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BigPapaSmurf
SFN Die Hard

3192 Posts

Posted - 05/24/2005 :  10:15:09  Show Profile Send BigPapaSmurf a Private Message
http://www.timesonline.co.uk/article/0,,2-1625253,00.html

"The worst I've ever seen"

Scary.
[Moved to the Health folder - Dave W.]

"...things I have neither seen nor experienced nor heard tell of from anybody else; things, what is more, that do not in fact exist and could not ever exist at all. So my readers must not believe a word I say." -Lucian on his book True History

"...They accept such things on faith alone, without any evidence. So if a fraudulent and cunning person who knows how to take advantage of a situation comes among them, he can make himself rich in a short time." -Lucian critical of early Christians c.166 AD From his book, De Morte Peregrini

pleco
SFN Addict

USA
2996 Posts

Posted - 05/24/2005 :  10:34:35   [Permalink]  Show Profile  Visit pleco's Homepage Send pleco a Private Message
Yikes.

by Filthy
The neo-con methane machine will soon be running at full fart.
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Dude
SFN Die Hard

USA
6891 Posts

Posted - 05/24/2005 :  12:11:23   [Permalink]  Show Profile Send Dude a Private Message
The cause of necrotizing pneumonia.

A very bad bug indeed.


Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson

"god :: the last refuge of a man with no answers and no argument." - G. Carlin

Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth
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filthy
SFN Die Hard

USA
14408 Posts

Posted - 05/24/2005 :  13:07:59   [Permalink]  Show Profile Send filthy a Private Message
One badass bug indeed -- it kills even faster than plague used to. I wonder what it evolved from.

It is noteworthy that no mention of cases in Africa was made. There, it seems, is where the really nasty ones are all but common place. Of course, further research might show that it orginated there.


"What luck for rulers that men do not think." -- Adolf Hitler (1889 - 1945)

"If only we could impeach on the basis of criminal stupidity, 90% of the Rethuglicans and half of the Democrats would be thrown out of office." ~~ P.Z. Myres


"The default position of human nature is to punch the other guy in the face and take his stuff." ~~ Dude

Brother Boot Knife of Warm Humanitarianism,

and Crypto-Communist!

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Dude
SFN Die Hard

USA
6891 Posts

Posted - 05/24/2005 :  13:41:24   [Permalink]  Show Profile Send Dude a Private Message
Most forms of S. aureus are opportunistic. They don't typically cause infection unless there is some break in the normal defenses.

The case described seems to have the guy dying within a very few days of this scratch, witch makes me wonder of that scratch was actually the source.

Being a military recruit, and one in a commando school at that, there is immense pressure to ignore your body and carry on with the job at hand. I'm betting that these guys don't report to sick call, but have to be ordered there by a superior. They'd rather die in place than appear to be malingering.

Also, while these bugs are resistant to some antibiotics, they are typically susceptable to drugs like vancomycin and gentamycin.

If caught and treated soon enough, it isn't fatal (typically). But if it progresses to the need for mechanical ventilation.... mortality is pretty high.

Any bacteria that produces a cytotoxin that kills white blood cells is serious bad news though.


Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson

"god :: the last refuge of a man with no answers and no argument." - G. Carlin

Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth
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filthy
SFN Die Hard

USA
14408 Posts

Posted - 05/24/2005 :  14:22:27   [Permalink]  Show Profile Send filthy a Private Message
quote:
Originally posted by Dude

Most forms of S. aureus are opportunistic. They don't typically cause infection unless there is some break in the normal defenses.

The case described seems to have the guy dying within a very few days of this scratch, witch makes me wonder of that scratch was actually the source.

Being a military recruit, and one in a commando school at that, there is immense pressure to ignore your body and carry on with the job at hand. I'm betting that these guys don't report to sick call, but have to be ordered there by a superior. They'd rather die in place than appear to be malingering.

Also, while these bugs are resistant to some antibiotics, they are typically susceptable to drugs like vancomycin and gentamycin.

If caught and treated soon enough, it isn't fatal (typically). But if it progresses to the need for mechanical ventilation.... mortality is pretty high.

Any bacteria that produces a cytotoxin that kills white blood cells is serious bad news though.



I'm not very knowledgable about this sort of thing, but I wonder; the speed of infection and resulting death from suffocation and heart failure sort of smacks of pneumonic transmition. Possible? And what might be the vector(s)?

It is entirely true that minor, and even some pretty messy, cuts and scratches are ignored, an aquired habit that can last long after their service is over.


"What luck for rulers that men do not think." -- Adolf Hitler (1889 - 1945)

"If only we could impeach on the basis of criminal stupidity, 90% of the Rethuglicans and half of the Democrats would be thrown out of office." ~~ P.Z. Myres


"The default position of human nature is to punch the other guy in the face and take his stuff." ~~ Dude

Brother Boot Knife of Warm Humanitarianism,

and Crypto-Communist!

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Dude
SFN Die Hard

USA
6891 Posts

Posted - 05/24/2005 :  14:46:57   [Permalink]  Show Profile Send Dude a Private Message
quote:
I'm not very knowledgable about this sort of thing, but I wonder; the speed of infection and resulting death from suffocation and heart failure sort of smacks of pneumonic transmition. Possible? And what might be the vector(s)?


