MRSA by Ray Sahelian, M.D.

MRSA, or Methicillin Resistant Staphylococcus Aureus, is a bacterium resistant to certain antibiotics. It occurs most frequently in patients with weakened immune systems in hospitals and nursing homes and can be spread by poor hygiene. Community-acquired MRSA has become the most frequent identifiable cause of skin and soft-tissue infections among patients treated at hospital emergency departments in several metropolitan areas across the US. It is my thought that MRSA infection may be more likely in those who have a poor diet with lots of junk food and high sugar intake, or those under a great deal of stress or those who do not get adequate sleep.

MRSA and Skin Infections
Many boils and pimples severe enough to send people to hospital emergency rooms are caused by a sometimes deadly bacterium that cannot be treated with conventional drugs. Doctors at the University of California, Los Angeles, found that 59 percent of skin and soft tissue infections seen in 11 emergency rooms across the United States were from the deadly superbug known as MRSA.

MRSA Monitoring
At Boston's Brigham and Women's Hospital, high-compliance screening for MRSA in adult ICUs led to dramatic decreases in MRSA bloodstream infections throughout the hospital. Dr. Susan S. Huang took a look back at the impact of four infection control strategies introduced one at a time during a 9-year period. They were: increasing compliance with maximal sterile barrier precautions during central venous catheter placement; institution of alcohol-based hand rubs for hand disinfection; introduction of a hand hygiene campaign; and institution of routine MRSA screening for all patients on admission to the ICU and weekly thereafter. Routine MRSA screening and subsequent contact isolation precautions were associated with a statistically significant change in MRSA bacteremia. In 16 months, the incidence density of MRSA bacteremia fell by 75% in ICUs and 40% in non-ICUs, leading to a 67% hospital-wide reduction in the incidence density of MRSA bacteremia. Clin Infect Dis 2006;43:971-978.

MRSA decontamination
Hydrogen peroxide vapor, in combination with decolonization of staff and patient carriers, successfully controlled an outbreak of methicillin-resistant Staphylococcus aureus MRSA on a surgical ward that had previously been MRSA-free. In January 2007, MRSA was detected during the routine culture of minor surgical wound infections in two patients who were located in different sections of a ward at the Royal County Hospital in Winchester. Further screening of all 28 patients on the ward identified MRSA colonization in 11 patients. MRSA was also detected in 6 out of 52 healthcare workers on the ward, and environmental sampling indicated "substantial" MRSA contamination throughout the ward on various surfaces. Hydrogen peroxide vapor was used to decontaminate the area. Bioquell ( Ltd., based in Andover, UK, supplied the hydrogen peroxide vapor service. At follow-up, all of the staff members and patients remained decolonized for MRSA. Over this period, all of the 69 patients who were discharged were MRSA-negative. Of the 81 patients who were admitted, 3 tested positive for MRSA. After the hydrogen peroxide vapor decontamination, no new MRSA acquisitions occurred among the patients or staff. Hydrogen peroxide, plus patient and staff decontamination, ended the MRSA outbreak and that the effect was maintained up to at least 4 weeks. Bioquell developed the hydrogen peroxide vapor for microbial decontamination in the late 1990s.

MRSA Research
Antimicrobial activity of berberine alone and in combination with ampicillin or oxacillin against methicillin-resistant Staphylococcus aureus.
J Med Food. 2005 Winter;8(4):454-61. Department of Food and Nutrition, Kunsan National University, Kunsan.
Methicillin-resistant Staphylococcus aureus ( MRSA ) bacteria have been responsible for substantial morbidity and mortality in hospitals because they usually have multidrug resistance. Some natural products are candidates as new antibiotic substances. In the present study, we investigated the antimicrobial activity of berberine, the main antibacterial substance of Coptidis rhizoma (Coptis chinensis Franch) and Phellodendri cortex (Phellodendron amurense Ruprecht), against clinical isolates of MRSA, and the effects of berberine on the adhesion to MRSA and intracellular invasion into human gingival fibroblasts (HGFs). Berberine showed antimicrobial activity against all tested strains of MRSA. Minimum inhibition concentrations (MICs) of berberine against MRSA ranged from 32 to 128 microg/mL. Ninety percent inhibition of MRSA was obtained with 64 microg/mL or less of berberine. In the checkerboard dilution test, berberine markedly lowered the MICs of ampicillin and oxacillin against MRSA. An additive effect was found between berberine and ampicillin, and a synergistic effect was found between berberine and oxacillin against MRSA. In the presence of 1-50 microg/mL berberine, MRSA adhesion and intracellular invasion were notably decreased compared with the vehicle-treated control group. These results suggest that berberine may have antimicrobial activity and the potential to restore the effectiveness of beta-lactam antibiotics against MRSA, and inhibit the MRSA adhesion and intracellular invasion in HGFs.

MRSA kills in England
December 2006 - A new strain of the MRSA superbug has killed two people following an outbreak in a hospital in England. The Health Protection Agency (HPA), which monitors infectious diseases, said eight cases of the strain known as Panton-Valentine Leukocidin (PVL) have been identified. Four people developed an infection, which destroys white blood cells that normally fight infection. A healthcare worker and a patient have died. The deaths are the first from PVL in a British hospital.