John Colson
Aspen, CO Colorado|Aspen Times
December 30, 2007
ROARING FORK VALLEY — Colorado and local public health officials say they don’t know the extent of reportedly increasing infection rates inside rural hospitals around the state, other than to concede that the rates are generally, if slowly, rising.
Laws are being passed in other states to require public data collection about hospital-acquired infections, in particular new strains of antibiotic-resistant bacterial infections.
Critics of existing health care policies nationwide are demanding that the new rules and techniques be adopted throughout the country to combat what they say is a particularly virulent and dangerous disease, known as MRSA.
In Colorado, however, data collection regarding MRSA (formally named Methicillin-Resistant Staphylococcus Aureus) is required only in Denver County. And Colorado is not one of the states that has adopted stringent new guidelines aimed at curbing the spread of MRSA in hospitals, nursing homes and other health care facilities.
“It is a persistent pathogen and it is out of control in most of the [U.S.] health care system,” declared Dr. Barry Farr, professor emeritus at the University of Virginia, and one of several nationally respected physicians tracking the MRSA phenomenon.
New infection control guidelines in several states in the U.S., as well as in European countries and other regions of the world, are requiring that hospitals screen all “at risk patients” and follow stringent measures to fight the spread of bacteria and disease.
The main enemy in this war is MRSA, although there are other bacteria and germs of concern. Together they amount to what some observers believe is a serious and worsening health care crisis in this country.
Dubbed a “superbug” by some, MRSA is the antibiotic resistant form of Staphylococcus Aureus, or S. Aureus, a type of staph infection that researchers believe has been around as long as humans have walked the earth.
It was not until the latter half of the 20th century that staph bacteria began developing resistance to treatment by antibiotics, particularly methicillin, which was commonly used to treat staph infections in hospitals.
The bacteria lives harmlessly on a person’s skin, and in nasal passages. Most infections result in skin problems ranging from pimples to boils. But the more serious complications from MRSA infections — most commonly in hospitals — are happening much more often, experts say.
And it is in hospitals around the country that the MRSA incidence is reaching what some experts say alarming, if not crisis proportions, causing serious diseases that can result in lengthy hospital stays, the amputation of limbs and even death.
An Illinois woman, Jeanine Thomas, founder of the MRSA Survivors Network and advocate for state and national legislation to combat the disease, writes on her Web site that she contracted an MRSA infection during ankle surgery in 2000. The infection went into her bone marrow, leading to seven surgeries to save her leg from amputation. She said she has spent 17 months out of the past five years in a sick-bed dealing with secondary infections, and still has health concerns.
Thomas, working with others, convinced the Illinois state legislature to pass laws requiring mandatory screening of “at-risk” patients for MRSA before they enter a hospital. “At-risk” means patients coming from nursing homes, or those headed to the intensive care unit, among other definitions.
Highly critical of health care officials who downplay the dangers of MRSA and similar pathogens, she said, “They always like to look like they’re doing something, but they’re doing nothing [in many areas]. We are where we are because of their inaction.”
In 1980, MRSA reportedly accounted for only 2 percent of all S. Aureus hospital-acquired infections reported in 300 hospitals that were part of a CDC study. More recently, MRSA is estimated to account for more than 60 percent of S. Aureus infections, according to an article in the February, 2006 edition of the magazine, “Infection Control Today.”
Across the U.S., advocates are calling for tighter monitoring of the resistant strains and much closer observance of what are known as “active detection and isolation” techniques aimed at cutting the incidence of MRSA-type infections.
Farr was a medical internist at UVA in the early 1980s, he said, when the university hospital detected rising MRSA rates and instituted “active detection and isolation” methods to keep the disease in check.
The measures include rigorous enforcement of rules on hand washing, the meticulous cleaning of equipment and hospital rooms, the use of gowns and disposable aprons to prevent doctors and nurses from spreading germs on clothing, and the testing of incoming patients to identify and isolate those carrying the bacterium.
Farr told an interviewer in 2004 that studies show that health care workers only wash their hands between patients about 40 percent of the time.
The measures have been formalized into guidelines published in 2003 by the Society for Healthcare Epidemiology of America (SHEA), authored largely by William R. Jarvis, MD, of Emory University School of Medicine, president of Jason and Jarvis Associates, and a former official of the Center for Disease Prevention and Control [CDC].
