Maryn McKenna

Journalist and Author

Catching up to MRSA news (not about me)

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Constant readers: I’m looking forward to having the breathing space to get back to in-depth blogging. Meanwhile, though, news is zipping by — so here’s a quick list of recent things worth reading.

“Cows on Drugs” — a superb history of the 30-year-old fight to get unnecessary antibiotics out of food animals. Note, written by a former commissioner of the Food and Drug Administration, not exactly a wild-eyed radical:

More than 30 years ago, when I was commissioner of the United States Food and Drug Administration, we proposed eliminating the use of penicillin and two other antibiotics to promote growth in animals raised for food. When agribusiness interests persuaded Congress not to approve that regulation, we saw firsthand how strong politics can trump wise policy and good science.Even back then, this nontherapeutic use of antibiotics was being linked to the evolution of antibiotic resistance in bacteria that infect humans. To the leading microbiologists on the F.D.A.’s advisory committee, it was clearly a very bad idea to fatten animals with the same antibiotics used to treat people. But the American Meat Institute and its lobbyists in Washington blocked the F.D.A. proposal.

Antibiotic resistance in your kitchen, playroom, car... — After years of begging from health advocates, the FDA and EPA are taking a second look at the chemical compound triclosan, an antibacterial that is put into, well, almost anything you can name: soaps, hand sanitizers, cutting boards, toys. Triclosan is suspected of interfering with hormone regulation in the body, and also increases resistance in organisms in our environment. (When I ask you to use hand sanitizers that contain only alcohol or salts, not antibacterials, triclosan is one of the things I’m thinking of.) The FDA will report its findings in a year. I’d rather see it happen sooner, but it’s a great move.

No progress on hospital-acquired infections — The Agency for Healthcare Research and Quality, part of the Department of Health and Human Services, has published its 2009 National Healthcare Quality Report. The news is not good. To quote the agency’s own language: “Very little progress has been made on eliminating health care-associated infections.” This is all hospital-acquired infections, not just MRSA, but MRSA is a leading organism. The ugly details:

  • Post-operative bloodstream infections up 8%
  • Post-operative catheter-associated urinary-tract infections up 3.6%
  • “Selected infections due to medical care” up by 1.6%
  • Bloodstream infections as a result of central lines unchanged.

(NB, three professional organizations — the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, and the Association for Professionals in Infection Control — put out a statement in response to this report saying it “presents an outdated and incomplete picture on healthcare-associated infections (HAIs) in our healthcare system.” The gist of the statement seems to be that they’ve got better numbers coming… soon. When there’s actual data, I’ll let you know.)

SUPERBUG on Capitol Hill

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Constant readers, I’ve been shamefully absent from the blog, but with reason, since I’ve been traveling promoting the book. There was a pretty interesting opportunity this week that I wanted to tell you about: I was asked to be part of two Congressional briefings in Washington, DC Wednesday, addressing the overuse of antibiotics in agriculture and the contribution that makes to the emergence of resistant organisms such as MRSA. I went specifically to tell the story of the emergence of MRSA ST398, which we’ve been talking about for years here.

The briefings (FYI, “hearings” are for Congresspersons, “briefings” are for their staff) were cosponsored by the Pew Charitable Trusts, Union of Concerned Scientists, American Public Health Association, Infectious Diseases Society of America, and the nonprofit Keep Antibiotics Working.

Here’s Pew’s announcement, here’s the UCS version, here’s a write-up from the Washington Examiner, and here’s a longer one from the site Spectrum Science.

Surfacing. (Whew.) And some great reaction.

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Well, constant readers, it’s been an amazing two weeks. SUPERBUG was published, and ate my life. I’ve been on NPR’s Fresh Air, and on 21 (22?) other radio stations so far, with more radio, and TV, to come.

I’m starting to plan the next phase of the book campaign. If you work at a hospital or medical school, or are a student, contact me: Wherever you are, I’ll come talk.

This week I’m headed out for some tour appearances in Atlanta: at Georgia Gwinnett College on Wednesday, and on Thursday, at the offices of Danya International in the afternoon, and then at Eagle Eye Book Shop in Decatur Thursday night. If you need more details, email or tweet me!

The book has gotten some wonderful reviews and, what matters more to me at this point, blog reactions, because the blogs signal to me that real people are really engaging with the story. I’ve put excerpts and links up on the book’s site on this page.

