Posted by: Chris Maloney | October 25, 2011

Forget MRSA, Fear VRSA

Scanning Electron Micrograph of Vancomycin Res...

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For those of you living in total health, the term MRSA may be unfamiliar.  It stands for methicillin-resistant S. aureus, a common nasal inhabitant that first developed antibiotic resistance in 1961. Since then, it has toured the globe and gone out into the community.  Periodically I’ll hear that a patient has been diagnosed with MRSA by their doctor, and many patients describe shame similar to having herpes.  But chances are very high that their infection was given to them by another health-care worker or even the doctor himself.

MRSA is so common now it is part of the territory.  It can be deadly if not caught in time, but there are still antibiotics that can be used.  One of these is VancomycinVancomycin is old school, introduced in 1958 with all the relevant side effects from that era.  But it is back because we need it.

The bugs have figured out who the real enemy is.  Slowly VRSA is spreading, and that means you go to the hospital for an infection and there is nothing they can do.  There are other compounds in trials, but we’re losing ground on this one.

How does VRSA spread?  The same way MRSA does, through your health care workers.  A little gift from your local hospital.

The awareness of MRSA And VRSA is one of the reasons I became an N.D. instead of an M.D.  I foresaw a time when antibiotics no longer worked for the majority of infections.  What might work?  Some herbs that can’t be patented.  Check out the ability of common garlic extract to take out MRSA below.

Br J Biomed Sci. 2004;61(2):71-4.

Antibacterial activity of a new, stable, aqueous extract of allicin against methicillin-resistant Staphylococcus aureus.

Source

University of East London, School of Health and Bioscience, Stratford Campus, Romford Road, London E15 4LZ, UK. r.cutler@uel.ac.uk

Abstract

The increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals and the community has led to a demand for new agents that could be used to decrease the spread of these bacteria. Topical agents such as mupirocin have been used to reduce nasal carriage and spread and to treat skin infections; however, resistance to mupirocin in MRSAs is increasing. Allicin is the main antibacterial agent isolated from garlic, but natural extracts can be unstable. In this study, a new, stable, aqueous extract of allicin (extracted from garlic) is tested on 30 clinical isolates of MRSA that show a range of susceptibilities to mupirocin. Strains were tested using agar diffusion tests, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Diffusion tests showed that allicin liquids produced zone diameters >33 mm when the proposed therapeutic concentration of 500 microg/mL (0.0005% w/v) was used. The selection of this concentration was based on evidence from the MIC, MBC and agar diffusion tests in this study. Of the strains tested, 88% had MICs for allicin liquids of 16 microg/mL, and all strains were inhibited at 32 microg/mL. Furthermore, 88% of clinical isolates had MBCs of 128 microg/mL, and all were killed at 256 microg/mL. Of these strains, 82% showed intermediate or full resistance to mupirocin; however, this study showed that a concentration of 500 microg/mL in an aqueous cream base was required to produce an activity equivalent to 256 microg/mL allicin liquid.

PMID:
15250668

 

Infect Control Hosp Epidemiol. 2001 Sep;22(9):560-4.

 

Contamination of gowns, gloves, and stethoscopes with
vancomycin-resistant enterococci.

 

Zachary KC, Bayne PS, Morrison VJ, Ford DS, Silver LC, Hooper DC.

 

 

Source

 

Infectious Disease Division Massachusetts General Hospital, Boston
02114-2696, USA.

 

 

Abstract

 

OBJECTIVE:

 

[corrected] To measure directly the rate of contamination, during
routine patient examination, of gowns, gloves, and stethoscopes with
vancomycin-resistant enterococci (VRE).

 

SETTING:

 

A large, academic, tertiary-care hospital.

 

PATIENTS:

 

Between January 1997 and December 1998, 49 patients colonized or
infected with VRE were entered in the study.

 

DESIGN:

 

After routine examination, the examiner’s glove fingertips, gown (the
umbilical region and the cuffs), and stethoscope diaphragm were pressed onto
Columbia colistin-nalidixic acid (CNA) agar plates with 5% sheep blood plus
vancomycin 6 pg/mL. The stethoscope diaphragm was sampled again after cleaning
with a 70% isopropanol wipe.

 

RESULTS:

 

VRE were isolated from at least 1 examiner site (gloves, gowns, or
stethoscope) in 33 (67%) of 49 cases. Gloves were contaminated in 63%, gowns in
37%, and stethoscopes in 31%. All three items were positive for VRE in 24%. One
case each had stethoscope and gown contamination without glove contamination.
Only 1 (2%) of 49 stethoscopes was positive after wiping with an alcohol swab.
Contamination at any site was more likely when the patient had a colostomy or
ileostomy. Patients identified by rectal-swab culture alone were as likely to
contaminate their examiners as were those identified by clinical specimens.

 

CONCLUSIONS:

 

Our study revealed a high rate of examiner contamination with VRE. The
similar risk of contamination identified by surveillance and clinical cases
reinforces concerns that patients not known to be colonized with VRE could
serve as sources for dissemination. Wiping with alcohol is effective in
decontaminating stethoscopes.

 

 

PMID: 11732785

Wonderful article on this subject at:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946685/?tool=pubmed

“There are only limited drugs available for the treatment of
VRSA. Quinupristin-dalfopristin and linezolid are two of the newer
antimicrobial agents currently available with activity against drug-resistant
staphylococci (including most VISA and VRSA strains in vitro). Though
cross-resistance has not been noted for linezolid, isolates have known to
developresistance during therapy. Daptomycin, a bactericidal agent that damages
the cytoplasmic membrane, is undergoing clinical trials.[78] Other agents in
the pipeline include modified glycopeptides, carbapenems, oxazolidinones,
quinolones and tetracyclines. But as they are still in the developmental
stages, it will take almost a decade for new drugs to be launched. Avoiding
irrational use of antibiotics and having rational antibiotic policy is the only
way forward till then.”

 


Responses

  1. […] I’ve written previously about my fear of VRSA, which is when nothing works to kill that bacteria.  If you want more on that, here’s the blog post. […]


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