The measures worked, Farr said, and have been adopted in other selected parts of the country, including the states of Illinois, New Jersey and Pennsylvania. But unless all states, meaning all hospitals, nursing homes, VA facilities, and other health care centers begin following the same methods, MRSA infection rates will continue to grow, he believes.
As an example, Farr said, medical officials in Western Australia recently adopted the “active detection and isolation” methodology in response to rising MRSA infection rates, and the rates declined. But other parts of Australia did not follow suit, “so they spectacularly failed” to curb the disease, he said, and MRSA spread back into Western Australia.
He said some European nations, including the Netherlands and Denmark, have made it a national priority to follow the “active detection and isolation” guidelines.
Locally, hospital and community health officials say there is no requirement by the Colorado Department of Public Health and Environment to enumerate or report MRSA infections. The result, these officials say, is that there is no data on how many patients who are carriers of the bacteria, or “colonized,” as medical professional term it, are admitted to hospitals.
Hospital officials in Aspen and Glenwood Springs recently have said their best option for controlling what they admit is a growing problem is to educate the public on different personal hygiene techniques, such as washing hands frequently and avoiding the use of towels, washcloths or sports equipment that has been used by someone else.
Within the halls of local hospitals, where patients are known to contract “hospital-acquired MRSA,” the standard procedures involve isolating the patient from others, and instituting sterile-room rules requiring that everyone, both hospital staff and visitors, don gowns and gloves before entering the patient’s room to avoid picking up and carrying the bacteria into other parts of the facility.
But according to Farr and others, such measures are typically viewed as a last resort and only come into play when hospital staff learns through general testing that a patient suffers from a MRSA infection. And that, he maintains, may well be too late both for that patient and to stop the possible spread of infection.
Roughly 94,000 Americans contracted life-threatening MRSA infections, and more than 18,600 of those died in the U.S. in 2005, roughly 2,600 more than died of AIDS or HIV that year, according to the CDC. The CDC estimates that perhaps 1 percent of the U.S. population is “colonized” by MRSA bacteria and capable of spreading it to others.
At least 1 percent of Americans are carrying the bacteria on their skin, but few of them get sick, Gershman said.
Sunday, December 30, 2007
Saturday, December 29, 2007
SV hospital seeing rise in community acquired MRSA cases
By Dana Cole
Herald/Review
Published on Friday, December 28, 2007
Hand washing is extremely important now more than ever. SIERRA VISTA — Know as Methicillin-resistant Staphylococcus aureus, or MRSA, this staph infection is extremely resistant to most antibiotics.
It has become one of the country’s most common causes of skin infection and is considered a rapidly emerging public health problem.
At one time MRSA was known as the “Hospital Superbug.”
“That’s because it was found in hospitals, nursing homes and other health care facilities,” said Ann Kuhl, infection control coordinator for Sierra Vista Regional Health Center. “But in recent years, we have seen a community acquired form of MRSA. In fact, the number of community acquired cases has jumped exponentially in the past five years.”
More than half of all MRSA cases seen at the Sierra Vista hospital are the community acquired form and have nothing to do with the hospital, Kuhl said.
“The two types look and act differently, so it’s easy for us to track,” she added. “The community acquired MRSA manifests as a skin infection and often starts out as a small red lesion that grows quickly and is generally localized.”
While hospital-associated MRSA was first identified in 1968, the community acquired form is fairly new, Kuhl said.
There are steps that can be taken to reduce the incidence of community acquired MRSA infections.
“Good hygiene is key,” Kuhl stated. “Wash your hands regularly, with soap. All open cuts or sores need to be kept clean.”
The smallest scrapes, paper cuts, animal scratches, as well as open skin lesions, are an invitation for MRSA infections. “Staph, in general, if you give it a way to enter into the body, can become a big problem,” Kuhl warns. “We just can’t emphasize thorough and frequent hand washing enough. Hand sanitizers are very effective.”
Taking basic contact precautions and keeping home environments clean also are imperative for good infection control. Clusters of community acquired MRSA skin infections have been documented in athletes participating in contact sports, military recruits, IV drug users and prisoners. Other risk factors include close skin-to-skin contact, exposure to contaminated items and surfaces and crowded living conditions.