Staph is typically transmited by physical contact with another person or object or body fluid.

There could be a small chance of transmission from an airborn vector, on droplets from a cough or a sneeze, but you'd have to be in close proximity to the carrier.

The rapid onset of respiratory symptoms and then death seems strange to me, considering that he was under medical supervision.

Necrotizing pneumonia takes some time to kill you when you recieve medical care.

But this story is from a "news" source, not a medical case study... Take it with a grain of salt.


Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson

"god :: the last refuge of a man with no answers and no argument." - G. Carlin

Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth
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filthy
SFN Die Hard

USA
14408 Posts

Posted - 05/24/2005 :  16:18:23   [Permalink]  Show Profile Send filthy a Private Message
Thamks, Dude.

10/4 on the news source. They write for the reader rather than the story, thus, too often they favor appeal over verasity. I'm sure there will be more on it before very long.




"What luck for rulers that men do not think." -- Adolf Hitler (1889 - 1945)

"If only we could impeach on the basis of criminal stupidity, 90% of the Rethuglicans and half of the Democrats would be thrown out of office." ~~ P.Z. Myres


"The default position of human nature is to punch the other guy in the face and take his stuff." ~~ Dude

Brother Boot Knife of Warm Humanitarianism,

and Crypto-Communist!

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Dude
SFN Die Hard

USA
6891 Posts

Posted - 05/24/2005 :  16:53:25   [Permalink]  Show Profile Send Dude a Private Message
I'd love to read a case-study write up on this one, would make for some educational reading no doubt.


Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson

"god :: the last refuge of a man with no answers and no argument." - G. Carlin

Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth
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Dave W.
Info Junkie

USA
25997 Posts

Posted - 05/24/2005 :  17:23:59   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message
86 PubMed hits for Panton-Valentine leukocidin.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too.
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beskeptigal
SFN Die Hard

USA
3834 Posts

Posted - 05/26/2005 :  08:46:04   [Permalink]  Show Profile Send beskeptigal a Private Message
That is not a superbug to worry about. Now here's a superbug to worry about.
quote:
Recently, many people died of avian influenza in Qinghai province.
The affected localities reveal that, as of early April 2005, there have
been several deaths of migratory birds. Because of lack of
reporting, the news has not traveled widely. Toward the end of April
2005, cases of human infection started to emerge. After 1 May
2005, some tourists who visited the areas were severely affected,
and 6 of them died.

During the month of April 2005, a large-scale dissemination of the
infection took place involving both humans and domesticated
animals. The affected area is vast but sparsely populated. Thus,
the problem of large-scale of infection involving both humans and
domesticated animals is relatively unnoticeable. The feral birds
migrate freely and so expand the area of transmission. The
Chinese authorities have admitted the outbreaks and started to seal
off the affected area.

Because of this, Mrs. Yi Wu (Chinese Minister of Health) has cut
short her visit to Japan and returned home. According to the local
news in the affected locality, the number of human casualties is
higher than 6.

The deceased persons are all foreign tourists (i.e. not local
residents): 2 (a man and a woman) from Chengdu, and one man
from Chongqing, Sichuang province. It is unknown from where the
remaining casualties come.

The information was provided by someone who has visited the area
of the outbreaks.
This news report came out yesterday but has yet to be confirmed. Whether true or not, the Avian flu marches on.

quote:
Dude:Staph is typically transmited by physical contact with another person or object or body fluid.

There could be a small chance of transmission from an airborn vector, on droplets from a cough or a sneeze, but you'd have to be in close proximity to the carrier.

The rapid onset of respiratory symptoms and then death seems strange to me, considering that he was under medical supervision.

Necrotizing pneumonia takes some time to kill you when you recieve medical care.

But this story is from a "news" source, not a medical case study... Take it with a grain of salt.

Staphylococcal infections are not airborne. But the bacteria are everywhere and surfaces are easily contaminated. Infections such as this are luck of the draw.

Drug resistant staph bacterial infections have become increasingly very common. Some are a tad more than opportunistic causing skin infections like folliculitis, a pustular infection of multiple hair follicles. Staph pneumonia is opportunistic and we haven't seen a change in that pattern though it is always possible some bacteria could acquire the ability to more readily initiate infection thus making 'opportunistic' a relative term.

Rapid onset and death despite medical care in this case is not the least bit strange. Just as rapidly invasive streptococcal infections cause "flesh eating" disease, the staph bacteria in this case cause a different but similar rapidly invasive disease. It also turned out in this case that the bacteria had drug resistance in addition to its other deadly qualities. That meant initial choices of antibiotics didn't work, delaying effective treatment. But with rapidly invasive disease, you can easily die within hours of getting infected and it is pretty hard to treat these folks fast enough. In addition, when you kill bacteria, the toxins within their cells are released as the cell dies. So killing the bacteria with antibiotics results in an initial increase in toxins released into the body. The fatality rate is high in these types of infections.

Jim Hensen of the Muppets died from rapidly invasive streptococcal pneumonia.

