Where do Staph infection come from? Why are they so frequent in hospitals? When I first heard of it I though it was a “Staff” infection. Some sort of infection that hospital staff had be were immune to but that they kept passing it on the patients which made me ask, why were they not vaccinated for that?
“Staph” refers to Staphylococcus which is a particular type of bacteria that live on your skin. There are mutiple different types, but the strain that most often causes skin infectionin humans is Staphylococcus aureus.
to expand on divers post, this is often the nasty that worries hospitals. It can run wild on otherwise healthy adults sometimes with lethal consequences…nasty nasty bug.
It’s a bacterial infection, it is very very comon, it frequently llives on your skin, in your nose ears where it is no problem at all.
Vaccination is a long way off, this has eluded medical science for years, speculation is that it shifts it shape - effectively - and any vaccine will need to have multiple components to handle this. Given that antibiotocs often have limited lifetimes, a vaccine would be highly desirable, and a huge prize awaits the company that can do it, it is not for lack of trying that there is not currently a vaccine.
Staphylococcus Aureus was the first infectious agent that was knowingly treated by Pennicillin, I believe a former Policeman has a bad case and this was tried as a last dich measure, unfortunately, although it bought him some time, there just was not enough of the extract to treat him fully, but his temporary respite proved that this would be an effective treatment.
Staph has been causing skin and soft tissue infections for as long as there’s been skin and soft tissue.
The miracle cure for this was found in penicillin. Unfortunately, within a few decades, strains of staph developed which were resistant to penicillin. This currently led us up to the common “Community-acquired Methicillin Resistant Staph Aureus” strain, or CA- MRSA.
Fortunately CA-MRSA is still pretty susceptible to sulfa antibiotics, along with tetracyclines and clindamycin.
It can cause much worse infections, but fortunately most of its manifestations are in the surface tissue, and easily treated, usually by simple incision and drainage or topical antibiotics.
There’s no vaccine for staph, and it commonly lives on skin without causing disease, so that is often how it is spread.
QtM, who has treated 4 staph infections in 2 days, 3 of them CA-MRSA.
[sub]Come work for me in my department, and I’ll inflict a powerpoint on you, written by me, which explains a lot about staph & CA-MRSA in prisons[/sub]
Can you PDF that and upload it somewhere? I’d actually like to read it.
Give me a site to upload it to, and I’ll try it.
I bet lots of us would like to read it. I would.
YouSendIt, MegaUpload, Rapidshare–those should all work. Or you could maybe throw it up on Google Docs?
Nice Preso. My only complaint was I was hoping for a picture of “the purse” on slide 25…
Awesome, thanks for that! I just read the whole thing while I waited for a meeting to finish up so I can get the hell out of here. Also: I didn’t realize you were a fellow 'Sconnie–hiya!
Outstanding! You did an amazing amount of work (and I hope you got well paid for it ;)).
FWIW, we, luckily, don’t have much CA-MRSA in Canada. Yet.
You’re right for now, but if you’ve got colleagues in Vancouver’s downtown eastside, and/or some neighbourhoods in Calgary, you might start to hear it’s coming!
The only thing I know for sure about S. aurens infections is that they are bad, bad news.
I think I mentioned my experiences with the “golden grapes” a time or two on the Dope, come to think of it…
Starts on post #44 of this thread
The sequel
Seriously, **Qadgop, **MAY be swollen and painful? Are you kidding me? S. aurens HURTS!
Nice presentation, Qadgop. I wish that I’d had it when I was dealing with the “golden grapes”.
Thanks, All. Broomie, not everyone’s abscesses are painful, and that’s a fact.
Karl, I create 2 or so of these types of powerpoints a year (on varying primary care topics), and inflict them on my staff and colleagues, and present them at a few conferences here and there. As such, I do get decent remuneration for it, and it’s always more pleasant to teach about MRSA than it is to drain another abscess. 
Here’s an interesting NPR interview with Maryn McKenna, author of Superbug: The Fatal Menace of MRSA.
Many hospitals are trying to crack down on the spread of MRSA by going above and beyond handwashing (which is still a good idea). They’re testing patients on their way into the hospital to see if they’re MRSA carriers, so they can be isolated from other patients and treated to eliminate the bugs. Any patient with a positive MRSA test (I think most places are using a nasal swab) is put under contact precautions so everyone needs to wear gloves & gown when dealing with the patient. This reduces the spread.
Our rapid MRSA test takes about an hour and we call all positives as “panic values” so that inpatients are isolated immediately, and the pre-surgical patients can get their prophylactic treatment before coming in for their procedures.
Thanks for the presentation, Qadgop!
Antigen- here you get groin, axilla and nasal swabs for MRSA, and they’ll just get you Bactroban washes and Nasosept. Isolation would be nice, but it really isn’t feasible for most patients (who are carrying MRSA as a commensal and who aren’t actually having any problems from it). Obviously contact precautions are in place even if isolation can’t be done.
MRSA positive patients will usually get put onto the end of a surgical list as another infection control measure- this ensures that the theatre and recovery area can be deep-cleaned after they leave and tries to ensure as few other patients as possible are exposed.
Thankfully we see very little MRSA in the community here- our Impetigos still get Fluclox or Azithromax with topical Fucidn as first line, with IV co-amoxiclav if they’re really sick. We rarely have to break out the expensive stuff (protocls here are gent+vanc for MRSA, or guided by sensitivity).