A new study about antibiotic-resistant infections, known as methicillin-resistant Staphylococcus aureus, or MRSA, is getting a lot of media play.
The media seem captivated by the gee-whiz that this disease now causes more deaths in the U.S. than AIDS (18,000-plus versus 17,000-plus). And it seems a Virginia school system has been shut down because a student died. The officials are scrubbing the schools down hope hoping to avoid further problems.
As I read through the study in the Journal of the American Medical Association, three facts stood out to me:
1. Not only is MRSA likeliest to originate in hospitals, but if you get it, you have about a 20% chance of dying.
2. The chances of getting it are statistically quite high, according to the study: “The standardized incidence rate of invasive MRSA for calendar year 2005 was 31.8 per 100 000 persons. The incidence of other important invasive pathogens in 2005, such as invasive infections with S pneumoniae or Haemophilus influenzae, ranged from 14.0 per 100 000 to less than 1 per 100 000…”
3. MRSA may once have been a hospital-related matter, but according to the study “is a major public health problem and is primarily related to health care but no longer confined to acute care.” It’s much worse than previous studies from the Centers for Disease Control projected.
I couldn’t help but come up with a few questions as I read through the study:
n Since hospitals and doctors originated this apparently massive public health problem (presumably by over-using antibiotics), don’t they have some responsibility for cleaning it up? Isn’t it similar to manufacturers’ responsibility for cleaning up toxic dump sites?
n What if consumers of raw milk got sick at the same rate as hospital patients? And what if 20% of those who got sick died? What would happen to the dairies with this kind of record? I think I know: their animals would be slaughtered and the farmers imprisoned, and we consumers couldn’t venture within 50 miles of one of these places.
n Should hospitals be quarantined? Required to post prominent warnings and alert prospective patients that they have a significant chance of dying from MRSA? I mean, where’s the disclosure here?
n What’s the relationship in this epidemic between health-immune function and susceptibility to MRSA?
The “problem” in the view of the media and medical authorities is the same as that affecting the spinach and burgers with E.coli 0157:H7: poor sanitation. I was just watching ABC Nightline, which reported on the student who died in Virginia, and the students and parents are up in arms because the school supposedly wasn’t clean enough. If the school was cleaner, the student wouldn’t have died. So now they’re putting sanitizing gel in each class. And (I swear this happened), the Nightline segment was followed up by an ad for a "Mr. Clean" product. So everyone makes out here.
Not a word is ever uttered in the studies and media reports about nutrition and immune function. Nothing, as many of the comments on my Monday post highlight, about the connections between good health and carbs, refined sugar, fermented foods, sprouted grains, and other such matters.
I think Steve Atkinson in his comment gets at an important part of the problem when he states, “The medical worldview is concerned with the symptoms and cure of disease, not with health.” The MRSA plague says to me that we’re getting the symptoms much faster than Big Pharma can come up with band aids that even look like cures.
Every day I have gone to work for the past 10 years, as a nurse, I have been exposed to MRSA or some other bug. I’ve been exposed to VRE (vancomycin resistant enterococcus, for which there is no cure). I am not sick; nor are my coworkers. I have to empty infected urine and stool; enter rooms of people who cough; take their vital signs – and daily.
Hospitals are regulated more than a farm will ever be, and doctors do go to jail; as do nurses. It is a profession where your actions are always in question. Facilities get shut down. There is a huge shortage of doctors and nurses because it aint no easy job.
There is no shortage of food.
Hospitals have oodles of regulations on infection control. Farms have few in comparison. For example, farmers do not have be be inserviced yearly on MRSA, handwashing, TB, bloodborne pathogens, personal protective equipment and HIPPA laws.
Farmers like their penicillin. I once questioned its prevalant use in a goat forum, and came under attack quickly. In the past 2 years, the number of community acquired MRSA infections I have personally seen has been impressionable. There was even an article in a nursing magazine I subscribe to about it. Doctors have taken to calling such carbuncles, "spider bites." My baby went to the ER with one a few months ago. They are acquired outside of the hospital with no apparent medical involvement.
I believe that despite this study blaming hospitals, that one day it will come out that MRSA is caused by antibiotics in our food. There are other studies on MRSA that haven’t been made so public. I’d love to see one involving factory farms. That is why I like to raise our own food, and our own raw milk.
Quaranteening hospitals and comparing them to the inappropriate handling of farms by the USDA is absurd from my point of view, although I do understand your point, David. People who acquire MRSA infections are generally sick to begin with however. In fact, I speak from 10 years of experience when I say that most people in hospitals are sick. If you quaranteen all facilities with MRSA, you will have no place to go when you are sick, for treatment by a licensed M.D. or D.O.. Then what?
Do you have a plan to rewrite the established healthcare system? If so, please elaborate. The nurses and doctors left – the tough ones still in the game who take the abuse – have developed an attitude…that if you don’t want help from us, go home. That is always an alternative.