Here’s one that just came in over the transom that just floored me. It’s from Rep. Louise Slaughter, Congress’s only microbiologist, author of PAMTA, the legislation intended to bring some direction and control to agricultural use of antibiotics:

Maryn McKenna’s Superbug provides a heart-rending and enlightening portrait of the spread of Methicillin-Resistant Staphylococcus Aureus (MRSA). Commonly imagined to be a disease that only affects elderly hospital patients, McKenna’s book shows that no area of the United States is untouched. Thirty percent of high school athletic programs in one survey reported MRSA. In another study, 80 percent of farms and 40 percent of pigs had MRSA. The consequences are horrific. In 2005, 94,360 invasive MRSA infections occurred in the United States, with almost 19,000 deaths.

In the United States, the response to MRSA has been largely uncoordinated, and left to individual institutions, schools, and health care centers. American hospitals have tried a range of responses. Some hospitals have tied executive pay to staff hand-washing rates; others isolate patients with MRSA. Nationwide educational campaigns reduced antibiotic prescription rates temporarily, only to see them rise again. The pipeline for new antibiotics dried up due to economic disincentives for drug companies to invest in short-course medications like antibiotics. The medical system has not yet been able to contain antibiotic resistant pathogens like MRSA.

The problem is just as dire on American farms. Limited action has been taken to reduce misuse of antibiotics in agriculture. While the FDA did ban agricultural usage of the powerful antibiotic fluoroquinalone, farms still regularly use powerful antibiotics as ‘growth promoters’ in daily feed for animals.  This year, I introduced legislation, HR 1549, the Preservation of Antibiotics for Medical Treatment Act, which would take additional steps to protect seven medically-critical classes of antibiotics for human usage against MRSA and other antibiotic resistant pathogens. Maryn McKenna’s book is a powerful call to action. 

– Louise M. Slaughter, MEMBER OF CONGRESS

PUBLICATION DAY and so many people to thank. The short list:

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Sara Austin, Susan Raihofer, Emily Loose, Maura O’Brien, Ali Pisano, Dominick Anfuso, Martha Levin, Elizabeth Stein.
Andrew Dodds, David Ratner, Shirley Sandler, Chuck Monroe, Elise Bogdan.
Penny Duckham, Deirdre Graham, Matt James, Drew Altman;  Bruce Shapiro, Frank Ochberg, MD, Dorie Griggs.
Barth Anderson, Frances Katz, Quinton and Jean Gregor, Anne Edwards, MD, Joanne Kenen, Howard Gleckman. 
Michael Coston, Crawford Kilian, Scott McPherson, “Revere.”
Michael T. Osterholm, PhD; Kristine Moore, MD; Jim Wappes, Robert Roos, Lisa Schnirring; Kathleen Kimball-Baker; Nicholas Kelley,  Paul Mamula, PhD.
Coilin Nunan; Ramanan Laxminarayan; Donald Berwick, MD, Donald Goldmann, MD Frances Griffin, Joseph McCannon, Madge Kaplan; Lisa McGiffert.
James Sliwa, Steven Baragona.
Robert S. Daum, MD, Susan Boyle-Vavra, PhD, Everly Macario, SciD, Michael Z. David, MD, PhD, Susan Crawford, MD, Christopher Montgomery, MD, Ben Yoon, Lakesha Lloyd; Robert Bielski, MD, Stephen Weber, MD, John Easton.
Henry “Chip” Chambers, MD, Francoise Perdreau-Remington, PhD, Adam Hersh, MD, Binh An Diep, PhD, Kristen Bole; Rick Loftus, MD, Steve Gray.  Elizabeth Bancroft, MD, Nolan Lee, MD, Gregory J. Moran, MD, John Edwards, Jr., MD, Loren G. Miller MD.
John Bradley, MD, Bradley Peterson, MD. Don Janssen, DVM, Nadine Lamberski, DVM, Jeff Andrews.
Nicole Coffin, David Daigle, Rachel Gorwitz, MD, Jeffrey Hageman, Fred Tenover, PhD, Timothy Naimi, MD, Denise Cardo, MD,  Joan Brunkard, PhD, David Sugerman, MD, Roberta Carey PhD, Brandi Limbago PhD, Lonnie King DVM, Jennifer Wright DVM; Susan Sanchez, PhD; Arthur Kellermann, MD, Katherine Heilpern, MD, Henry Blumberg, MD, Leon Haley, MD, Michael Huey, MD, Andre Nahmias, MD; Tom Keating, PhD.
David Edell, Cathy Supak, Mike Carroll, Marilyn Felkner, MD.  Heinz Eichenwald, MD, Mari Nicholson-Preuss.
Gregory Belzley, Martha Sperling, Anita Alberts, Nate Wenstrup, Natalie Leonard, Carrie Takahata, Eric Balaban; John Clarke, MD, Luis Rivera, MD, Timothy Faloon, Rhonda Moore; Charles Alexander, Jr., Gary Benson, David White, Chris Pearson; Pierre Tattevin, MD, Jason Farley, PhD; Elizabeth Cumming, Katie Schwartzmann, Samuel Gore, MD.
Tara Smith, PhD, Michael Male, DVM, Abby Harper; J. Scott Weese, DVM; Andreas Voss, Md, PhD,  Jan Kluytmans, Md, PhD; Pat Gardiner.
Barry Farr, MD, William Jarvis, MD, William Schaffner, MD. Jeff Bender, DVM, BJ Anderson, MD, John Odom, MD, Marjorie Hogan, MD, Kirk Smith, DVM,  Patrick Schlievert, PhD.
Paul M. Wiles, Thomas N. Zweng, MD, Stephen L. Wallenhaupt, MD, James W. Lederer, Jr., MD, Suzie Rakyta, RN, Sandy Cox, RN, Patti Deltry, RN, Kati Everett. Keith M. Ramsey, MD, Kathy Cochran, RN, Delores Nobles.
Barry Eisenstein, MD, Richard Baltz, PhD, Grace Thorne, PhD Jared Silverman, PhD,  Kevin Tally, MD. Joann Lindenmayer, DVM, Robert Moellering, MD, Jeffrey Linder, MD. John Powers, MD,  Ron Najafi, PhD, Mary Beth Minyard,  Henry Shinefield, MD,  Lisa Bayne.
Allison Agwu, MD; Steven J. Barenkamp, MD; Gonzalo Bearman, MD; Benjamin Estrada, MD; Eugene L. Green; Brenda Hollier; Christoph U. Lehmann, MD; Nkuchia Mikinatha, DrPH; Michael Nagy, MD; Louis Rice, MD; Lisa Saiman, MD; Torrance Williams.
Rose Aliberti; Kepa Askenasy; James Bell; Michael Bennett; Laura Chen Davies, Robin Cook; Stephanie Crowell; Amber Don; Eva Ferguson and Beverly and Ernie Dieringer; Nick and Janet Johnson; Kevin Keller; Mollie and Brian Logan; Diane Lore and Richard Ross; Clarissa and Tony Love; Christina Marzullo; Jane McGuinn, Molly Donohue, Charlotte McGuinn Freeman; Steve, Sue and Pat McNees; Karen Moser; Carole and Ty Moss; Victoria Nahum; Melissa Quintana; Debbie Russ; Danielle Sheffler; Scott and Katie Smith; Andrea and Jay Sorensen; Jeanine Thomas; Suzanne Turpin Upton; Tom Wolff, Christine Fusco, Lourraine Stamets.
Samara Cummins, Krista Reese, Rich Eldredge. Lt. Col. Robert J. McKenna, Cerise McKenna Vablais, PhD, Zach McKenna. Rev. Robert E. Lauder, John J. McKenna. Matthew McKenna, Darla Albrigh, Davd Tuller, Randy Dotinga, Elizabeth McKenna.
Loren D. Bolstridge III.

From my heart, thank you all.

More from Fresh Air: a playlist

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In advance of the Fresh Air interview today, their tweeter(s) asked for suggestions for a MRSA playlist! Here’s some of the suggestions:
Fever, Peggy Lee
Countin’ On A Miracle, Bruce Springsteen
Ready or Not, the Delfonics (or as sampled by the Fugees)
Time to Get Ill, Beastie Boys
Hurts So Good, John Mellencamp (was he John Cougar Mellencamp then?)
Infected, Bad Religion
and of course:
I’ve Got You Under My Skin.