The bacteria Staphylococcus aureus is present in many people and typically causes no problems. It’s estimated that about a third of the population carry it in the nose, throat and on the skin. But if it gets inside the body, such as under the skin, it can cause serious, potentially fatal infections. If staph infects the lungs, it can cause pneumonia.
“Staphylococcus aureus becomes a health problem when it’s resistant to commonly used antibiotics,” Kuhl said. “Staphylococcus aureus that is resistant to Methicillin is MRSA.”
More than 50 percent of the staph isolates seen by SVRHC are resistant to the usual antibiotics that are used to treat them, Kuhl said.
While most healthy people will never become seriously ill from this bacteria, it can be a health threat for young children, the elderly and people with weakened immune systems. Despite documented risk factors, Kuhl warns there are no patterns when it comes to community acquired MRSA, which further emphasizes the need for everyone to take extra precautions.
The hospital is planning a three-month-long MRSA prevention campaign, an educational program that all 800 hospital employees will be required to attend.
“We’re using this program as a reminder for our staff, emphasizing the importance of good hand hygiene and why we need to take extra precautions,” Kuhl said. “When a patient comes in with MRSA, it’s our policy to take special precautions when working with that person.”
Herald/Review
Published on Friday, December 28, 2007
Hand washing is extremely important now more than ever. SIERRA VISTA — Know as Methicillin-resistant Staphylococcus aureus, or MRSA, this staph infection is extremely resistant to most antibiotics.
It has become one of the country’s most common causes of skin infection and is considered a rapidly emerging public health problem.
At one time MRSA was known as the “Hospital Superbug.”
“That’s because it was found in hospitals, nursing homes and other health care facilities,” said Ann Kuhl, infection control coordinator for Sierra Vista Regional Health Center. “But in recent years, we have seen a community acquired form of MRSA. In fact, the number of community acquired cases has jumped exponentially in the past five years.”
More than half of all MRSA cases seen at the Sierra Vista hospital are the community acquired form and have nothing to do with the hospital, Kuhl said.
“The two types look and act differently, so it’s easy for us to track,” she added. “The community acquired MRSA manifests as a skin infection and often starts out as a small red lesion that grows quickly and is generally localized.”
While hospital-associated MRSA was first identified in 1968, the community acquired form is fairly new, Kuhl said.
There are steps that can be taken to reduce the incidence of community acquired MRSA infections.
“Good hygiene is key,” Kuhl stated. “Wash your hands regularly, with soap. All open cuts or sores need to be kept clean.”
The smallest scrapes, paper cuts, animal scratches, as well as open skin lesions, are an invitation for MRSA infections. “Staph, in general, if you give it a way to enter into the body, can become a big problem,” Kuhl warns. “We just can’t emphasize thorough and frequent hand washing enough. Hand sanitizers are very effective.”
Taking basic contact precautions and keeping home environments clean also are imperative for good infection control. Clusters of community acquired MRSA skin infections have been documented in athletes participating in contact sports, military recruits, IV drug users and prisoners. Other risk factors include close skin-to-skin contact, exposure to contaminated items and surfaces and crowded living conditions.
The bacteria Staphylococcus aureus is present in many people and typically causes no problems. It’s estimated that about a third of the population carry it in the nose, throat and on the skin. But if it gets inside the body, such as under the skin, it can cause serious, potentially fatal infections. If staph infects the lungs, it can cause pneumonia.
“Staphylococcus aureus becomes a health problem when it’s resistant to commonly used antibiotics,” Kuhl said. “Staphylococcus aureus that is resistant to Methicillin is MRSA.”
More than 50 percent of the staph isolates seen by SVRHC are resistant to the usual antibiotics that are used to treat them, Kuhl said.
While most healthy people will never become seriously ill from this bacteria, it can be a health threat for young children, the elderly and people with weakened immune systems. Despite documented risk factors, Kuhl warns there are no patterns when it comes to community acquired MRSA, which further emphasizes the need for everyone to take extra precautions.
The hospital is planning a three-month-long MRSA prevention campaign, an educational program that all 800 hospital employees will be required to attend.
“We’re using this program as a reminder for our staff, emphasizing the importance of good hand hygiene and why we need to take extra precautions,” Kuhl said. “When a patient comes in with MRSA, it’s our policy to take special precautions when working with that person.”
Friday, December 14, 2007
CDC and other health groups ask public to consider dangers of antiobiotic resistance
While viruses cause colds and the flu, taking antibiotics for a virus may do more harm than good.