I’m sorry if that sounds too brash, but it is the reality of the matter as it stands. I am all for alternatives. The USDA and the healthcare system are different entities. It isn’t people penicillin that is a legal over-the counter drug. But they have pretty big bottles of it at Tractor Supply Store.
Gwen Giffen
There is also C-Diff that can run rampant in nursing homes and also spread like wildfire in hospitals. It causes code browns and you have to suit up in your lovely yellow isolation gowns,etc.
Did you know that nurses are supposed to wash their hands when they enter the patients room and then again before they leave that room? I know many facilities use that sanitizer foam,you squirt the foam on your hands and rub it in, most people do not cover all the hand’s areas and the chemicals in the foam are harsh and cause skin breakdown, which leads to potential infection in the nurse and/or spreading her germs to other patients. If the foam does not cover all areas, then it will not kill all the bacteria(good old soap and water works best),I agree that sanitation (or lack there-of) is the leading cause of spread.On the night shift, many facilities only have one or 2 housekeepers for the entire facility working. They are supposed to clean the rooms in a specified amount of time. They are spread very thin thus making it impossable to clean correctly. If you go into a facility, look at the bed rails, the overbed table legs, IV pole, the bedside table.. and the bathroom..the floors, if tile, are mopped with a nasty mop, if carpeted (I don’t know who the fool is who thought to put carpet in a hospital)the carpets harbor bacteria (People let their kids crawl around on those nasty floors).
The reasons for the increased resistance has been known for years, yet nothing has changed The chemicals are still used and the bacteria still become resistant.
Common sense says healthy eating leads to a healthy immune system….
Well now; If the big pharmacy cured anything, they wouldnt be making the big $$$. Cure isnt used much, the key word is treat. Healthcare is big business, the almighty dollar is most important to them, not the patients.
In the case of MRSA, It does colonize the nasal passages of even healthy people and is common in ICU patients as some one pointed out.
C. dif DOES come in the front door in younger and younger people with only one exposure to antibiotics. I even see it now in infants.
Norovirus is another emerging problem. We had a horrible time with it in Virginia last winter with literally hundreds ill. What a mess in the ED!
I don’t think David is being critical of hospitals, but it is time to focus attention on real microbial threats instead of fabricated ones.
I love the quote from Dr. Mendelsohn. I immediately googled him and ordered his book. I am from three generations of physicians and have to agree with his premise.
I was involved in studies in the mid 70s at the University of Wisconsin that clearly demonstrated the prevalence of drug resistant enteric bacteria in the feces of poultry and pigs fed antibiotics. These and other data became part of the movement to ban antibiotics from animal feed, since many of the bacteria could be passed on to humans. The government and business promoted widespread use of these drugs, as growth enhancers, was a clear disconnect between policy and sound science. I should mention that we saw a prevalence in animal feces; however, by low level and continual selection using antibiotics you can isolate antibiotic resistant organisms from just about any source-in or outside of hospitals. The explosive growth of an infection comes when competing microbial flora are killed off by antibiotic treatment, or when someone becomes immunocompromised.
It was during the 70s that big Pharma began to move away from investing in infectious diseases research. I remember sitting through meetings where arguments were made that the major pathogenic bacteria were in check because of the number of effective antibiotics on the market. There were many heated argumentsand again a clash of science versus business. Promoted over-use resulted in the rise of resistant organisms and later increases in investment in the quest for more effective antibiotics.
In the mid 90s, I was part of a team (Emerging Infectious Diseases Research) that discovered the FIRST NEW CLASS of antibiotics in almost 30 years that specifically killed gram-positive pathogens. The oxizolidinones hopefully will never have to become widely available. The significance here is that there have been no new classes of antibiotics discovered in decades. We understand the mechanisms for drug resistance, and transmission down to the molecular level, and even the genetics that control and regulate these phenomena. We can even create mutant strains through various processes. Healthcare professionals are now well versed in resistance issues. Yet, still despite scientific and pragmatic understanding-there are policies and cultural habits that facilitate the rise of resistant strains and promote the spread of infectious agents (including viruses).
Good husbandry not only is important in controlling parasites in my pastures-it extends to how we deal with all aspects of our lives.
You can access the CDCs Journal of Emerging Infectious Diseases on line http://www.cdc.gov/ncidod/eid/ if you have an interest in many of the common-reemerging diseases as well as new infectious diseases.
I meet monthly with a group of physicians, physical therapists, and athletic trainers to discuss contemporary research in sports medicine. Yesterdays meeting covered skin infections. There are a number of interesting issues here relevant to Davids post, but one in particular is worth exploring because it points out just how dominant the status quo is.
Several of the studies we looked at noted that drug-resistant infections are increasing. (One of the most widely appreciated is methicillin-resistant staph aureus, or MRSA, which is now moving from nosocomialhospital-acquiredto community-acquired). The question around the table: What do we do about it?