Early book reaction! Positive so far

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Folks, it’s Sunday, and SUPERBUG will be officially released on Tuesday. Press copies have been landing at last. Readers who responded to my plea for pre-orders (because pre-orders are very important to how the publisher and the market behave subsequently about the book) have been telling me they’re getting emails saying the book is on its way.

And a few reviews are starting to pop up!

Kirkus said: “A gripping account of one of the most devastating infectious agents on the planet… A meticulously researched, frightening report on a deadly pathogen.”

Booklist said: “Lays bare, often all too graphically, the ravages of a disease with the potential to do grievous international harm.”

But of most value to me today, my blog-friend and supporter Michael Coston of Avian Flu Diary said this morning:

I can think of a great many superlatives to describe this book; engaging, harrowing, fascinating, powerful… even terrifying at times.
But the descriptive term that keeps coming back to me is: Important. …
Superbug, quite frankly, should be required reading for every doctor, nurse, and health care professional, if for no other reason than to alert them to the changes they must make in order to help curb the spread of these deadly pathogens.
But it should also be on the reading list of parents, students, and teachers who need to be able to recognize the early warning signs of infection.
And just as importantly, read by those who make policy at the local, state, and Federal level.  We either make institutional changes or risk serious peril from these resistant bacteria.

The cheering of Mike and other bloggers including Revere of Effect Measure and Crof of H5N1 has meant so much to me as I’ve worked on this book (and also written about flu and other diseases at CIDRAP.) I’m grateful.

MRSA research round-up: hospitals, vitamins, pets

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Because I’ve been so behind, there’s so much to cover! So let’s dive in:

In today’s Archives of Surgery, researchers from Seattle’s Harborview Medical Center report that one simple addition to the routine of caring for trauma patients made a significant difference to the patients’ likelihood of acquiring a hospital-associated infection:
bathing them once a day with the antiseptic chlorhexidine (in an impregnated wipe). Patients who were bathed with the antiseptic wipe, compared with patients wiped down with an inert solution, had
one-fourth the likelihood of developing a catheter-related bloodstream infection and
one-third the likelihood of ventilator-associated MRSA pneumonia. Cite: Evans HL et al. Effect of Chlorhexidine Whole-Body Bathing on Hospital-Acquired Infections Among Trauma Patients.
Arch Surg. 2010;145(3):240-246.

How important are hospital-acquired infections? Here’s a piece of research from a few weeks ago that I sadly failed to blog at the time: Just
two categories of HAIs, sepsis and pneumonia, account for 48,000 deaths and $8.1 billion in health care costs in a single year. Writing in the Archives of Internal Medicine, researchers from the nonprofit project Extending the Cure analyzed 69 million hospital-discharge records issued in 40 states between 1998 and 2006. Hospital charges and number of days that patients had to stay in the hospital were
40% higher because of those infections, many of which are caused by MRSA — and all of which are completely preventable. Cite: Eber, MR et al. Clinical and Economic Outcomes Attributable to Health care-Associated Sepsis and Pneumonia.
Arch Intern Med. 2010; 170(4): 347-53.

 What else could reduce the rate of MRSA infections? How about Vitamin D? South Carolina scientists analyze data from the NHANES (National Health and Nutrition Examination Survey 2001-2004), a massive database overseen by the CDC, and find
an association between low blood levels of Vit. D and the likelihood of MRSA colonization. More than 28% of the population is Vitamin D deficient. MRSA colonization is increasing in the US. Can giving Vit. D decrease MRSA carriage? More research needed. Cite: Matheson EM et al. Vitamin D and methicillin-resistant Staphylococcus aureus nasal carriage.
Scand J Infect Dis
. 2010 Mar 8. [Epub ahead of print]

And finally: Who else carries MRSA? Some unlucky pet owners have found that animals can harbor human strains, long enough at least to pass the strain back to a human whose colonization has been cleared. So it makes sense to ask whether humans who spend time with pets are carrying the bug. Last month’s Veterinary Surgery reports that the answer is Yes.
Veterinarians are carrying MRSA in very significant numbers: 17% of vets and 18% of vet technicians at an international veterinary symposium held in San Diego in 2008. Cite: Burstiner, LC et al. Methicillin-Resistant Staphylococcus aureus Colonization in Personnel Attending a Veterinary Surgery Conference.
Vet Surg. 2010 Feb;39(2):150-7.

