Saturday, October 17, 2009

New Strains of MRSA: Are You Safe With Elective Surgery

By Dr. Richard E. Busch III

MRSA (Methicillin-resistant Staphylococcus Aureus ) is often called the "Super-Bug". MRSA is not a virus, it can be many strains of S. aureus bacteria and it is antibiotic resistant. A major concern about MRSA is the limited options for treatment, and now some sources of MRSA are outside of the hospital walls. Many studies are projecting over six million cases in 2010 - with a death rate of over 30% percent. MRSA could be considered a global plague. Most of us have heard about MRSA, and you may know someone who has been infected, and you may even know of someone who has died. There have been studies that have shown that 80% of tested common surfaces in hospitals, such as doors, walls, and elevator buttons, had evidence of MRSA. Some studies show a contamination rate as high as 64% of hospitals. MRSA is most likely to be contracted from hospitals (hospital-acquired infection). There is a continued effort to develop more antibiotics, but it is difficult because of its evolving resistance to more and more drugs.

MRSA was detected around 1945 (correlating with the development of penicillin), and it has become a significant problem in hospitals and nursing homes over the last 40 years. Obviously, many of the patients in these facilities are sick and their immune systems weakened and vulnerable. Those would include anyone who is in a hospital for surgery. MRSA in the early stages was treated by penicillin; however it soon tested resistant to penicillin, as well as many other antibiotics. MRSA cases identified in a healthcare setting are referred to as healthcare-associated MRSA (HA-MRSA).

A relatively new source of transmission of MRSA is the use computer keyboards since the implementation of computer technology in healthcare facilities. Proper hand-washing procedures and hygiene is critical since MRSA is predominately spread by hand-to-hand contact.

Since the mid-to-late 1990's, additional strains were identified as CA-MRSA (community-associated MRSA), and these were different because there were no healthcare settings involved from which to contract MRSA, and there were no risk-factors such as the injured, sick and immune compromised people. As these CA-MRSA infections were studied, it was determined that they were not caused by the healthcare-associated MRSA strain. According to a majority of research, MRSA occurs in our noses, and if it enters the body through injuries and open sores, then there is a possibility of fatal infections. Anyone can carry MRSA and never have a symptom, and it can be transmitted through contact with contaminated objects and surfaces such as keyboards, door knobs, and direct physical contact. Athletes who have sports contact, locker rooms, gyms, military recruits, and prisons are groups and areas where CA-MRSA is found to be more concentrated. The way to avoid contamination is to always use proper hand washing techniques, always bandage cuts and scrapes, and don't share any personal items such as towels and razors.

Headaches, fatigue, fever, swelling, pain and heat around an incision, wound or injury are common symptoms of MRSA. Infections that are more severe are in the joints, bones, surgical incisions, heart, lungs and bloodstream. Many times a bump on the skin will be dismissed as a spider bite. If it doesn't get better in 3-4 days and you have a fever and flu-like symptoms, this could be MRSA.

There is reporting of MRSA infecting horses, and these cases are on the increase. This is just one of several ways strains of MRSA are challenging the human and animal barrier. Studies have shown that MRSA can be passed from humans to horses and horses to humans. There is now a strain of MRSA (ST398) detected in pigs. Initially it was reported from the Netherland five years ago, and then, more recently, it was reported in Canada. Now it has been found in the US, although there is no clear proof that the infection can contaminate our foods or humans. If that should become a fact, that will further complicate the battle against MRSA. It is also been determined that our pets have a strain of MRSA, and again, there is no proof of this infecting people. In fact, it could be that humans are infecting their pets.

If you are contemplating surgery, most especially elective surgery, for conditions such as lumbar and cervical disc problems, you should research all your options and investigate nonsurgical treatment options, because one major surgery risk is the MRSA contamination of hospitals. Many hospitals do not screen for MRSA, although screening could be done. However, if a patient tested positive for MRSA, even without symptoms, they would be isolated and this could lead to longer hospital stays. From there we could have overloaded, understaffed facilities with less careful hand washing, and more exposure to infectious people.

About the Author:

No comments:

Post a Comment