What's The SD on Flesh-Eating Bacteria?

General Questions
#1

Thanks to God, this stuff seems rare. However, all of the newspaper accounts are pretty terrifying-you get it, and your flesh starts rotting off you. One account I read mentioned that the doctors treating a young woman had to amputate both of her hands-no antibiotic they had was effective against it. From what I read, most people who have picked up the bacteria have a few things in common:
-a deep wound, infected under extremely filthy conditions

  • a compromised immune system
    -ignoring a cut or wound
    Is the bacteria itself common? One case I read about was a guy who cut his hand on barnacles (while scraping a boat hull)-his infection developed within hours, and his hand had to be amputated.
    What is it about the bacteria that makes it so virulent? Is it a recent mutation?
    And, supposing its on your skin-will washing with soap and water get rid of it?
#2

Necrotizing fasciatis (which is the clinical name for what the media calls flesh-eating bacteria) isn’t caused by a single bacteria species. Many bacteria can do this (although it’s most common for the culprit to be a Staphylococcus, Streptococcus, or Clostridium species). And no, there’s not much in the way of preventative measures you can take. No matter how much you wash, you’re not going to get all the bacteria off your skin, or out of a wound.

#3

My ex wife was a critical care nurse in a county hospital. She brought home resistant staff bacteria many many times. I was told I was getting spider bites for what was actually staff infections. Over use of anti-biotics I believe is the major cause of these resistant strains.

#4

At some point you have to stop living in fear. When I was in Florida I stayed out of the water because I was afraid of Vibrio Vulnificus, but now I regret it.

#5

Staph. As in Staphylococcus.

Necrotizing fasciitis spreads very quickly, and is mostly due to the toxins released by the bacteria. Antibiotics generally do work, but not always fast enough to save the affected area.

#6

One thing I did learn about these staff infections. They always started the same way, first an itching and redness, then severe burning and the spreading of the redness and then the postule will start to form. If I took a very hot wash rag and kept rotating it with another very hot compress for about 5 min I could stop it in it’s tracks before it got to the burning stage that would literaly melt the flesh away.

#7

Part of the devastation caused by the infection is due to the bacteria’s ability to activate the victim’s immune system in a diffuse and non-specific manner. That can lead to an overwhelming local immune/inflammatory response, i.e. most of the damage is due to the person’s own defense mechanisms and not due to the bacteria per se.

The process involves what’s called a superantigen. According to the Wiki article, superantigen expression can lead to a more than ten-thousand fold greater immune response than is normally produced in response to a similar ‘foreign’ substance. Hence the damage suffered by the host.

#8

Well, now, he did say his wife as a nurse, so it sounds as though it truly was a staff infection.:smiley:

#9

Hippocrates (yes, the guy who wrote the famous Hippocratic Oath) in the fifth century BC wrote of a case of what was very likely necrotizing fasciitis (NF). He didn’t use the modern name, of course, but this is NOT a new disease.

In the sense that the bacteria involved are commonly found in the environment, but it’s not well understood why most cases of, say, strep are just ordinary strep while a very few become NF. Or why most staph infections are ordinary staff but a few become NF. As noted by another poster, it’s not just one species of bacteria that causes this.

Also as previously noted, the bacteria aren’t “eating” the flesh, it’s actually toxins produced by the bacteria that kills body cells.

Washing/cleaning wounds is always a good idea, but combined with appropriate wound treatment a very important thing is to GO TO A DOCTOR if the wound/infection suddenly starts to spread, spreads rapidly, or is extremely painful all out of proportion to the size of the wound. Also if you start running a fever. The earlier you get treatment the more likely you are to survive, or survive intact.

In many instances it’s not just the bacteria that destroys limbs. You see, if you go into shock (which isn’t that unusual in these cases past a certain point) your blood pressure drops. As a result, your fingers and toes might die simply because your blood pressure can no longer push blood through the capillaries sufficiently well to keep the tissues supplied with oxygen. Or perhaps not well enough to even keep your internal organs going. When dropping blood pressure becomes life threatening they give you drugs to keep it high enough to keep you alive. The problem is, those same drugs severely restrict the capillaries in your extremities, which can, again, result in insufficient oxygen reaching your hands and feet. If this goes on long enough your fingers/toes and hands/feet simply die. Sometimes you have a choice between dying of shock, or killing off the ends of your limbs in order to survive. The doctors might also have to carve off large swaths of your torso if the NF moves to that part of your body, because any dead tissue has to be cut away to get the infection under control.

It really is a hideous thing.

#10

Sounds like she needs to wash her hands more!

#11

A nitpick - it’s actually the body itself (the immune system) that’s doing the “eating”, by virtue of its over-exuberant inflammatory response to the bacteria (see my post above).

#12

Nearly all my infections were on forearms and stomach, looking back I wonder if it was the hug I gave her when she came home at night in uniform. Total of 27 infections in 2 years.

#13

The cases that make the news are the ones that occur in the US, since this is so rare. But what about the prevalence of this in other countries? I mean, there are a lot of people in the world living in filth in slums and shanty-towns, some right on top of the local dump. I would imagine someone sorting through trash would get a fair amount of cuts and scrapes, and not having access to clean, running water and soap, well, I wonder how often this horrible thing occurs in those less-than hygenic situations? Just curious.

#14

Keep in mind that untreated this stuff can kill remarkably fast. Third world peasants and garbage-pickers who pick this up probably die quickly and never make it to a hospital or any sort of official notice.

#15

IANAD, but it sounds like you’re talking about boils, which are often Staph infections - and can progress to bigger problems, but start off as an infected hair follicle (and typically, not infected from an external source - just from the staph population that’s part of your skin flora)

#16

The term flesh-eating bacteria is annoying. There’s nothing magic about necrotizing fasciitis. It’s just a bad soft tissue infection that starts tracking along the fascia and it can be caused by a lot of different bacteria. MRSA gets a lot of press but its just one of many. The treatment for nec fasc is the same as any other severe soft tissue infection: antibiotics, drainage, and debridement. Some people really do need radical debridements, though I’ve always felt people get carried away because the patient is septic, and not because they really need their whole torso skinned. Can’t fault erring on the side of caution though.

A significant minority of the US population carries Staph around in their nose. In specific populations, like the urban poor, inpatients at a county hospital, or people who present to the doctor with an infection, it can hit 50% or more. Most people don’t have any real problems because of it. A significant fraction of those people have MRSA, which is not the same as the multi drug resistant Staph you get in hospitalized patients. Community acquired MRSA is annoying because it produces a toxins that cause a lot of tissue necrosis, not because it’s difficult to treat with antibiotics. MRSA abscesses tend to have a distinct appearance to them because the skin over the abscess tends to die much faster than usual, but it responds just fine to incision, drainage, and generic antibiotics.

A superfical wound in an otherwise healthy person which is appropriately cared for… can still result in necrotizing fasciitis. It’s pretty rare though. Sometimes a minor scratch develops an infection, which progresses to abscess formation, which doesn’t drain spontaneously/isn’t treated appropriately, which then develops into a deeper infection. Much more commonly the patient has some combination of diabetes/smoking/peripheral vascular disease in their history and then had an infection which was neglected for 2-3 days before they sought attention.

In my own experience, at least 95% of cases involve diabetes and/or skin popping. YMMV