So what we have here is drug resistance combined with high lethality. That is a tad worrisome but doesn't mean the bacteria will become commonplace. Drug resistance has OTOH become very commonplace and is a serious threat.

The news story is correct. I have read about the cases already in the medical lit. I am not worried about this bug yet but it bears watching.


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Dude
SFN Die Hard

USA
6891 Posts

Posted - 05/26/2005 :  14:08:32   [Permalink]  Show Profile Send Dude a Private Message
quote:
Rapid onset and death despite medical care in this case is not the least bit strange. Just as rapidly invasive streptococcal infections cause "flesh eating" disease, the staph bacteria in this case cause a different but similar rapidly invasive disease. It also turned out in this case that the bacteria had drug resistance in addition to its other deadly qualities.


In a hospital, even on a plain old medical ward, patients are monitored frequently.

With the availability of mechanical ventilation, emergency life support, and anti-sepsis drugs in addition to anti-biotics, it is strange that anyone dies in such a short period of time.

I'm not saying to doesn't happen, but the cases of necrotizing pneumonia I have had first hand experience with (3 or 4 in the last few years) typically lived for a week or two after admission to an ICU.

As I said before though, because it is a news story it doesn't have alot of medical detail.

quote:
Drug resistance has OTOH become very commonplace and is a serious threat.



Big time. The ability of bacteria to exchange genetic material across species is an amazing tool for adaptation. Combined with the very short generation times (20 min for Staph in ideal conditions) it only becomes a matter of when, not if, a bacteria will gain resistance to new antibiotics.

If we could only convince doctors to stop prescribing antibiotics to treat the common cold. Antibiotic prescrition should require confirmation of bacterial presence via culture, and a sensitivity report should be used to determine what antibiotic to prescribe. Then, if you could convince people to actually take their antibiotics for the full time ordered, we'd have alot less new resistant strains.


Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson

"god :: the last refuge of a man with no answers and no argument." - G. Carlin

Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth
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Dave W.
Info Junkie

USA
25997 Posts

Posted - 05/26/2005 :  19:07:47   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message
quote:
Originally posted by Dude

Antibiotic prescrition should require confirmation of bacterial presence via culture...
A little off-topic, but given that there are some kooks out there (exhibit A, exhibit B) who recommend antifungals as primary treatment for psoriasis, and tons of "yeast doctors" for general ills, I was very pleased to hear, years ago, a representative from my company's health insurance provider state flat-out that for them to pay for antifungals requires the prescribing doctor to submit positive test results.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too.
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beskeptigal
SFN Die Hard

USA
3834 Posts

Posted - 05/27/2005 :  12:21:21   [Permalink]  Show Profile Send beskeptigal a Private Message
quote:
Originally posted by Dave W.

quote:
Originally posted by Dude

Antibiotic prescrition should require confirmation of bacterial presence via culture...
A little off-topic, but given that there are some kooks out there (exhibit A, exhibit B) who recommend antifungals as primary treatment for psoriasis, and tons of "yeast doctors" for general ills, I was very pleased to hear, years ago, a representative from my company's health insurance provider state flat-out that for them to pay for antifungals requires the prescribing doctor to submit positive test results.

You know your stuff about psoriasis. However, in general, you all are over simplifying the medical world.

Every provider should be using protocol standards and currently practitioners do a very bad job of that. For the life of me, I can't figure out why.

But not all protocols require cultures. It really does depend on many many things. Antibiotics should be reserved for clearly bacterial infections. The problem is prescribing for the whining patient rather than the bacterial signs. When the infection is more likely bacterial than not, then antibiotic choice and decision to culture can be done via an algorhythm. Some situations require cultures: eye infections (too dangerous to see if you made the right choice), antibiotic failures or relapses within 2 weeks of previous treatment, stuff like that. Even with staph infections, I'd start the person on drugs based on their risk of MRSA or lack of risk. With MRSA risks, I culture. No risks, I only culture if treatment fails in the first 48 hours. And so on and so on.
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Dave W.
Info Junkie

USA
25997 Posts

Posted - 06/05/2005 :  00:21:05   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message
Bizarre little find: "Praise the Lord, and Pass the Antiseptic."

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too.
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beskeptigal
SFN Die Hard

USA
3834 Posts

Posted - 06/14/2005 :  02:09:05   [Permalink]  Show Profile Send beskeptigal a Private Message
quote:
Originally posted by Dave W.

Bizarre little find: "Praise the Lord, and Pass the Antiseptic."

From the article, "The major route of transmission of MRSA is health-care workers' hands," he said, and if doctors and nurses practise proper hygiene, even Bible-borne MRSA doesn't have a prayer."

However, that doesn't mean the Bibles couldn't contribute. NOVA did a program on MRSA waaay back when it first emerged. They found it being spread via dust in the halls. They had to seal some central supply windows in an Australian hospital to stop an outbreak. They also recovered the bacteria from nurses' uniforms. The bibles have a porous cloth cover then they should be replaced. Everything needs to be conducive to being disinfected between patients.

How stupid for folks to be insulted rather than to just take an objective approach. Either the bibles can spread contamination or they can be disinfected between patients. It's a simple question.
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