MRSA by Shelby Smith

MRSA

            Introduction

Eleven thousand, two hundred and eighty five people die each year of Methicillin-resistant Staphylococcus aureus, also known as MRSA (MRSA Fast Fact 1). At least that is what the CDC is saying. The reality is that we have no idea how many people a year are truly dying of MRSA because medical facilities aren’t reporting it. And even cases that are being recorded aren’t included in the numbers reported by the CDC (McNeill 1). It’s frightening to think that a disease also known as a “superbug”, could be running rampant and people would have no idea. How do we know that we are not at risk to contract this “super bug” and how can we trust that the facilities we attend for medical care can protect us if they themselves are hiding the infection?

            History

MRSA was first introduced to the world in 1961 by British scientists who were first beginning to examine resistant strains of staphylococcus aureus (History Methicillin-Resistant Staphylococcus Aureus Antimicrobial Resistance. 1).  The first case reported in the United States was in 1968 at Boston City Hospital where 18 patients contracted the disease (Kak and Levine 1). The rate at which the patients contracted a disease that had hardly been introduced was incredible. The infection was labeled as an endemic in large urban hospitals and increasingly became more and more prominent as a nosocomial disease (MRSA History Timeline 1). In 1981, MRSA began to run rampant in the streets of Detroit. (1). Many drug users who injected their narcotics intravenously became infected with MRSA (1). However there is little information regarding any detailed accounts of these outbreaks.

As we move into the 90’s, we begin to see that children are beginning to pop up nationwide with MRSA (MRSA History Timeline 1). The disease had changed because the source was no longer in the hospital, but could be found in your everyday community (Gupta 1). Children face this risk more readily because of their close contact with each other in schools or camps and they tend to be less hygienic (1). In 1999, we began to see that healthy children were beginning to die of MRSA (MRSA History Timeline 1). The most dangerous part about MRSA is its ability to evolve and health care professionals were failing to keep up. However in 2005, the health care community was able to identify risk factors and this began the trek towards stepping ahead of MRSA (1).

            Effects

Though people are still dying from MRSA, the health care community has greatly reduced the numbers. However this does not change the fact that MRSA is still at risk for becoming an epidemic. The mere name MRSA sends people into a panic. To the community, MRSA is a death sentence. MRSA is not the only disease that is scaring the nation. But, what the individuals of this nation don’t seem to understand is that it’s not just a disease that causes an epidemic but the behavior of the people regarding the sickness. While it is important to be aware of the infections you could be contracting, it’s not hard to see why government associations such as the CDC is covering up the true number of those infected by dangerous disease such as MRSA. Take a look at the way diseases like Ebola and Zika have affected the population. People begin to panic instead of dealing with the situation the way the trained professionals; doctors; are recommending. It’s important to recognize that it is the public’s job to follow the instructions of those who were taught to deal with these situations and to stay calm.  So, how are we supposed to deal with MRSA?

            Examples

Well to start, our first line of defense is washing our hands (Hill 1) Maintaining good hygiene is an important part of preventing any infection. 15-20% of people have MRSA colonized on their skin (1). If it comes to your attention that you may have MRSA it is important to keep your infection covered to prevent the spread of infection as well as keeping any open wounds clean (1). Another way to contain the infection is to stop sharing personal items like razors, towels or clothes (1). It is common for children to contract the disease because of their slightly less than hygienic habits (Gupta, 1). A young girl name Addie Rerecich was eleven years old when she got MRSA. (Rerecich 1) She was a healthy athletic girl until she began to experience pain in her hip and she suddenly had a fever of 103. (1) She was rushed to the emergency room but she didn’t leave the hospital for five months. (1) After testing a sample of her blood, doctors realized that MRSA had permeated her blood stream and her body was struggling to fight it off. (1) She had developed pneumonia and the pain in her hip was an abscess that developed as a result of the infection, prompting surgery. (1) Addie had to undergo a lung transplant to treat her failing lungs after spending time on a machine called ECMO (extracorporeal membrane oxygenation). (1) After running through the entire regiment of common antibiotics to treat Addie, the doctors acted in desperation. (1) The doctors used an antibiotic called colistin. (1) Colistin is a very strong and very old form of antibiotic that was known to be toxic to the body’s vital organs. (McLaren 1) The colistin was effective however the five months that Addie spent in the hospital added up to over six million dollars.