SUPERBUG the book: First excerpt, first interview, and news!

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Constant readers: It’s two weeks to publication, and I’m starting to lose my grip on everything there is to do. (As you might be able to tell by my radio silence…) I’m very backed up on great research to tell you about.

First, though, let me share some book news:

EXCERPT: The first excerpt of SUPERBUG has been published on Simon and Schuster’s website! It looks like the entire Chapter One.


INTERVIEW: I was invited to Chicago the past few days to do a speech for International Women’s Day, and ended up doing some sneak-preview media appearances. Here’s the sound file of an interview with the fabulous Alison Cuddy of WBEZ-FM.

MORE INTERVIEWS: I’ll be listing forthcoming interviews and appearances on my page at BookTour.com. You’ll notice there isn’t much up there yet: We’re still working on publicity. So help me fill this page, OK? Here’s how:


TOUR, A PLEA: My publisher, Free Press, doesn’t really believe in sending authors around. They have some justification: As I can testify from my last tour, sometimes a book tour mean spending two hours making painful chit-chat in an empty bookstore whose entire population is the staff, the friend who drove you, and a street person who wandered in and is conversing quietly with her demons. (Twenty-Third Street Books, Portland, OR, thanks for asking. I hear they closed.) But that bad experience notwithstanding, I believe there’s value in getting out and talking to readers, victims, disease geeks and anyone else interested in this bug, and I’m willing to do it, if you’ll help.

So: If you’re a clinician, a professor, or a teacher, and you’re willing to host SUPERBUG and me at a class, a department brown-bag or a Grand Rounds, please get in touch. Ditto if you run a Cafe Scientifique, have a book club that wants to talk about science or medicine, have a church group, a kid’s group, a med-student society… you get the idea. If I can get there, I’ll come. I know already that I’ll be in and out of Minneapolis and Atlanta, my two home bases, and also in North Carolina, Iowa, Chicago, and I hope San Francisco, Portland and Boston as well. Help me add to the list!

Right, back to research tomorrow.

"Pig MRSA" causing human infections

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Hi, everyone. Apologies for dropping out of sight! As SUPERBUG’s publication draws closer (and it’s very close now), I keep finding new tasks that I have do to. Last week’s was to go to New York to shoot a video for the Simon & Schuster website — and while there, I got caught in Snowpocalypse, got delayed coming home, and picked up a nasty cold. So I’m a bit behind.

But there’s exciting news tonight to start us up again: “pig MRSA,” ST398, causing human infections in Canada and Denmark.

“Infections” is important, because up til now, most evidence for  the spread of MRSA ST398 in humans has been through detection of colonization, the symptomless carriage of MRSA on the skin and in the nostrils. The first finding of ST398 in the Netherlands was via colonization; so was its first identification in humans in Canada, and also in the United States just about a year ago.

[Read more…]

Antibiotics and farming — how superbugs happen

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Constant readers: There’s an important new paper that’s been out for a week that I haven’t gotten to you. I apologize; it’s been busy. (Let’s not even talk about the important paper that’s been out for two weeks. Maybe over the weekend…)

We’ve talked for ages now about the potential dangers of unrestricted antibiotic use in agriculture, and how it’s analogous to the inappropriate antibiotic use that human health authorities disapprove of in humans. The main culprits, in farming, are subtherapeutic dosing, also known as growth promotion — that’s giving routine smaller-than-treatment doses to animals to increase their weight — and prophylactic dosing, which is giving a treatment dose to an entire herd or flock either routinely, if there is thought to be a disease threat, or when there is known to be disease in some members of the herd/flock. In either case, animals are getting antibiotics when they do not need them — when they are not sick. And just as in humans who take antibiotics when they are not sick, or take too-low doses when they are sick (such as not finishing a prescription), these practices in animals encourage the development of resistant bacteria.

(Necessary comment here: No one, to my knowledge, objects to giving the appropriate doses of antibiotics to animals that are sick. Why would you?)

[Read more…]

New film on organic farming (for European readers and Francophones)

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This is a little outside our usual subject matter, but:

What looks like a marvelous new documentary exploring environmental damage and human illness from pesticides and other farming chemicals is coming out in France, but needs assistance to get onto the international festival circuit. It’s called Nos enfants nous accuseront (Our Children Will Hold Us Responsible), and among other things, looks at the efforts of a French village to make all the food served in its schools organic — which, even in food-centric France, is much harder than it sounds.