That’s why the Centers for Disease Control and Prevention, along with other health advocates, are asking that during this cold and flu season people consider the dangers of antibiotic resistance. A course of antibiotics won’t fight the virus, make the patient feel better, yield a quicker recovery or keep others from getting sick.
In fact, antibiotic resistance, which is associated with the recent news reports of methicillin-resistant Staphylococcus aureus, or MRSA, is among the growing public health concerns in the world.
Antibiotic resistance occurs when bacteria change or adapt to treatments. That reduces or eliminates the effectiveness of drugs designed to cure or prevent infections. Public health officials have been increasingly outspoken about how widespread inappropriate use of antibiotics has fueled an increase in antibiotic-
resistant bacteria.
Here are tips from the CDC:
Do not demand antibiotics when a healthcare provider says they are not needed. They will not help treat your infection.
Do not take an antibiotic for a viral infection like a cold, a cough, flu or acute bronchitis.
When you are prescribed an antibiotic, do not skip doses or stop taking the medicine early.
Do not take antibiotics prescribed for someone else. Taking the wrong medicine may allow bacteria to multiply.
Prevent the spread of infections through frequent hand washing.
Talk with your healthcare provider about antibiotic resistance.
That’s why the Centers for Disease Control and Prevention, along with other health advocates, are asking that during this cold and flu season people consider the dangers of antibiotic resistance. A course of antibiotics won’t fight the virus, make the patient feel better, yield a quicker recovery or keep others from getting sick.
In fact, antibiotic resistance, which is associated with the recent news reports of methicillin-resistant Staphylococcus aureus, or MRSA, is among the growing public health concerns in the world.
Antibiotic resistance occurs when bacteria change or adapt to treatments. That reduces or eliminates the effectiveness of drugs designed to cure or prevent infections. Public health officials have been increasingly outspoken about how widespread inappropriate use of antibiotics has fueled an increase in antibiotic-
resistant bacteria.
Here are tips from the CDC:
Do not demand antibiotics when a healthcare provider says they are not needed. They will not help treat your infection.
Do not take an antibiotic for a viral infection like a cold, a cough, flu or acute bronchitis.
When you are prescribed an antibiotic, do not skip doses or stop taking the medicine early.
Do not take antibiotics prescribed for someone else. Taking the wrong medicine may allow bacteria to multiply.
Prevent the spread of infections through frequent hand washing.
Talk with your healthcare provider about antibiotic resistance.
Manure Management Reduces Levels Of Antibiotics And Antibiotic Resistance Genes
ScienceDaily (Dec. 3, 2007) — Antibiotic resistance is a growing human health concern. Researchers around the globe have found antibiotics and other pharmaceuticals to be present in surface waters and sediments, municipal wastewater, animal manure lagoons, and underlying groundwater. Researchers at Colorado State University (CSU) describe a study to find out if animal waste contributes to the spread of antibiotics and antibiotic resistance genes (ARG), and if they can be reduced by appropriate manure management practices.
In the study researchers investigated the effects of manure management on the levels of antibiotics and ARG in manures. The study was conducted at two scales. In the pilot-scale experiment, horse manure was spiked with the antibiotics chlortetracycline, tylosin, and monensin and compared to horse manure that was not spiked with antibiotics to determine the response of ARG in unacclimated manures. In the large-scale experiment, dairy manure and beef feedlot manure, which were already acclimated to antibiotics, were monitored over time.
The manures were subjected to high-intensity management (HIM-amending with leaves and alfalfa, watering, and turning) and low-intensity management (LIM-no amending, watering, and turning) for six months. During this time, the levels of antibiotics were monitored using high-performance liquid chromatography (HPLC) and tandem mass spectrometry (MS/MS). In addition, two types of ARG that confer resistance to tetracycline, tet(W) and tet(O), were monitored using quantitative polymerase chain reaction (Q-PCR).
In the pilot study, chlortetracycline, tylosin, and monensin all dissipated more rapidly in the HIM-manure than in the LIM-manure. In the large-scale study, feedlot manure initially had higher concentrations of the several tetracycline antibiotics than the dairy manure. After four months of treatment, tet(W) and tet(O) decreased significantly in dairy manure, but two more months of treatment were necessary for similar reductions of ARG in the feedlot manures.
