Antibiotics fun

Suppose that one morning, on your way to class, you were to touch a surface, like a doorknob, that was contaminated with some lingering Staphylococcus aureus (Figure 1). The bacterium S. aureus, known by health care workers as "staph," is the most common cause of skin infections in humans. Suppose another student who had walked into the building just minutes beforehand had left the organism there, after grabbing hold of the same doorknob. Now imagine that you have an open cut on your finger, and some of the bacteria that are on that doorknob get into your wound. Although this seems like a minor event, it could actually have great repercussions for your overall health.

MRSA: The Spread of Drug Resistance

In fact, there is a good chance that the staph infection you picked up from that contaminated doorknob is already antibiotic resistant. Most staph infections in humans are caused by methicillin-resistant Staphylococcus aureus, or MRSA, a drug-resistant phenotype that has been circulating for more than 45 years, almost as long as methicillin has been on the market. According to the U.S. Centers for Disease Control (CDC), in 2004, 63% of all reported staph infections in the United States were caused by MRSA (CDC, 2007). That figure represents a remarkable 300% increase in just 10 years' time. (In 1995, about 22% of all reported staph infections were MRSA, compared with only 2% in 1974.) The irony is that methicillin, a chemically modified version of penicillin, was developed in the 1950s as an alternative treatment for the growing proportion of staph infections already resistant to penicillin. At that time, about 60% of all staph infections were resistant to penicillin.

Needless to say, physicians no longer prescribe traditional antibiotics for methicillin-resistant staph infections (Micet, 2007). Instead, they usually administer "last-resort" intravenous vancomycin, although a growing number of doctors are now prescribing other newer antibiotics. Even with these options, scientists estimate that about 19,000 people in the United States die every year from MRSA (Klevens et al., 2007)—that's more than the number of U.S. residents and citizens that die from HIV/AIDS (about 17,000 every year). Of course, not all staph infections are deadly. In fact, about 30% to 40% of us have both methicillin-resistant and non-methicillin-resistant S. aureus living on the surface of our skin yet suffer no symptoms at all. Most deaths from S. aureus occur when what is normally "just" a skin infection enters the bloodstream and becomes invasive, affecting a person's internal anatomy. Moreover, most MRSA deaths occur in the hospital among patients being treated for other reasons and whose immune systems are too weak to fight off the infection, even when vancomycin is administered. In fact, MRSA used to occur only in hospitals. Also, as little as twenty years ago, MRSA did not spread via contaminated doorknobs (except in hospitals). The first so-called "community-acquired" MRSA infection—an infection occurring in a person neither hospitalized nor having had any recent contact with someone who was hospitalized—wasn't reported until the early 1990s. Since then, a growing number of MRSA cases and deaths have occurred outside of hospitals.

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no need to worry guys, somebody will come up with a plan someday….maybe.

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