Carlos Don is another child case. (Don 1) Carlos first contracted MRSA from sixth grade camp. (1) He arrived home following camp looking pale and sickly. (1) He had a fever of one hundred and 4 and displayed flu like symptoms. (1)  His parents tried to keep him hydrated but as his condition failed to improve, he was taken to the emergency room. (1) When he was taken in, he was diagnosed with bilateral pneumonia. (1) While he was correctly diagnosed, the doctors failed to see that his infection was antibiotic resistant. (1) They prescribed him antibiotics and sent him home. (1) Within 24 hours, Carlos was hallucinating (1). He was rushed back to the emergency room in an ambulance because his oxygen levels had fallen so drastically low. (1) The doctors induced Carlos into a coma to keep him on a ventilator and give his lungs a rest but they soon realized his condition was far direr than they first thought. (1) His lungs stopped working and after two weeks of his organs shutting down one by one, Carlos died. (1) It only took two weeks for the MRSA infection to pass into his lungs and kill him. (1) Antibiotic resistant infections make our medicine as useful as the medicines of the renaissance and children have the same poor hygiene as those who lived during that time period. But it’s not just children who contract MRSA.

Twenty seven year old Josh Nahum developed hospital associated MRSA after spending six weeks in ICU following a tragic skydiving accident. (Nahum 1) Though he was able to recover, he became more susceptible to infection. (1) Enterobacter aerogenes was found in his cerebral spinal fluid. (1) The build-up of pressure in his spine caused Josh to become paralyzed and he had to be put on a ventilator. (1) For two weeks Josh suffered from this infection before he finally died. (1)

Solutions

MRSA is growing problem but there may be solutions to its most dangerous attribute. Many eastern European countries have stopped using antibiotics to treat antibiotic resistant infections and moved on to phages. (Wetmore 1) Phages are viruses that kills bacteria. (1) The cost can range from $800 to $6,000 for a treatment depending on if you must travel abroad to receive treatment however if we compare his to the millions that is spent for a few months in a hospital, the phage option is exponentially cheaper. (1) However the treatment is not FDA approved because of the high cost of testing.(1) Phages are engineered specifically for patients meaning that each patient must be send in cultures of their infection to find a phage that will appropriately attack their bacteria.(1) Unfortunately, America is known for wanting to mass produce a single cure that will work for all patients for the sake of economic advantage so it is unlikely that America will adopt this form of treatment.(1) However 85% of those who have undergone phage treatment with MRSA have made a full recovery. (1)

Another solution for prevention purposes would be to increase the sanitation regulations in hospitals to prevent the spread of MRSA within the health care facilities. Many people who go in for routine procedures come out of the operating room with infection. However this is unsurprising when you realize that hospital workers wash their hands less than 30% of the time that they interact with patients. (Harticollis 1) By increasing the sanitation standard, the spread of nosocomial diseases could be diminished exponentially. Certain hospitals have begun enforcing handwashing frequency by using video tapes to monitor health care professionals and writing up employees who do not wash their hands when they should be. (1) North Shore University Hospital did a trial run of this “video snooping” and found that less than 10% of their employees were washing their hands appropriately. (1) However by implementing the system and sending reports to the health care workers who have not been using proper measures to keep clean, they were able to increase the hand hygiene of their employees to 88%.

The development of new antibiotics is also being explored. This is not the best course of action because of the bacteria’s ability to evolve however it is a temporary solution. The FDA is actively funding the research of new antibiotics that can be used to treat infections that have become resistant to the average regiment of drugs that health care professionals are currently handing out. (Commissioner 1) However the real epidemic lies with the antibiotic resistance itself not the MRSA which means this solution is mildly ineffective. The FDA is also trying to raise awareness within the public on the prevalence of MRSA and how hygiene connects to the spread of infection. (1) This is good for the prevention of the disease which could lessen the need for a cure for infections like MRSA. Prevention measures theoretically give experimental scientists more time to come up with a plan to treat MRSA when it comes up because there is less loss of life in the meantime.

Absurdity

            Camus’ belief is that there is no purpose in life and searching for one is absurd. Absurdity fiction can be defined as a genre of purposelessness but the topic cannot be associated with purposelessness. There is a purpose in stopping MRSA because even if life has no purpose, life would be easier if we could eradicate suffering. Even if life has no purpose, there should at least be a goal of making life more comfortable which is the purpose of exploring science itself.  The entirety of the health science department is focused on improving human lifestyle. There could be no greater purpose for the purposeless. Anyone in the health care industry can tell you that their motivation is to help people. Absurdity itself is absurd because everyone has some sort of motivation and rather there is some large existential being facilitating it or not, there is still purpose. Camus would find my topic absurd because of the way that it is being handled. The fact that the United States government is passing up on a potential cur because it doesn’t match their “uniform trademark” is utterly absurd and proves the point that everything in the world is about money. It’s absurd that humans have come to worship value in such an unproportioned form. Everything we invest is a useless and fragile piece of paper and the United States government thinks it’s more important than the lives of citizens. Not only that, but the government is feeding the real epidemic by trying to use “stronger” antibiotics that will teach the bacteria to evolve to be stronger as well. Camus would also find this absurd because the government, who should be the best and brightest, seems to be missing the whole idea of antibiotic resistance itself.

