Pat's Note: An important article from a regular writer on MRSA, that
may well have implications for Britain.

Colonisation is not the same as infection, but it may pose risks to
the carrier as well as others.

This points towards selective screening of pig and pork workers, as on
the Continent, as being of even more use in the heavily infected and
colonised  areas of  Britain.

http://drugresistantstaph.blogspot.com/2008/07/mrsa-colonization-long-term-risk.html

05 July 2008

MRSA colonization - the long-term risk 

One of the ongoing puzzles of MRSA's behavior is the significance of
colonization, that situation of MRSA living on the skin — or in the
nostrils or other locations close to the body's external surface —
without causing illness. It's not known how frequently MRSA
colonization occurs, for one thing: The long-standing estimate of 1%
of the population has been challenged by a number of recent studies.

Another persistent question has been whether the risk of illness and
death changes as colonization continues. It has been established that
up to one-third of newly colonized carriers will become seriously ill
within a year of their acquiring the bug (Huang, SS. et al., Society
for Healthcare Epidemiology of America Annual Meeting 2006, abstract
157 - not online that I can find)— but what happens beyond that? Does
the risk of illness persist or decrease?

In Clinical Infectious Diseases, the same team that defined the risks
of recent colonization report that there are significant risks to
long-term carriage as well: 27% of invasive illness in the second year
and 16% thereafter, based on a review of 281 patients who were
followed for at least one and up to four years at Brigham & Women's
Hospital, a Harvard Medical School teaching hospital. These patients
become very ill, and in addition use a significant amount of
health-care resources:

At our hospital, there are 2–3 times as many hospital admissions
involving patients previously known to harbor MRSA than there are
hospital admissions of individuals who are newly detected as MRSA
carriers each year.

What is the precipitating event that tips MRSA carriage over into MRSA
illness? It may be health care. In other words, the long-term carriers
do not become ill with MRSA disease and then come to the hospital.
Instead, they come to the hospital for some other reason, and the
surgery, IV placement, dialysis etc. they receive allows their MRSA
strain to slip past the protective barrier of their skin and begin an
invasive infection.

We submit that these high risks of MRSA infection among
culture-positive prevalent carriers are not only preferentially
detected because of hospitalization but may, in fact, be incurred
because of the device-related, wound-related, and immunologic declines
associated with a current illness.
This raises the question of whether any admitted patient found to be
colonized should undergo the routine known as decolonization before
any other procedures are performed — and whether institutions and
insurance companies will be open to the additional hospital days and
drug costs that will represent.

The cite is: Datta, R. and Huang, SS. Risk of Infection and Death due
to Methicillin-Resistant Staphylococcus aureus in Long-Term Carriers.
Clinical Infectious Diseases. 2008 47:176-81. 

-- 
Regards
Pat Gardiner
Release the results of testing British pigs for MRSA and C.Diff now!
www.go-self-sufficient.com