The results showed that HIM was more effective than LIM at increasing the rate of antibiotic dissipation, but it was not a significant factor in reducing the levels of ARG. The length of treatment time was the main factor in reducing the levels of both antibiotics and ARG. For manures with initially high levels of antibiotics, treatment times of at least six months may be necessary for a significant reduction in levels of antibiotics and ARG. The results also provided evidence that ARG may be present for extended time periods even after antibiotics have fully dissipated.
Scientists at Colorado State University are continuing research in this area by examining full-scale local on-farm waste management practices. Together this research will lead to a better understanding of possible ARG mitigation strategies so that best management practices can be developed to reduce the effects that animal waste may have on the spread of ARG.
This research was published in the November-December issue of Journal of Environmental Quality. Funding was provided by the USDA Agricultural Experiment Station at CSU and the National Science Foundation (NSF).
Adapted from materials provided by American Society of Agronomy.
In the study researchers investigated the effects of manure management on the levels of antibiotics and ARG in manures. The study was conducted at two scales. In the pilot-scale experiment, horse manure was spiked with the antibiotics chlortetracycline, tylosin, and monensin and compared to horse manure that was not spiked with antibiotics to determine the response of ARG in unacclimated manures. In the large-scale experiment, dairy manure and beef feedlot manure, which were already acclimated to antibiotics, were monitored over time.
The manures were subjected to high-intensity management (HIM-amending with leaves and alfalfa, watering, and turning) and low-intensity management (LIM-no amending, watering, and turning) for six months. During this time, the levels of antibiotics were monitored using high-performance liquid chromatography (HPLC) and tandem mass spectrometry (MS/MS). In addition, two types of ARG that confer resistance to tetracycline, tet(W) and tet(O), were monitored using quantitative polymerase chain reaction (Q-PCR).
In the pilot study, chlortetracycline, tylosin, and monensin all dissipated more rapidly in the HIM-manure than in the LIM-manure. In the large-scale study, feedlot manure initially had higher concentrations of the several tetracycline antibiotics than the dairy manure. After four months of treatment, tet(W) and tet(O) decreased significantly in dairy manure, but two more months of treatment were necessary for similar reductions of ARG in the feedlot manures.
The results showed that HIM was more effective than LIM at increasing the rate of antibiotic dissipation, but it was not a significant factor in reducing the levels of ARG. The length of treatment time was the main factor in reducing the levels of both antibiotics and ARG. For manures with initially high levels of antibiotics, treatment times of at least six months may be necessary for a significant reduction in levels of antibiotics and ARG. The results also provided evidence that ARG may be present for extended time periods even after antibiotics have fully dissipated.
Scientists at Colorado State University are continuing research in this area by examining full-scale local on-farm waste management practices. Together this research will lead to a better understanding of possible ARG mitigation strategies so that best management practices can be developed to reduce the effects that animal waste may have on the spread of ARG.
This research was published in the November-December issue of Journal of Environmental Quality. Funding was provided by the USDA Agricultural Experiment Station at CSU and the National Science Foundation (NSF).
Adapted from materials provided by American Society of Agronomy.
Teacher Dies from Staph Infection
ROCKVILLE, Md. -- A Rockville teacher died Sunday evening due to complications from a virulent form of staph infection.
Merry King, 48, was a special education teacher at Herbert Hoover Middle School.
School officials said the 48-year-old had been absent from Hoover since Nov. 30 and hospitalized since early last week.
King's daughter, Charlotte Oliver, told school officials her mother had been in a coma and died five days later of complications from a methicillin-resistant Staphylococcus aureus, or MRSA, infection.
"We're not really certain when or how she picked it up," Oliver said. "She may have had it for a while. By the time she checked into the hospital it was so acute that there wasn't a lot they could do."
"Ms. King was a beloved staff member and students in her class will be deeply affected by her death," said Hoover Middle School Principal Billie-Jean Bensen, in a letter sent home with students.
Bensen said there is no indication King's illness was related to her work at the school and there is no reason to believe anyone there has an increased risk of contracting MRSA.
The classroom in which King worked was sanitized with bleach, News4's Megan McGrath reported. Common areas at the school are scheduled to be sanitized Tuesday night. Officials said they do not believe there is a threat to students, staff or faculty at the school.
As King's family copes with the loss, they are also disinfecting the teacher's home.
