from....(sorry for the convoluted grammar)...This is a nation of medicine takers, mostly self-prescribed!!!!! OMG! This is staph heaven...

cobraboy · #8 01-22-2008, 10:35 AM

Quote:

Originally Posted by Hillbilly

And I have to disagree heartily! Here every Tom, Dick and Pedro go to Pharmacies to get antibiotics for coughs, colds and anything that they feel pooly from....(sorry for the convoluted grammar)...This is a nation of medicine takers, mostly self-prescribed!!!!! OMG! This is staph heaven...

Good point.

Yikes...

I'm curious: when you take a "physical" for your residencia (Chest X-ray and blood test), what are they looking for?

planner · #9 01-22-2008, 11:02 AM

I agree with HB. I watched a man in the pharmacy ask for a "cipro" - just one because he had a headache. When I asked him why this he told me last time I had a headache this made it go away!

Most likely it was the glass of water he washed it down with that made the headache go away! It definately was NOT the cipro. Of course they do not understand this.

Self medicating and over medicating is rampant here.

drloca · #10 01-22-2008, 11:30 AM

Quote:

Originally Posted by cobraboy

Good point.

Yikes...

I'm curious: when you take a "physical" for your residencia (Chest X-ray and blood test), what are they looking for?

Generally, and I cant comment on the DR specifically, the screening physical for immigration/residencia is to rule out TB (chest xray) and STD's (syphilis) in the blood work as well as HIV.