You can view the trailer here. The more clicks, the more the film will be taken to have support, and the higher its rankings will go for festival consideration.

It comes well-recommended by friends of mine in Paris, so I hope you’ll take a look.

Farming and antibiotics – and voices from the ag side

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The whole issue of how antibiotics get used in agriculture — as growth promoters, as prophylatic treatment to prevent spread of infection within a farm, or as true treatment — is intensely controversial. For a sense of how farmers feel embattled, read the comments to this entry at FairFoodFight on whether there is a distinction between “Big Ag” and “small ag.” and consider that the PAMTA legislation I posted about in December, which would require veterinarian oversight of farm use of antibiotics,  has been strongly opposed by agricultural interests every time it has been introduced. (Large-farm use of antibiotics, let me remind you, has been concluded to be the driver behind the emergence of “pig MRSA” ST398.)

But I recently ran across two pieces online that I want to draw your attention to, because they demonstrate that thinking in agriculture about antibiotic use is not monolithic, and may be changing. Both were posted on the same site, the Illinois-based Agri-News Online.

[Read more…]

Bad news in the President's budget request

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It’s been a few days since the rollout of the White House’s proposed 2011 budget request, time enough for people to dig deep into the minutiae and figure out what that massive document really says. The Infectious Diseases Society of America has done the drilling for the health and infectious disease line items, and I’m sorry to say the news is not good.

Worst first: The proposed budget would cut funding for the CDC’s antimicrobial resistance programs by 50%, $8.6 million. That means that only 20 state or local health departments, or health care institutions, will get money from CDC for surveillance and control of resistant bugs. That’s only 40% of what was funded this year, when 48 health departments and health systems were funded. Which is very disturbing: If there’s one thing almost everyone agrees on with regard to MRSA, it’s that we need more surveillance, not less.

In addition, all state grants in the Get Smart About Antibiotics program, which runs campaigns to reduce inappropriate use, get zeroed out.

There are other cuts as well to infectious-disease program at CDC and elsewhere in HHS, including to to a major childhood immunization program and to pandemic defenses. And funding for HIV/AIDS, TB and other NIH research programs barely tiptoe upward.But these frank cuts in programs to combat antimicrobial resistance, at a time when MRSA is burgeoning, Gram negative organisms such as Acinetobacter are gaining ground, and drug development is stalling, surely cannot be smart.

The IDSA analyis is here.

Back again to MRSA in animals, and spreading to humans

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There are two new reports out regarding new findings of “pig MRSA” ST398 (about which we have talked a lot; archive of posts here.)

First, researchers from the Complejo Hospitalario Universitario de Vigo and Complejo Hospitalario de Pontevedra, both in Pontevedra in northwest Spain, report that they have identified that country’s first human cases of infection with ST398. (It was only last fall that Spain reported the first identification of the strain in animals.)

The age of the three patients was 59, 82, and 83 years, respectively. Two patients owned pigs and the other a calf. Two patients were diabetic and were hospitalized because they developed skin and soft-tissue infections by MRSA ST398. The third patient had bronchitis and the strain was isolated from a respiratory secretion submitted to the laboratory from an outpatient clinic. The three patients had had multiple hospital admissions in the last 12 months.

Tellingly, the researchers spotted these particular isolates (out of 44 analyzed at the two hospitals in 2006) because they were resistant to tetracycline. Tetracycline resistance is not common among community strains of MRSA, because the drug isn’t the first-line choice for skin and soft-tissue infections; and when it is given, it’s usually for a short course, so the drug does not exert much selection pressure on the bug. But tetracycline is a very common animal antibiotic, and tetracycline resistance is a hallmark of ST398; it is one of the factors that led the Dutch researchers who first identified the strain to take a second look at the bug.

Second, researchers from several institutions in Italy report a very troubling case of ST398 infection that produced necrotizing fasciitis — better known as flesh-eating disease. [Read more…]

Once again, flu and bacterial co-infection

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With the H1N1 pandemic trending down, it may seem that the question of how much bacterial co-infection affects the outcome of flu is less important than it was. But though the pandemic is subsiding — for ever, for this season, or just until a third wave, who can say — researchers are just now getting enough good data to be able to make solid observations about what happened during the past 10 months.