Students learned of her death on Monday and said they were very upset by it.
Officials said there were grief counselors on hand at the school.
In a letter sent home to parents, the school's principal expressed condolences and at the same time moved to reassure parents that their children are safe.
As parents dropped their children off at school Tuesday, many said they were not worried about their children contracting the disease.
The Montgomery school system has had 43 cases in 31 schools this school year, primarily among student athletes, said Kate Harrison, a spokeswoman for the Montgomery County school system. There are currently only four active cases among county students. Harrison said King's case was believed to be the first since August involving a teacher.
Dozens of cases of the infection have been reported in the Washington region, but exact figures are not available because doctors are not required to report MRSA to state health authorities.
An estimated 90,000 people in the United States fall ill each year from MRSA. It is not clear how many die from the infection; one estimate put it at more than 18,000, which would be slightly higher than U.S. deaths from AIDS.
Merry King, 48, was a special education teacher at Herbert Hoover Middle School.
School officials said the 48-year-old had been absent from Hoover since Nov. 30 and hospitalized since early last week.
King's daughter, Charlotte Oliver, told school officials her mother had been in a coma and died five days later of complications from a methicillin-resistant Staphylococcus aureus, or MRSA, infection.
"We're not really certain when or how she picked it up," Oliver said. "She may have had it for a while. By the time she checked into the hospital it was so acute that there wasn't a lot they could do."
"Ms. King was a beloved staff member and students in her class will be deeply affected by her death," said Hoover Middle School Principal Billie-Jean Bensen, in a letter sent home with students.
Bensen said there is no indication King's illness was related to her work at the school and there is no reason to believe anyone there has an increased risk of contracting MRSA.
The classroom in which King worked was sanitized with bleach, News4's Megan McGrath reported. Common areas at the school are scheduled to be sanitized Tuesday night. Officials said they do not believe there is a threat to students, staff or faculty at the school.
As King's family copes with the loss, they are also disinfecting the teacher's home.
Students learned of her death on Monday and said they were very upset by it.
Officials said there were grief counselors on hand at the school.
In a letter sent home to parents, the school's principal expressed condolences and at the same time moved to reassure parents that their children are safe.
As parents dropped their children off at school Tuesday, many said they were not worried about their children contracting the disease.
The Montgomery school system has had 43 cases in 31 schools this school year, primarily among student athletes, said Kate Harrison, a spokeswoman for the Montgomery County school system. There are currently only four active cases among county students. Harrison said King's case was believed to be the first since August involving a teacher.
Dozens of cases of the infection have been reported in the Washington region, but exact figures are not available because doctors are not required to report MRSA to state health authorities.
An estimated 90,000 people in the United States fall ill each year from MRSA. It is not clear how many die from the infection; one estimate put it at more than 18,000, which would be slightly higher than U.S. deaths from AIDS.
Montgomery Village Student Diagnosed With MRSA
MONTGOMERY VILLAGE, Md. -- A student at Montgomery Village Middle School has been diagnosed with MRSA, an antibiotic-resistant strain of staph infection.
The student is the first at the school to be diagnosed with methicillin-resistant Staphylococcus aureus, school officials said.It's the 43rd case in the Montgomery County school system this year.
School officials said the student is being treated and is attending class, News4's Jane Watrel reported.
Principal Edgar E. Malker and school nurse Maureen Reges released a statement urging families of students at the school to practice good hygiene and check skin regularly for lesions.
Merry King, a middle school special education teacher in Potomac, died earlier this week from MRSA.
The Montgomery school system has had 43 cases in 31 schools this school year, primarily among student athletes, said Kate Harrison, a spokeswoman for the Montgomery County school system.
Health officials said MRSA is not found only in schools, but also in places like rec centers and health clubs.
Dozens of cases of the infection have been reported in the Washington region, but exact figures are not available because doctors are not required to report MRSA to state health authorities.
Health officials said basic hygiene can prevent the spread of the disease. Washing hands and clothes and not sharing personal articles are the best safeguards, they said.
An estimated 90,000 people in the United States fall ill each year from MRSA. It is not clear how many die from the infection; one estimate put it at more than 18,000, which would be slightly higher than U.S. deaths from AIDS.
The student is the first at the school to be diagnosed with methicillin-resistant Staphylococcus aureus, school officials said.It's the 43rd case in the Montgomery County school system this year.