For my part I brought along a CDC report of a well-referenced presentation by Dr. Stuart B. Levy of Tufts University School of Medicine, called Antibacterial Household Products: Cause for Concern. Heres a great line from the reports summary:
Scientists are concerned that [Antibacterial Household Products] will select bacteria resistant to them and cross-resistant to antibiotics. Moreover, if they alter a person’s microflora, they may negatively affect the normal maturation of the T helper cell response of the immune system to commensal flora antigens; this change could lead to a greater chance of allergies in children. As with antibiotics, prudent use of these products is urged.
Dr. Levys report clearly and effectively made the case that hyper-sanitization can both create a more pathogenic environment and weakened immune systems. I figured that that information, along with some discussion of the better-understood notion that liberal antibiotic use has similar negative effects, would turn a small tide. But the consensus opinion at the end went the other way: We ought to be using suppressive therapy to control skin infections in athletes. That means prophylactic antibiotic useantibiotics when there is no sign of infection. In other words, what we need is more of the same thing thats making everybody sick to begin with.
I had been working in the pig pen fixing their house. I got a small scrape from a pig mud laden nail, not a big deal, but I wanted to clean it well. Previously I had gotten a very bad scratch on the palm of the same hand from a mean rooster I was wresting to tame.
So I came into the house and washed my hands vigorously for 20 seconds. I scrubbed them with a brush (yikes, on recollection it almost seems OCD…lol) and then rinsed and dried my hands. Then, because of the scrape from the rooster, I poured hydrogen peroxide on my hands and was absolutely shocked at the amount of bubbling that went on. My hands weren’t clean?
My daughter-in-law uses that gel sanitizer all the time and has, as I’ve mentioned before, trained her 3 year old to use it many times over the course of the day. I emailed her and asked if she would wash her hands for vigorously for 20 seconds then use the gel then pour on hydrogen peroxide and report the results to me. She said that the only place on her hands where the hydrogen peroxide bubbled was under her wedding ring.
I’m not sure what it means but it is interesting.
He was transferred from ICU into a regular room and immediately got a bad staph infection. He then proceeded to be in the hospital for a month, and his kidneys almost failed because they couldn’t seem to be able to kill it until they used some sort of old time antibiotic that almost killed him, too.
Long story short, he got out a month and a half later and now his pancreas is a mess. He was never given any probiotics!
Moral of story: do not go to hospital? Ah well.
Also, another three people on the same floor as him got the same thing.
There was a very scary article in Esquire a few months back. It was about the superbug – not sure if it was MRSA – and Iraqui veterans as well as hospitalized soldiers. If you can, find it and read, if you are interested. It was harrowing.
Basically: the bugs are fighting a war of their own. The one outlined in the article was a bug that learns from other bugs – and borrows their survival techniques.
I also believe that extreme hygiene and city living have contributed to decreased resistance of people in general. When you are a child, playing in the dirt and being dirty in general actually makes you healthier in the long run: I guess the bugs that live in you and fight the bad guys either make friends with them, or learn of them and figure out how to repel them down the line. The whole antibacterial soap thing is, forgive my french, ******t;-)
As for hand washing, most people do not wash their hands well enough to remove all bacteria. . Henwhisper, you used a brush, was it new? Did it have prior germs on it? And the towels, were they fresh, washed and unused? Was the water hot, cold, warm? One persons perception of vigorous washing may be completely different than another. Tap water can have bacteria in it also. I would guess that your hands were clean.
http://www.cdc.gov/nceh/vsp/cruiselines/hand_hygiene_general.htm <~~It states to wash for "at least" 20 seconds.
http://en.wikipedia.org/wiki/Hand_washing
http://www.mayoclinic.com/health/hand-washing/HQ00407
I still believe plain old soap and water are best. Everyone has Staph (along with other microbes) on their skin. You cannot sterilize your skin, only clean it. I would think, if all the normal flora was killed off, that would leave you more susceptible to overgrowth of certain other flora. For example; You take antibiotics for sinus infection and you end up with an overgrowth of Canidas (Yeast) in your intestines. The antibiotics killed the flora that kept the yeast under control, now the yeast is causing havoc with your guts. There needs to be a balance of the normal flora.
Speaking as a mom, obygn’s can and do spread Beta Strep ,which mom’s by protocol are given IVs during labor, is spread by having numerous pelvic checks and lack of handwashing.
Medicos need to admit the wrong done and change. MRSA should not exist especially as an epidemic in the public arena.
A big problem today is diseases that are resistant to antibiotics. We as a society over use antibiotics so germs are becoming stronger. Then there is also the overuse of hand sanitizers and antibacterial soaps.
We also need to take personal responsibility for our health and build up our immunities with proper sleep,eating well,and avoiding toxic lifestyles.