Lessons from across the pond – Part 1

OK….aside from a lot of obligatory introductory babbling in my first post we’ve at least established that MRSA is an acronym describing strains of the bacteria Staphylococcus aureus that have become resistant to commonly used antibiotics. MRSA has become a pretty hot topic in the last few years – who wouldn’t be concerned about a “deadly superbug” that can strike man, woman, and child with almost no warning?

Well if you think you hear about it often here in North America, you should travel to the United Kingdom sometime and experience a whole new level of concern over MRSA and antibiotic resistant infections. Across the pond MRSA awareness isn’t limited to the healthcare profession and those who have been personally affected. On the contrary, MRSA outbreaks are rabidly covered in the media and its not at all uncommon for an MRSA-related headline to jump off the front pages of major London daily newspapers. Is this a byproduct of an overly sensational news media and a jumpy, easily influenced public? Take a look at the following statistics and you tell me….

  • While the number of annual deaths in the UK due to non-resistant bacterial infections remained relatively flat from 1993 to 2005, fatalities attributed to MRSA infections increased dramatically over this time leading to a >300% increase in overall death rate due to bacterial infection (source: UK National Office of Statistics)
  • The number of MRSA bacteremias (ie. bloodstream infections) reported in the UK between 2000 and 2004 increased by 25% (source: UK Health Protection Agency)
  • MRSA accounted for 25% of all surgical site infections in the UK between 2000 and 2005 (source: UK Health Protection Agency)
  • In 2007, 36% of all UK Staphylococcus aureus isolates were resistant to methicillin (data collected by the European Antimicrobial Resistance Surveillance System)

Seems to me the public had every right to become concerned about MRSA in the face of these kinds of numbers. When an antibiotic resistant organism is suddenly accounting for fully one quarter of your country’s post-surgical infections, you’d better start thinking about Plan B for taking care of patients and assuring safe care in your hospitals.

Now notice the fact that all the statistics I’ve quoted above are a few years or more old, dealing with MRSA trends only in the late 90’s and first half of the current decade. Is this an oversight? Could I only find old public data? Am I hiding something? Am I just lazy?…..

Truth is, given the magnitude and long-term timeline of the trends I noted above, you won’t believe what’s happened in the UK since 2008. Next week I’m going to focus on how things changed, what the UK healthcare system did to actually change them, and how this relates to what’s coming for us North Americans….

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6 Responses to “Lessons from across the pond – Part 1”

  1. Yvonne Odell says:

    I was diagnosed with MRSA in my blood in 2002, yet when they do a nose swab, it always comes back negative for MRSA, even if I have an active return of the Cellulitis/Staph that showed the MRSA. I read on one medical site that in 30% of patients who have MRSA infections in their extremities, often get a negative on their nose swab. Is this correct? I get so sick and tired of having a cotton swab barely used on the inside of my nose, yet if they would check my medical records at the hospital where it showed up first in a lab test, then confirmed in a hospital test as I had MRSA in my blood. I then read on a medical site, a nose swab does not always test positive for someone who has had active MRSA infections, especially on a yearly basis in my right hand. Is that true?

    Thanks for any info.
    Sincerely,
    Yvonne Odell

  2. Cale Street says:

    Hi Yvonne, thanks for the post. It is quite widely accepted that the nose is the primary (but certainly not the only!) reservoir for MRSA colonization. Some researchers in the field have even suggested that all people who have MRSA colonization or infection will be co-colonized in the nose, and that sustained decolonization of MRSA from the nose will lead to natural disappearance of the bacteria in all other body sites. Still others, however, have reported small numbers of cases like yours in which an active infection exists but the nasal swab comes up negative. There are several newer studies that suggest that the throat is another major MRSA colonization site, and it could be possible that you have the bacteria there rather than in your nasal passages. Its probably more likely though that you are what clinicians call a “transient carrier”. This means that you will be colonized with MRSA at some times, but that the bacteria will seem to disappear at other times and your swabs will read negative. Brief periods of nasal/body colonization may in fact precede your frequent hand infections, but by the time you go to the clinic and get swabbed it may have already disappeared again.

    Either way, I can understand it must be very frustrating to keep getting the same standard test and have it come up negative while continuing to get periodic infections! We’re still learning a lot about how MRSA lives in and on people, and it certainly doesn’t behave the same way in one person as it does in another. Good luck to you in overcoming these infections and getting back to a normal life.

    Cale

  3. Barb says:

    yes MRSA stands for metaphormin resistant Staphylococcus aurelius bacteria metaphormin is the most potent antibiotic us humans have there is no stronger antibiotic there for any one who catches MRSA has a very difficult time getting rid of the bacteria .. theres also c difficile which is also very dificcult to get rid of and the most offending places to catch these super bugs is hospital yes you read right hospitals are the worst offenders for MRSA and C difficile Infections of patients

  4. Barb says:

    another nasty bug that you can catch at the hospital is flesh eating bacteria that bacteria usually leads to amputations because it eats away flesh and blood vessels and multiplies very quickly once person is infested with it

  5. Lessons from across the pond part 1.. He-he-he :)

  6. Kodjovi says:

    my friend has had C Dif for 6 mnohts and has been prescribed one antibiotic after another. Can you recommmend an effective probiotic for this condition. She’s desperate!

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