School officials said the student is being treated and is attending class, News4's Jane Watrel reported.
Principal Edgar E. Malker and school nurse Maureen Reges released a statement urging families of students at the school to practice good hygiene and check skin regularly for lesions.
Merry King, a middle school special education teacher in Potomac, died earlier this week from MRSA.
The Montgomery school system has had 43 cases in 31 schools this school year, primarily among student athletes, said Kate Harrison, a spokeswoman for the Montgomery County school system.
Health officials said MRSA is not found only in schools, but also in places like rec centers and health clubs.
Dozens of cases of the infection have been reported in the Washington region, but exact figures are not available because doctors are not required to report MRSA to state health authorities.
Health officials said basic hygiene can prevent the spread of the disease. Washing hands and clothes and not sharing personal articles are the best safeguards, they said.
An estimated 90,000 people in the United States fall ill each year from MRSA. It is not clear how many die from the infection; one estimate put it at more than 18,000, which would be slightly higher than U.S. deaths from AIDS.
Lyme Arthritis Study Sheds Light On Antibiotic Resistance And Persistent Joint Inflammation
Lyme disease in the U.S. is caused by a form of bacteria, the spirochete Borrelia burgdorferi, infecting humans by tick bites. It typically begins with a bull's-eye skin rash, accompanied by fever, muscle aches, or other flu-like symptoms. If diagnosed early, Lyme can be treated successfully within a month with either oral or intravenous antibiotics. Nearly 60 percent of patients who do not receive antibiotic therapy early in the illness develop intermittent or persistent arthritis, particularly affecting the knees. Moreover, a small percentage of Lyme patients who do receive antibiotic therapy suffer from persistent arthritis for months or even several years after 2-3 months of oral and intravenous antibiotic therapy. This confounding condition has been termed antibiotic-refractory, or slowly resolving, Lyme arthritis.
To gain insights into the survival of spirochetes following antibiotic therapy, researchers at the Center for Immunology and Inflammatory Diseases at Massachusetts General Hospital, Harvard Medical School, and the National Center for Infectious Diseases at the Centers for Disease Control and Prevention teamed up to study antibody responses to Borrelia burgdorferi in patients with antibiotic-refractory or antibiotic-responsive Lyme arthritis. Presented in the December 2007 issue of Arthritis & Rheumatism , their findings indicate that joint inflammation persists in patients with antibiotic-refractory Lyme arthritis after the disease-spreading spirochetes have been killed.
To compare antibody responses and determine their effect on Lyme arthritis, the team tested at least 3 blood serum samples each from 41 patients with antibiotic-refractory arthritis, 23 patients with antibiotic-responsive arthritis, and 10 non-antibiotic-treated controls - arthritis patients who had contracted Lyme disease during the late 1970s before the cause of the disease was known. Samples were obtained during the period of arthritis and sometimes after several months of remission for all patient groups. The patients with antibiotic-refractory and antibiotic-responsive arthritis had a similar age range, sex distribution, and duration of arthritis prior to antibiotic therapy.
All samples were tested for IgG reactivity with Borrelia burgdorferi bacteria and 4 outer surface lipoproteins of the spirochete. Among non-antibiotic-treated patients, antibody titers to Borrelia burgdorferi remained high throughout a prolonged period of persistent arthritis, 2 to 5 years. In contrast, in patients with antibiotic-responsive arthritis, the level of antibody titers to Borrelia burgdorferi and most outer-surface proteins remained steady or decreased within the first 3 months of starting antibiotic therapy. Consistent with this finding, these patients usually experienced relief from joint swelling during a 1-month course of oral antibiotics. In patients afflicted with antibiotic-refractory arthritis, the level of antibody titers to Borrelia burgdorferi and most outer-surface antigens increased slightly during the first 1 to 3 months of treatment. These patients suffered from persistent joint swelling for a median duration of 10 months, despite 2 to 3 months of oral or intravenous antibiotics. However, by 4 to 6 months after starting antibiotic therapy, antibody titers declined to similar levels in both antibiotic-treated groups, regardless of their differences in arthritis symptoms.