Case in point: Writing in the journal Public Library of Science (PLoS) ONE, a team of researchers from Australia has pinpointed the incidence of MRSA co-infection during flu in two hospitals in Perth last summer, which was the Australian winter and the height of their flu season. Of 252 patients admitted for H1N1 infection, 3 were identified during treatment as having MRSA pneumonia. They survived, but two other patients who died were found to have MRSA pneumonia during post-mortem exams. [Read more…]

MRSA in the journal Science – spread, outbreaks and an argument for active surveillance

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I have a story tonight at CIDRAP about a paper published this evening in the journal Science. To respect fair use and make sure my colleagues get clicks, I just quote the story here — but then I want to talk about why I think it’s such an important study.

   A multi-national team of researchers has applied a new genomic tool to a 50-year-old bacterial foe, using minute mutations to track the spread of drug-resistant staph both across continents and within a single hospital.
On a global scale, their sleuthing tracked the movement of one clone of methicillin-resistant Staphylococcus aureus (MRSA) back and forth across the planet, pinpointing when individual cases transported infections across national borders to spark new outbreaks. Separately, their method demonstrated that what appeared to be a hospital epidemic of MRSA was not a single outbreak, but rather a mixed event of patient-to-patient transmission of one strain that was accompanied by multiple importations from outside the hospital of similar but unrelated strains. …
In a briefing yesterday for the press, the authors emphasized the latter finding, pointing out that the traditional infection control measures usually applied to hospital outbreaks would not curb the spread of infections that were carried in undetected from outside. Their method, they said, provides a proof of concept for using cutting-edge genomics to uncover the precise pathways by which MRSA spreads within hospitals—not only tracing its path from patient to patient, but also identifying the bug in patients whose undetected bacterial carriage could spark outbreaks but have not yet.

If you’d like more, here’s a very good story at Scientific American, one at BBC Health and one by the Associated Press; and Science Daily‘s version.

[Read more…]

News round-up!

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As promised, lots to catch up on — so here’s a quick round-up of some great reading that I have been stashing and that you may have missed in the past few weeks.

BBC News: Disinfectants may train bacteria to resist antibiotics
The BBC Health page (bookmark it!) translates a paper from the journal Microbiology on Pseudomonas aeruginosa’s newly recognized ability to pump the active ingredient in disinfectants out of its cells — and then to apply that same ability to the antibiotic Ciprofloxacin, even when it has never been exposed to Cipro before. Money quote: “... Residue from incorrectly diluted disinfectants left on hospital surfaces could promote the growth of antibiotic-resistant bacteria.”

Associated Press:  Solution to killer superbug found in Norway
In the latest installment in a 6-month series, AP writers Martha Mendoza and Margie Mason examine Norway’s success in forcing down rates of hospital MRSA. chiefly by extremely strict control of antibiotics dispensed in hospitals. I have some disagreements with this story; I don’t think they account for how much easier it is to do antibiotic stewardship, as it’s called, in a single-payer health system such as Norway or their second example, England, compared to the extremely complex US system. But I’m very glad to see the AP (and the Nieman Foundation at Harvard, where Mason was a fellow) support public exploration of antibiotic resistance, which I obviously feel gets insufficient attention. (Stay tuned for SUPERBUG’s discussion of one US stewardship program that has worked and may be replicable.)

Time: Should weight factor into antibiotic dosage?
Time.com looks at a provocative new paper in the Lancet that questions whether standard prescribed dosing of antibiotics isn’t really a form of inappropriate use. Money quote: “Dosage according to body mass is standard in anesthetics, pediatrics, oncology and other fields, [but] when it comes to antibiotics and antimicrobials the dosing guidelines are too broad… and may undermine a medications efficacy. …In the face of both widespread obesity and the increasing prevalence of antibiotic-resistance, tailoring dosage for optimal results is increasingly important.”

And finally, new today:
Science Daily: Bacteria Are More Capable of Complex Decision-Making Than Thought
University of Tennessee researchers explore the ability of a bacterium (the soil bacterium Azospirillum brasilense) to sense changes in its environment, process that information and make surprisingly complex decisions in response.