Tuesday, January 15, 2008

Is it now time for hysteria?

This about does it for me. I'm not leaving the house, going to the gym or touching anyone ever again. These bugs are evolving faster than our ability to retaliate. My own non-medically educated opinion? Within five years, they will have wiped out the human race, leaving a very quiet planet with the exception of beeping smoke detectors wanting their batteries changed and then giving up. It certainly does alter one's long-range financial planning. From the Wall Street Journal:

Resistance of Superbug Grows
New MRSA Strain
Hits Communities
Of Gay Men Hardest
January 15, 2008; Page D5
A highly drug-resistant superbug is gaining resistance to more drugs and burrowing deeply into the gay communities of San Francisco and Boston, researchers said.

Sexually active gay men are 13 times as likely to have this strain of the highly resistant bacterium, known as MRSA, or methicillin-resistant staphylococcus aureus.

More worrisome still, the new strain of MRSA called USA300 is growing resistant -- or unresponsive -- to three or even four classes of widely used antibiotics.

MRSA causes deep and stubborn skin infections and has been called the most common cause of skin infections treated in the nation's emergency rooms. It also more rarely can cause lethal invasive infections such as pneumonia or sepsis (blood poisoning).

Several drug classes that have lost their punch against the worsening strain include families that contain: penicillin, erythromycin, clindamycin, tetracycline and fluoroquinolone drugs such as Cipro, said Binh Diep, researcher at the University of California at San Francisco and first author of the study in the Annals of Internal Medicine.

The toughest strain also now is resistant to mupirocin, a topical antibiotic drug used to clear MRSA from the skin surface and nostrils where the bug is known to colonize even people without an infection.

The study emerged from a retrospective review of charts from 183 patients treated for MRSA at the San Francisco General Hospital's Positive Health Program, an outpatient clinic used by people with HIV, the virus that causes AIDS. An additional 130 patients were studied at Boston's Fenway Community Health clinic.

The review of charts found gay men age 18-35 to be hardest-hit. ZIP Codes around San Francisco's Castro District, a largely gay neighborhood, were heavily affected. Previously, MRSA infections have been documented in sports teams, prison populations, gym-goers and the community at large.

Skin-to-skin contact, including sexual relations, are believed to be major ways the bug spreads from person to person. But Henry "Chip" Chambers, chief of infectious diseases at SF General and a study co-author, said heavy antibiotic use is "the most important factor" that the superbug's toughest strain resides among gay men.

Unlike resistant infections of the past, which thrived mainly in hospitals, MRSA runs rampant through the community and can crop up in people with no recent antibiotic use.

"It's more virulent than standard staph," said Shelley Gordon, an infectious-disease specialist in private practice at California Pacific Medical Center. To avoid using the wrong drug and fueling even more resistance, she urged testing for drug resistance, adding, "doctors in emergency settings have to be hip to this and do cultures."

Write to Marilyn Chase at marilyn.chase@wsj.com


Homer said...

Marilyn uses the word "bug" to describe the bacteria. Very professional.

riot said...

Oy vey. It's the media again, as usual. There is absolutely no cause for hysteria.

I had community-based MRSA a year and a half ago. My doctor in Chelsea immediately recognized it, treated it correctly, and it was gone in a couple weeks. It was very painful but hardly deadly. I missed no work.

I know at least a half dozen guys in NYC who have had it in the past couple years. None of them are close so they all got it from different sources. Like me, none of them was likely infected through sex.

It's more likely we got it at the gym. Do gay men in urban areas use gyms more than average? I don't have any studies but I'd wager they do.

Community-based MRSA has been common for a while and has always been resistant to the classes of antibiotics mentioned. Increased resistance in the class mentioned in the article is not a huge deal as an educated health care provider wouldn't start with that class.

There other options for treatment, such as silver, which is highly effective. silverlon.com

Common sense and good hygiene will reduce your risk and cure your infection, if necessary. Pay attention to your body and educate yourself. Don't give in to media-induced panic. And don't go running to your doctor for antibiotics you don't need every time you get a cold.

On a positive note, when you need a sensational and alarmist article on a slow news day, MRSA is a reliable source!

David said...

Good Lord, is EVERYONE going to freak out about this? I for one plan to change my gym-going habits not one iota. Oh, and SARS is going to kill us all, too. What ev.

St. Sebastien of the Dunes said...

Here in Texas, it 'lives' on the AstroTurf, showing up amongst high school students in high numbers. Hmm, maybe I should start an AstroTurf steam cleaning business??????


Atari_Age said...

I already blogged about my semi-hystera. I'm kinda over it now. This is being badly reported with not enough information. For anyone to do anything but be afraid. Now I'm just pissed.

henry said...

I hope that Project Runway is going to pick this up. I have absolutely nothing to wear for the brave new world and need inspiration on how to dress appropriately for les bugs. Some kind of full-body condom with self-decontamination feature. Maybe Apple will come out with an i-suit.

Stash said...

Having been inflicted with MRSA three times in the past four years, I don't look forward to the next recurrence whensoever that may be.

All of the previous encounters were from the gym.

It's no picnic.