"In Lyme disease, there is a great need for a test that could be used in clinical practice as a marker for spirochetal eradication," observes Dr. Allen C. Steere, the senior author of the study. Yet, as he acknowledges, ridding the body of the Borrelia burgdorferi bacteria and its surface antigens does not always bring relief from arthritis. "Increasing antibody titers in patients usually suggested the presence of live spirochetes, whereas declining titers suggested that they had been killed," he notes. "Thus, patients with Lyme arthritis who have a sustained, gradual decline in antibody reactivity probably have the nearly complete or total eradication of spirochetes from the joint as a result of antibiotic therapy, even if joint inflammation persists after the period of infection."
----------------------------
Article adapted by Medical News Today from original press release.
----------------------------
Article: "Antibody Responses to Borrelia burgdorferi in Patients With Antiobiotic-Refractory, Antibiotic-Responsive, or Non-Antibiotic-Treated Lyme Disease," Priya Kannian, Gail McHugh, Barbara J.B. Johnson, Rendi M. Bacon, Lisa J. Glickstein, and Allen C. Steere, Arthritis & Rheumatism, December 2007.
Source: Amy Molnar
Wiley-Blackwell
To gain insights into the survival of spirochetes following antibiotic therapy, researchers at the Center for Immunology and Inflammatory Diseases at Massachusetts General Hospital, Harvard Medical School, and the National Center for Infectious Diseases at the Centers for Disease Control and Prevention teamed up to study antibody responses to Borrelia burgdorferi in patients with antibiotic-refractory or antibiotic-responsive Lyme arthritis. Presented in the December 2007 issue of Arthritis & Rheumatism , their findings indicate that joint inflammation persists in patients with antibiotic-refractory Lyme arthritis after the disease-spreading spirochetes have been killed.
To compare antibody responses and determine their effect on Lyme arthritis, the team tested at least 3 blood serum samples each from 41 patients with antibiotic-refractory arthritis, 23 patients with antibiotic-responsive arthritis, and 10 non-antibiotic-treated controls - arthritis patients who had contracted Lyme disease during the late 1970s before the cause of the disease was known. Samples were obtained during the period of arthritis and sometimes after several months of remission for all patient groups. The patients with antibiotic-refractory and antibiotic-responsive arthritis had a similar age range, sex distribution, and duration of arthritis prior to antibiotic therapy.
All samples were tested for IgG reactivity with Borrelia burgdorferi bacteria and 4 outer surface lipoproteins of the spirochete. Among non-antibiotic-treated patients, antibody titers to Borrelia burgdorferi remained high throughout a prolonged period of persistent arthritis, 2 to 5 years. In contrast, in patients with antibiotic-responsive arthritis, the level of antibody titers to Borrelia burgdorferi and most outer-surface proteins remained steady or decreased within the first 3 months of starting antibiotic therapy. Consistent with this finding, these patients usually experienced relief from joint swelling during a 1-month course of oral antibiotics. In patients afflicted with antibiotic-refractory arthritis, the level of antibody titers to Borrelia burgdorferi and most outer-surface antigens increased slightly during the first 1 to 3 months of treatment. These patients suffered from persistent joint swelling for a median duration of 10 months, despite 2 to 3 months of oral or intravenous antibiotics. However, by 4 to 6 months after starting antibiotic therapy, antibody titers declined to similar levels in both antibiotic-treated groups, regardless of their differences in arthritis symptoms.
"In Lyme disease, there is a great need for a test that could be used in clinical practice as a marker for spirochetal eradication," observes Dr. Allen C. Steere, the senior author of the study. Yet, as he acknowledges, ridding the body of the Borrelia burgdorferi bacteria and its surface antigens does not always bring relief from arthritis. "Increasing antibody titers in patients usually suggested the presence of live spirochetes, whereas declining titers suggested that they had been killed," he notes. "Thus, patients with Lyme arthritis who have a sustained, gradual decline in antibody reactivity probably have the nearly complete or total eradication of spirochetes from the joint as a result of antibiotic therapy, even if joint inflammation persists after the period of infection."
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Article adapted by Medical News Today from original press release.
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Article: "Antibody Responses to Borrelia burgdorferi in Patients With Antiobiotic-Refractory, Antibiotic-Responsive, or Non-Antibiotic-Treated Lyme Disease," Priya Kannian, Gail McHugh, Barbara J.B. Johnson, Rendi M. Bacon, Lisa J. Glickstein, and Allen C. Steere, Arthritis & Rheumatism, December 2007.
Source: Amy Molnar
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