Below are two discussion posts I'd like you to read and respond to individually, Elaborate more on these topics, cite your sources. 1 250 word Response per post.
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterial infection resistant to several different antibiotics (Lights & Solan, 2001, para. 1). Staphylococcus aureus, commonly called staph is considered to be the most common bacteria related to skin infections (Pray, 2008, para. 1). One S. aureus cell is capable of multiplying and colonizing within thirty minutes (Pray, 2008, para. 1). S. aureus has the potential to reach a million or more cells in as much as ten hours if given optimal conditions for growth (Pray, 2008, para. 1).
According to the U.S. National Library of Medicine, Staph is susceptible to just about every antibiotic produced (U.S. National Library of Medicine, 2017, para. 2). Alexander Fleming’s discovery of penicillin by experimenting on the bacteria S. aureus instigated the start of what is known as the antibiotic era (U.S. National Library of Medicine, 2017, para. 2). By the mid-1940s, shortly after it’s introduction into clinical practice, the miracle drug that was destroying infections was now producing penicillin resistance within hospitals (U.S. National Library of Medicine, 2017, para. 2). Ten years later, S. aureus is one such bacteria that is very capable of acquiring resistance to any antibiotic (U.S. National Library of Medicine, 2017, para. 2).
Important factors to be aware of in regards to S. aureus is that close to 30% of all humans are natural, or asymptomatic, carriers of the bacteria in their nasal passages (U.S. National Library of Medicine, 2017, para. 3). Carriers are at higher risk of developing infection as well as possible sources of spreadable strains (U.S. National Library of Medicine, 2017, para. 3).
There have been epidemic level infections of antibiotic resistant strains of Staph, particularly infections related to methicillin resistant S. aureus strains (MRSA) (U.S. National Library of Medicine, 2017, para. 4). MRSA related infections are found to be increasing worldwide, both in healthcare and community settings (U.S. National Library of Medicine, 2017, para. 4). The community-associated MRSA (CA-MRSA) strains are spreading, diversifying, and cloning at an alarming rate (U.S. National Library of Medicine, 2017, para. 5). CA-MRSA infections seem to be more virulent, with severe tissue-destructive infections including necrotizing pneumonia (U.S. National Library of Medicine, 2017, para 5).
Due to S. Aureus, or MRSA, being able to mutate so prolifically and become resistant to such a wide array of antibiotics; prevention has become the key. The Centers for Disease Control and Prevention offer the following tips regarding CA-MRSA.
- Maintain good hand and body hygiene.
- Wash hands often. Clean your body regularly, especially after exercise.
- Keep cuts, scrapes, and wounds clean and covered until healed.
- Avoid sharing personal items (i.e.: towels and razors).
- Get care early if you think you might have an infection (Centers for Disease Prevention, 2016, para. 5).
An alternate form or therapy that is proactive seems to be most beneficial pre-operatively. Although, more research may be needed before it is the final solution. There is a known risk for colonization of MRSA after a surgical procedure (Infectious Diseases in Children, 2007, para. 3). Again, strategies to help prevent or reduce transmission of MRSA are proper hand washing, not sharing personal items, proper cleaning of wounds (Infectious Diseases in Children, 2007, para. 5). Mupirocin (Bactroban Nasal ointment) has been the most tested topical agent used for MRSA decolonization (Infectious Diseases in Children, 2007, para. 6). Bactroban has been found to decolonize MRSA within the anterior nares by 90%, and is considered to be almost as effective as some systemic treatments (Infectious Diseases in Children, 2007, para. 6-7). There are some hospitals that are now looking to use Bactroban in preventative form for all incoming surgical patients. This plan is to replace the somewhat expensive/time consuming practice currently in place of obtaining a nasal swab on all pre-surgical patients and testing them for MRSA prior to surgery. However, caution must be used. The CDC has not yet recommended mupirocin for routine use in decolonization for pre-surgical patients as there has not been enough research to signify it will not result in an additional drug resistant strain (Infectious Diseases in Children, 2017, para. 10). It has already been noted that there is a gene encoded for high-level mupirocin resistance identified within the MRSA genome (Infectious Diseases in Children, 2017, para. 9).
The antibiotic and organism I chose are azithromycin and Group A streptococcus. One of my friends has been battling chronic strep throat for over three years. Group A streptococcus causes strep throat, toxic shock syndrome, rheumatic fever, tonsillitis, flesh eating disease and meningitis (UCSD 2017). Eventually, even with the use of antibiotics, her ailment developed from strep throat into chronic tonsillitis. What used to be an infection a few times a year has turned in to a monthly ordeal.
Typically, penicillin or amoxicillin is used to treat these infections, however due to the high rate of people allergic to these drugs, doctors prescribe another class of antibiotics called macrolide antibiotics (Martin, J. M., et al). Doctors, patients and parents of young children prefer macrolide antibiotics because of its convenience, one pill per day for five days (Martin, J. M., et al). The over use of the drug, coupled with the short amount of time patients are prescribed to take the drug could be factors to the bacteria’s resistance to the drug.
When antibiotics are taken to kill bacteria, there may be a few stubborn microbes left behind. If we consider Darwin’s natural selection, these organisms are more fit to survive compared to their counterparts. If the drug treatment is shortened, even if the symptoms are no longer a bother, the survining stronger bugs multiply, creating a more resistant, tougher army of germs, exacerbating the infection (Belk, C., & Maier, V. B. 2016).
According to an article in The New England Journal of Medicine (2002), the prevalence of macrolide antibiotic resistance is much greater than a neighborhood epidemic. This particular drug resistant strain is found in parts of Europe, Japan and all over the United States (NYT 2002). The impact this has on human health is troublesome. The World Health Organization named streptococcus on their list of most dangerous superbugs, calling for an immediate need for a new antibiotic (scientificamerican). When drug resistance increases, so does the frequency of infection, death toll and the burden on health care systems (scientificamerican).
One report suggests using a third class of antibiotics: clindamycin (NYT). The WHO is calling for a new antibiotic all together (scientificamerican). But for my friend, her next option is a tonsillectomy. While this procedure does not address the antibiotic resistance, it will provide her with relief.