that's normal

1/17/2008 10:30:45 AM

RIP Chapel Hill

1/17/2008 10:31:31 AM

its ok travis, we cool now


hollar if you need anything.... i mean it

1/17/2008 10:32:18 PM

an email from promedmail -- in response to that news article




STAPHYLOCOCCUS AUREUS (MRSA), COMMUNITY ACQUIRED, MEN WHO HAVE SEX
WITH MEN - USA: (MASSACHUSETTS, CALIFORNIA)
**************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 15 Jan 2008
Source: New York Times [edited]
<http://www.nytimes.com/2008/01/15/health/15infe.html?ex=1358053200&en=9307cd688f932b4d&ei=5124&partner=permalink&exprod=permalink>

[Methicillin-resistant _Staphylococcus aureus_ (MRSA) is a type of
_S. aureus_ that is resistant to antibiotics called beta-lactams,
which include methicillin, oxacillin, and other more common
antibiotics such as penicillin, amoxicillin, and cephalexin. MRSA
have been causing infections acquired in a healthcare facility, such
as a hospital, long-term care facility (e.g., nursing home), or
hemodialysis unit for more than 40 years. Most healthcare-associated
MRSA (HA-MRSA) are also resistant to multiple other classes of
antibiotics than include the macrolides (e.g., erythromycin),
fluoroquinolones (e.g., ciprofloxacin), and clindamycin. HA-MRSA are
usually sensitive to vancomycin, daptomycin, and linezolid; and are
also likely sensitive to the tetracyclines and
trimethoprim/sulfamethoxazole. While 25 percent to 30 percent of the
healthy population carry _S. aureus_ in their nose and on skin, they
infrequently carry HA-MRSA.

The appearance of MRSA in infections acquired outside healthcare
settings is a more recent problem. Community-Associated MRSA
(CA-MRSA) strains have been generally susceptible to a wider range of
antibiotics, other than beta-lactams (e.g., fluoroquinolones and
clindamycin). Most CA-MRSA carry a specific type of genetic element
that encodes methicillin-resistance (staphylococcal chromosomal
cassette Type IV), whereas HA-MRSA carry Types I, II, and III. Many
CA-MRSA carry genes that encode Panton-Valentine leukocidin, a toxin
that predisposes to severe skin and soft-tissue infections and
necrotizing pneumonia.

Unlike HA-MRSA, CA-MRSA often cause infection in children and adults
without any obvious risk factors. Clusters of CA-MRSA skin infections
have been documented among athletes participating in contact sports,
military recruits, Pacific Islanders, Alaskan Natives, Native
Americans, men who have sex with men, IV drug users, and prisoners.
Factors that have been associated with the spread of CA-MRSA skin
infections in otherwise healthy people include close skin-to-skin
contact, skin cuts or abrasions, contact with contaminated surfaces
(e.g., gym equipment, shared towels), and poor hygiene.

1/19/2008 5:58:11 PM

part deux

The CDC classifies MRSA isolates into pulsed-field types (currently
USA100-1200) based on genetic relatedness (McDougal, L. et al.
Pulsed-field gel electrophoresis typing of oxacillin-resistant
_Staphylococcus aureus_ isolates from the United States: Establishing
a national database. J Clin Microbiol. 2003;41:5113-20). USA300, the
predominant epidemic clone in numerous outbreaks in the United
States, is also increasingly seen in Canada and Europe. International
travel and the increasing trend of training or working abroad among
health care workers probably is contributing to its global spread
(Tietz et al. Transatlantic spread of the USA300 clone of MRSA. NEJM
2005 353:532-533). USA300 has been implicated in skin and soft tissue
infections, as well as invasive disease, including septicemia,
necrotizing pneumonia, and necrotizing fasciitis.

More recently, some CA-MRSA USA300 have accumulated multiple drug
resistance genes resulting in resistance not only to beta-lactam
antibiotics, but also resistance to fluoroquinolones, tetracycline,
macrolides, clindamycin, and mupirocin (Diep et al. Lancet 2006;
367:731-9). Spread of multidrug-resistant USA300 limits options both
for oral therapy and for use of mupirocin topically to eradicate MRSA
carrier state during CA-MRSA outbreaks. Because genes that determine
resistance to erythromycin, clindamycin, tetracycline, and mupirocin
are plasmid-mediated, they could spread quickly. In 2006 and 2007,
clusters of infection due to multidrug-resistant CA_MRSA were
reported among gay men in San Francisco and Boston (Carleton,
Perdreau-Remington. 46th ICAAC. San Francisco, CA. September 27-30,
2006. Abstract C2-1142; Han et al. J Clin Microbiol 2007; 45:1350-2).

The above New York Times news release refers to a recent publication
in the Annals of Internal Medicine by the same San Francisco and
Boston investigators that further characterizes the epidemiology
of multidrug-resistant USA300 infection among men who have sex with
men. The MRSA clone USA300 infection of the buttocks, genitals and
perineum suggested transmission by skin-to-skin contact during anal
intercourse; however the evidence remains circumstantial, since
specific sexual practices were not assessed systematically in this
retrospective study. The investigators postulated that spread of the
MRSA clone USA300 between the Boston and San Francisco outbreaks
could have been facilitated by an infected man who had sex with men
and who travel frequently between the two cities.

The investigators cited another recent study that reported CA-MRSA
clone USA300 infections of the buttocks and genito-perineal area in
heterosexual partners (Cook et al. Clin Infect Dis 2007; 44:410-3)
and an on-line reader response to the Diep et al. publication
questioned if this could be also attributed to heterosexual practice
of anal intercourse. - Mod.ML]

[see also:
2003
----
Staph. aureus (MRSA), community acq. - USA (MA) 20030302.0529
Staph. aureus (MRSA), community acq. - USA (CA) (03) 20030227.0490
Staph. aureus (MRSA), community acq. - USA (NY) 20030208.0336
Staph. aureus (MRSA), community acq. - USA (CA) (02) 20030131.0270
Staph. aureus (MRSA), community acq. - USA (CA) 20030128.0252
2002
----
Staph. aureus (MRSA), community acq. - USA (TX) (02) 20021115.5813
Staph. aureus (MRSA), community acquired - USA (Texas) 20021115.5805
2001
----
MRSA surveillance - Netherlands: 2001 20010923.2302
Staphylococcus, MRSA, linezolid resistant - USA 20010730.1493
MRSA, imported - Canada ex UK 20010517.0960
2000
----
Staphylococcus aureus, MRSA - New Zealand 20000516.0768
1999
---
Staph. aureus, MRSA - UK (Wales, W. Midlands) 19991107.1997
Staph. aureus, MRSA, community acquired - USA 19990822.1467
1998
----
Staphylococcus, drug-resistant, community acquired 19980225.0366]
..........................ml/ejp/dk

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1/19/2008 5:59:05 PM

So, what do you think the chances of getting MRSA are if you live with people who work in hospitals?

1/23/2008 10:52:37 PM

My brother's wife is a nurse. He never goes near the hospital but he got it on his arm. It ate into it and had to be surgically opened up to heal. It looked like a gunshot. They said it wasn't the most virulent strain (like I would expect to see in a hospital) and it does get contracted outside the hospital so it may have just been a coincidence.

1/23/2008 11:45:14 PM

Thanks for confirming what I already thought might be the case...

1/24/2008 2:03:35 PM

MRSA


not MSRA.

1/24/2008 4:51:40 PM

Shit's nasty... if you have a "zit" that doesn't heal as it should get that shit checked.

1/24/2008 5:41:31 PM