MRSA

RECENT POSTS

Mapping Antibiotic Resistance: Know The Germs In Your Neighborhood

By Dr. David Scales

You may have heard about Daniel Fells, the tight end on the New York Giants who almost lost his foot due to a drug-resistant infection. You’ve heard about drug resistant infections like Fells’ because dire reports about “the end of antibiotics” are all over, but maybe you want to know if resistant germs are common near you.

Unfortunately, you’re out of luck. While your hospital probably collects that data, they probably won’t share it with you.

John Brownstein, an associate professor at Harvard Medical School, and his colleagues at Boston Children’s Hospital (the group responsible for HealthMap.org), are working to make these data more available. They are tracking resistant bacteria through an online map called ResistanceOpen. The goal is to shed light on how much resistant bacteria is in your area and which antibiotics those bacteria are resistant to. (Full disclosure: I did my post-doc with HealthMap, leaving in 2013.)

Other groups track drug-resistant bacteria — like ResistanceMap put out by the Center for Disease Dynamics, Economics and Policy, based in Washington, D.C. — but it’s never been done at such a local level. ResistanceOpen provides data and information on four of the most dangerous types of resistant bacteria, including MRSA, the infection that Fells caught in his foot.

A screenshot from ResistanceOpen (Courtesy)

A screenshot from ResistanceOpen (Courtesy)

It’s not yet so detailed where you can get data on your local hospital, but currently you can search for information on which drug-resistant bugs are circulating in a 25-mile radius from your location, or any other location you choose. The hope is that if people know which resistant germs are in their area, it’ll help draw attention to the issue. One day, ResistanceOpen hopes to map data at the hospital level.

“I feel like antimicrobial resistance should be treated with the same urgency that other communicable diseases are met with and I believe it has to start with transparency and awareness,” Dr. Derek MacFadden, a Canadian infectious disease doctor who worked on the project, told HealthMap’s Disease Daily. “ResistanceOpen provides the public with both.”

While some of the data for the map comes from news reports about resistant bacteria, Dr. MacFadden, who is also a doctoral student at Harvard T.H. Chan School of Public Health, found much of the data for ResistanceOpen by scouring hospitals’ websites.

Hospitals routinely track antibiotic resistance on their wards and in their clinics. With that data they usually create a yearly “antibiogram” — a catalogue of bacteria found in patients treated at that hospital in the past year. Antibiograms help guide physicians at that hospital on how to treat patients by avoiding antibiotics that are unlikely to work. But antibiograms are not always public, so only the physicians (and patients) at that hospital benefit from the information. Continue reading

Added Fear Of Flying: Disease-Causing Bacteria Linger On Plane Surfaces

(Doug/flickr)

(Doug/flickr)

Add this to your lengthy list of flying-related miseries: disease-causing bacteria that live on airplane armrests, tray tables, toilet buttons and other surfaces can linger on and on — for up to an entire week.

This new data, with its off-the-charts gross factor, comes from scientists attending the annual meeting of the American Society for Microbiology. From the news release:

In order for disease-causing bacteria to be transmitted from a cabin surface to a person, it must survive the environmental conditions in the airplane. In the study Kiril Vaglenov, of Auburn University who presented the data, and his colleagues tested the ability of two pathogens, methicillin-resistant Staphylococcus aureus (MRSA) and E. coli O157:H7 to survive on surfaces commonly found in airplanes. They obtained six different types of material from a major airline carrier (armrest, plastic tray table, metal toilet button, window shade, seat pocket cloth, and leather), inoculated them with the bacteria and exposed them to typical airplane conditions.

MRSA lasted longest (168 hours) on material from the seat-back pocket while E. coli O157:H7 survived longest (96 hours) on the material from the armrest.

“Our data show that both of these bacteria can survive for days on the selected types of surfaces independent of the type of simulated body fluid present, and those pose a risk of transmission via skin contact,” says Vaglenov.

This research is laying the groundwork for important work to come.

“Our future plans include the exploration of effective cleaning and disinfection strategies, as well as testing surfaces that have natural antimicrobial properties to determine whether these surfaces help reduce the persistence of disease-causing bacteria in the passenger aircraft cabin,” says Vaglenov.

Why H1N1 Flu Proved Fatal In Some Healthy Children

You might be tempted to slack off on flu vaccines this year. You may have vaguely heard that the make-up of the vaccine is basically the same as last year’s, so maybe that’ll do it, right? And hey, H1N1 didn’t turn out to be as scary as it seemed at first, right?

Wrong. Well, right, in that H1N1 didn’t produce a death toll as high as originally feared. But how’s this for scary? H1N1 did take a mystifying toll among dozens of children who were otherwise healthy, and a new study out of Children’s Hospital Boston helps explain it: If a child was infected with Methicillin Resistant Staph Aureus, or MRSA, one of those “superbugs” helped along by our overuse of antibiotics, the child’s risk of death rose eight-fold.

MRSA was long thought of as a hospital problem, but it has spread out into the community, and a 2008 study found that the bug had “colonized” the noses of an average of 2 percent of children, with some populations showing a rate as high as 9%. Children are not routinely screened for MRSA. Do I want to take the chance that my child happens to be among the 9 percent? No, I do not. Do you? Forgive my nudging. I knew a brilliant, beatific boy who died suddenly at age 15 from the deadly combination of flu and MRSA.

The H1N1 study is just out in the journal Pediatrics — link to come when available. Here’s the New York Times take on it, and this from the Children’s press release:

Why did healthy children fall critically ill in the 2009 H1N1 flu pandemic?
Largest study to date finds co-infection with MRSA increased death risk 8-fold; flu vaccination urged

Boston, Mass. — During the 2009 H1N1 influenza pandemic, many previously healthy children became critically ill, developing severe pneumonia and respiratory failure, sometimes fatal. The largest nationwide investigation to date of influenza in critically ill children, led by Children’s Hospital Boston, found one key risk factor: Simultaneous infection with methicillin-resistant Staphylococcus aureus (MRSA) increased the risk for flu-related mortality 8-fold among previously healthy children.

Moreover, almost all of these co-infected children were rapidly treated with vancomycin, considered to be appropriate treatment for MRSA. The fact that they died despite this treatment is especially alarming given the rising rates of MRSA carriage among children in the community.

“There’s more risk for MRSA to become invasive in the presence of flu or other viruses,” says study leader Adrienne Randolph, MD, MsC, of the Division of Critical Care Medicine at Children’s Hospital Boston. “These deaths in co-infected children are a warning sign.”

The researchers hope their findings, published November 7 by the journal Pediatrics, (eFirst pages) will promote flu vaccination among all children aged 6 months and older. (No flu vaccine is currently available for children younger than 6 months.) Continue reading