On Jul 6, 4:16 am, Pat Gardiner 
wrote:
> Pat's Note: An important article from a regular writer on MRSA, that
> may well have implications for Britain.
>
> Colonisation is not the same as infection, but it may pose risks to
> the carrier as well as others.
>
> This points towards selective screening of pig and pork workers, as on
> the Continent, as being of even more use in the heavily infected and
> colonised  areas of  Britain.
>
> http://drugresistantstaph.blogspot.com/2008/07/mrsa-colonization-long...
>
> 05 July 2008
>
> MRSA colonization - the long-term risk
>
> One of the ongoing puzzles of MRSA's behavior is the significance of
> colonization, that situation of MRSA living on the skin — or in the
> nostrils or other locations close to the body's external surface —
> without causing illness. It's not known how frequently MRSA
> colonization occurs, for one thing: The long-standing estimate of 1%
> of the population has been challenged by a number of recent studies.
>
> Another persistent question has been whether the risk of illness and
> death changes as colonization continues. It has been established that
> up to one-third of newly colonized carriers will become seriously ill
> within a year of their acquiring the bug (Huang, SS. et al., Society
> for Healthcare Epidemiology of America Annual Meeting 2006, abstract
> 157 - not online that I can find)— but what happens beyond that? Does
> the risk of illness persist or decrease?
>
> In Clinical Infectious Diseases, the same team that defined the risks
> of recent colonization report that there are significant risks to
> long-term carriage as well: 27% of invasive illness in the second year
> and 16% thereafter, based on a review of 281 patients who were
> followed for at least one and up to four years at Brigham & Women's
> Hospital, a Harvard Medical School teaching hospital. These patients
> become very ill, and in addition use a significant amount of
> health-care resources:
>
> At our hospital, there are 2–3 times as many hospital admissions
> involving patients previously known to harbor MRSA than there are
> hospital admissions of individuals who are newly detected as MRSA
> carriers each year.
>
> What is the precipitating event that tips MRSA carriage over into MRSA
> illness? It may be health care. In other words, the long-term carriers
> do not become ill with MRSA disease and then come to the hospital.
> Instead, they come to the hospital for some other reason, and the
> surgery, IV placement, dialysis etc. they receive allows their MRSA
> strain to slip past the protective barrier of their skin and begin an
> invasive infection.
>
> We submit that these high risks of MRSA infection among
> culture-positive prevalent carriers are not only preferentially
> detected because of hospitalization but may, in fact, be incurred
> because of the device-related, wound-related, and immunologic declines
> associated with a current illness.
> This raises the question of whether any admitted patient found to be
> colonized should undergo the routine known as decolonization before
> any other procedures are performed — and whether institutions and
> insurance companies will be open to the additional hospital days and
> drug costs that will represent.
>
> The cite is: Datta, R. and Huang, SS. Risk of Infection and Death due
> to Methicillin-Resistant Staphylococcus aureus in Long-Term Carriers.
> Clinical Infectious Diseases. 2008 47:176-81.
>
> --
> Regards
> Pat Gardiner
> Release the results of testing British pigs for MRSA and C.Diff now!www.go-self-sufficient.com

Dear Mr. Gardiner:   One of the problems in the Medical and
Microbiological fields is that these researchers conduct their
studies, assemble their data and present their papers to their peer
groups, get the notoriety to justify their work, get acknoledged and
lauded.....then their work gets tucked behind the Iron Curtain of Peer
Group membership, not generally open to public scrutiny.  That is a
Big Problem.   You'll (we) will have to contact these named
researchers directly to get more commentary.   (Same problem has
existed with the likes of Dr. Chris Oura, IAH Pirbright, on such
subjects as Bluetongue and FMD.)   First, we didn't know who to
contact.   Then, when we started publishing names....things started
happening.   For the first time, since last fall, Dr. Oura has been
pretty visible and vocal in sharing what he's learned.   That's
progress.

Burkie

On Sun, 6 Jul 2008 06:45:18 -0700 (PDT), Burkie 
wrote:

>On Jul 6, 4:16 am, Pat Gardiner 
>wrote:
>> Pat's Note: An important article from a regular writer on MRSA, that
>> may well have implications for Britain.
>>
>> Colonisation is not the same as infection, but it may pose risks to
>> the carrier as well as others.
>>
>> This points towards selective screening of pig and pork workers, as on
>> the Continent, as being of even more use in the heavily infected and
>> colonised  areas of  Britain.
>>
>> http://drugresistantstaph.blogspot.com/2008/07/mrsa-colonization-long...
>>
>> 05 July 2008
>>
>> MRSA colonization - the long-term risk
>>
>> One of the ongoing puzzles of MRSA's behavior is the significance of
>> colonization, that situation of MRSA living on the skin — or in the
>> nostrils or other locations close to the body's external surface —
>> without causing illness. It's not known how frequently MRSA
>> colonization occurs, for one thing: The long-standing estimate of 1%
>> of the population has been challenged by a number of recent studies.
>>
>> Another persistent question has been whether the risk of illness and
>> death changes as colonization continues. It has been established that
>> up to one-third of newly colonized carriers will become seriously ill
>> within a year of their acquiring the bug (Huang, SS. et al., Society
>> for Healthcare Epidemiology of America Annual Meeting 2006, abstract
>> 157 - not online that I can find)— but what happens beyond that? Does
>> the risk of illness persist or decrease?
>>
>> In Clinical Infectious Diseases, the same team that defined the risks
>> of recent colonization report that there are significant risks to
>> long-term carriage as well: 27% of invasive illness in the second year
>> and 16% thereafter, based on a review of 281 patients who were
>> followed for at least one and up to four years at Brigham & Women's
>> Hospital, a Harvard Medical School teaching hospital. These patients
>> become very ill, and in addition use a significant amount of
>> health-care resources:
>>
>> At our hospital, there are 2–3 times as many hospital admissions
>> involving patients previously known to harbor MRSA than there are
>> hospital admissions of individuals who are newly detected as MRSA
>> carriers each year.
>>
>> What is the precipitating event that tips MRSA carriage over into MRSA
>> illness? It may be health care. In other words, the long-term carriers
>> do not become ill with MRSA disease and then come to the hospital.
>> Instead, they come to the hospital for some other reason, and the
>> surgery, IV placement, dialysis etc. they receive allows their MRSA
>> strain to slip past the protective barrier of their skin and begin an
>> invasive infection.
>>
>> We submit that these high risks of MRSA infection among
>> culture-positive prevalent carriers are not only preferentially
>> detected because of hospitalization but may, in fact, be incurred
>> because of the device-related, wound-related, and immunologic declines
>> associated with a current illness.
>> This raises the question of whether any admitted patient found to be
>> colonized should undergo the routine known as decolonization before
>> any other procedures are performed — and whether institutions and
>> insurance companies will be open to the additional hospital days and
>> drug costs that will represent.
>>
>> The cite is: Datta, R. and Huang, SS. Risk of Infection and Death due
>> to Methicillin-Resistant Staphylococcus aureus in Long-Term Carriers.
>> Clinical Infectious Diseases. 2008 47:176-81.
>>
>> --
>> Regards
>> Pat Gardiner
>> Release the results of testing British pigs for MRSA and C.Diff now!www.go-self-sufficient.com
>
>Dear Mr. Gardiner:   One of the problems in the Medical and
>Microbiological fields is that these researchers conduct their
>studies, assemble their data and present their papers to their peer
>groups, get the notoriety to justify their work, get acknoledged and
>lauded.....then their work gets tucked behind the Iron Curtain of Peer
>Group membership, not generally open to public scrutiny.  That is a
>Big Problem.   You'll (we) will have to contact these named
>researchers directly to get more commentary.   (Same problem has
>existed with the likes of Dr. Chris Oura, IAH Pirbright, on such
>subjects as Bluetongue and FMD.)   First, we didn't know who to
>contact.   Then, when we started publishing names....things started
>happening.   For the first time, since last fall, Dr. Oura has been
>pretty visible and vocal in sharing what he's learned.   That's
>progress.

Sure Burkie. 

There is a lot in our scientific procedures that needs urgent change.

Change has to come from within and that will only come when they fear
the barbarians beyond outside the gates, more than they fear their
colleagues.

You have to kick them as often as possible  in the most tender place,
and explain just what will happen to them if they don't test the pigs
and publish believable results.

They will be going to prison for a very long time, unless they are the
first to speak. That will shorten the sentences considerably
naturally.

Those that retian any kind of job in science will never pull a stroke
like this again. And those that follow them will be taught that you
don't fake results - ever.

-- 
Regards
Pat Gardiner
Release the results of testing British pigs for MRSA and C.Diff now!
www.go-self-sufficient.com 
>
>Burkie