Conclusion

            MRSA and its antibiotic resistance is a dangerous epidemic to allow to spread. There are definitely solutions to help those who contract it but perhaps the epidemic is not being handled well in western civilization. Sometimes it is important to take a step back and recognize the priorities you have and how you should go about their upkeep. Antibiotic resistance introduces supreme danger to the health care system and the way infections are treated. If we want to continue to consider infection a minor issue, we must search for alternatives to antibiotics and ways to fight evolution when it threatens our lives. It is time that we eradicate the super bug and fight it with a “super cure”.

Bibliography

Commissioner, Office of the. “Consumer Updates - Combating Antibiotic Resistance .” U S Food and Drug Administration Home Page, Office of the Commissioner, 20 Mar. 2017, www.fda.gov/ForConsumers/ConsumerUpdates/ucm092810.htm#what. Accessed 6 May 2017.

Don, Amber. “Carlos Don.” IDSA : Carlos Don's Story, Infectious Diseases Society of America, June 2007, www.idsociety.org/Templates/nonavigation.aspx?Pageid=12884901901&id=12884901903. Accessed 30 Apr. 2017.

Gupta, Rupal Christine editor. “MRSA.” KidsHealth, The Nemours Foundation June 2014, kidshealth.org/en/parents/mrsa.html. Accessed 6 Mar. 2017

Harticollis, Anemona. “U.S. Hospitals Take Drastic Steps to Improve Sanitation.” National Center for Policy Analysis, National Center for Policy Analysis, 28 Mar. 2013, www.ncpa.org/sub/dpd/index.php?Article_ID=23236. Accessed 8 May 2017.

Hill, Karen Nazor. “MRSA: While Easily Treated These Days, Infection Is Showing up More Often.” Timesfreepress.com Times Free Press 1 June 2014, www.timesfreepress.com/news/life/entertainment/story/2014/jun/01/mrsa/141733/. Accessed 10 Mar. 2017.

“History Methicillin-Resistant Staphylococcus Aureus Antimicrobial Resistance. ”National Institutes of Health U.S. Department of Health and Human Services 8 Mar. 2016, www.niaid.nih.gov/research/mrsa-antimicrobial-resistance-history. Accessed 6 Mar. 2017.

Kak, Vivek, and Donald Levine. “: Community-Acquired Methicillin-Resistant Staphylococcus Aureus Infections—Where Do We Go from Here?” oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/cid/29/4/10.1086/520438/2/29-4-801.pdf?Expires=1489152709&Signature=Fo8LQ2FerGdbSLjSp38wsRuPd22KC~2UPrl7Yvxsg6w1zfErJ72pLlVkU0Uj92nfd2KEtWKukfWFvM1manrNgHKwJdUVbL0l7LdwCbMCDCeePlxwb6f9TCERtV-T4lvjfZozOIeta7BdHu~kl9~9MaIitfie1z5l4xxOzQP2UeLdvH6QxHjsHdLkZNF9pc4eBCOzeGy03Toio1bjQQYd1x5K3j4tAAjP5O72mb-XFqskP13usVBwqMnHwiFakp~w1~q654wkHPUD46T7CKpuEjS2mzpTuOMM1xJMMprk4LA6LivyxBkI3q9jpRjGc0xk2b14ULyjAHFn4oFrwU3ZQw__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q. Accessed 6 Mar. 2017.

McLaren, Graeme, and Denis Spelman. “Colistin: An Overview.” Up To Date, Wolters Kluwer, 14 Mar. 2017, www.uptodate.com/contents/colistin-an-overview. Accessed 8 May 2017.

McNeill, Ryan et al. “'Superbug' Scourge Spreads as U.S. Fails to Track Rising Human Toll.” Reuters, Thomson Reuters 7 Sept. 2016 www.reuters.com/investigates/special-report/usa-uncounted-surveillance/. Accessed 20 Feb. 2017.

“MRSA Fast Facts.” CNN Cable News Network 9 June 2016, www.cnn.com/2013/06/28/us/mrsa-fast-facts/. Accessed 13 Feb. 2017.

“MRSA History Timeline.” MRSA Research Center | University of Chicago University of Chicago Medicine 2010, mrsa-research-center.bsd.uchicago.edu/timeline.html. Accessed 6 Mar. 2017.

Nahum, Victoria. “Josh Nahum.” IDSA , Infectious Diseases Society of America, Oct. 2010, www.idsociety.org/Joshs_Story.aspx. Accessed 8 May 2017.

Rerecich, Tonya. “Addie Rerecich.” IDSA : Addie Rerecich's Story, Infectious Diseases Society of America, Feb. 2012, www.idsociety.org/Addie_Rerecich/. Accessed 30 Apr. 2017.

Wetmore, Horen. “A Cure Exists For Antibiotic-Resistant Infections. So Why Are Thousands Of Americans Still Dying?” Prevention, Rodale Inc., 18 Feb. 2015, www.prevention.com/health/health-concerns/cure-antibiotic-resistance. Accessed 6 May 2017.