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mrsa in bloodstream
Started by sasha_442000
Posted: May 2, 2006 at 19:25
Do you know what the prognosis is for mrsa in the bloodstream? My brother in law is presently in icu with this. Is there anything they can give him for this. They are saying it is antibiotic resistant. He has multiple problems besides this. They say he is a very sick man. Please help.
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Re: mrsa in bloodstream
Reply #1 by Bev
Posted: May 2, 2006 at 20:15
dear sasha please take a look at website www.mrsaactionuk.com it will give you lots of information ~ it would depend on what antibiotics your brother in law is resistant to ~ the hospital should be testing him everyday and getting the sensitivity tests done to ascertain what medication to put him on ~ the microbiology dept will be telling the ICU what meds he should be on
best wishes
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Re: mrsa in bloodstream
Reply #2 by Peter
Posted: May 10, 2006 at 10:21
Hi Sasha,
Bloodstream infections are hard to treat. However, the prognosis is the same if he has MRSA or a "normal" Staf A infection. The only difference is they are treated with different antibiotics depending on which one will kills the infection. If he has MRSA they may have to use antibiotics such as vancomycin, teicoplanin or linezolid which do have different side effects to the more conventional antibiotics.
Peter
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Re: mrsa in bloodstream
Reply #3 by Ruth Wollacott
Posted: May 10, 2006 at 12:07
This reinforces the official NHS/government line - MRSA is no big deal, not much different to normal staph infection. I suspect those who have actually been affected by MRSA take a different view.

Bloodstream MRSA infection is likely to kill. I think that's a big deal.
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Re: mrsa in bloodstream
Reply #4 by Peter
Posted: May 10, 2006 at 12:44
Ruth
I take your point, but the fact is Staff A is as equally hard to treat as MRSA in bloodstream infections. It is the same bacteria but MRSA has adapted to be resistant to certain antibiotics. You do not suffer different symtoms etc if you have Staff A to MRSA and the prognosis is the same.
Peter
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Re: mrsa in bloodstream
Reply #5 by Ruth Wollacott
Posted: May 10, 2006 at 13:25
I would have thought that if MRSA has adapted to be resistant to the antibiotics used to treat ordinary staph infection, it must follow that it is harder to treat than an ordinary staph infection, as the range of choices is severely limited. If the range of choices is limited, the prognosis must be poorer. The poorer the prognosis, the more likelihood of the worst outcome.

I am happy to be convinced otherwise.
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Re: mrsa in bloodstream
Reply #6 by Peter
Posted: May 10, 2006 at 16:00
Hi Ruth,
I am pleased to see you are happy to be convinced. In fact the newer reserved antibiotics such as vancomycin and linezolid are very effective against Staff A infections that show suseptability. Certainly with the way linezolid works it is extremly effective. As long as the patient has a Staff A infection that is suseptable to an antibiotic the prognosis will be similar. The problems really lay with using the newer antibiotics because of the risk of side effects and the chance of the bacteria mutating further to become resistant to all antibiotics.
Peter
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Re: mrsa in bloodstream
Reply #7 by Bev
Posted: May 10, 2006 at 16:20
if Staph A is showing suseptability and resistance surely thats where the name play comes in Staph A when resistant to methicilin became MRSA Staph A that is now coming resistant to vancomycin is now known as VRSA or am i missing something here ?
there is proof that there is growing resistance to quite a lot of antimicrobials (ref BSAC)
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Re: mrsa in bloodstream
Reply #8 by Peter
Posted: May 11, 2006 at 10:46
I totally agree that there is VRSA out there and that there is growing resistance to many antibiotics. All I am saying is that if the bacteria shows suseptability to an antibiotic you do not suffer from different symtoms or have a different prognosis if you have VRSA, MRSA or Staff A. All the infections are caused by the same bacteria and therefore have the same symtoms etc. Your infection may be VRSA, ie resistant to vancomycin but it may be suseptable to older antibiotics or teicoplanin or linezolid.

I really do have concerns about multi-resistant bacteria and this article highlights what could be in store.
http://news.bbc.co.uk/1/hi/health/4758021.stm

Regards
Peter

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Re: mrsa in bloodstream
Reply #9 by Bev
Posted: May 11, 2006 at 11:01
i totally agree about the growing concerns over multi resistant bacteria ~ we have been calling for some kind of monitoring on the over prescribing of antibiotics ~ and before anyone jumps on and says we should stop asking for them it is not joe public who prescribes them its the medics ~ there seems to have been born this culture of patient becomes ill and before root cause is found lets shove some broad spectrum antibiotics at them to 'shut them up' ~ yes i would have to agree there are some members of the public that have a sniffle and jump straight to the doc for the magic miracle cure but the majority don't ~ antibiotics from the medic point of view seemed to have been seen as the cure all for everything and now we have this growing problem of resistance ~ i know someone who has been diagnosed with D Colitus gets pain goes the docs and every single time comes away with courses of antibiotics ~ and thats not a rare scenario there are many i could quote for varying different on going ailments ~ so until there is a block on overprescribing there will be this growing problem of resistance
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Re: mrsa in bloodstream
Reply #10 by Ruth Wollacott
Posted: May 11, 2006 at 11:50
The problem is that antibiotic-resistant staph infections are, by the fact that they resist antibiotics, more difficult to eradicate than staph infections which are susceptible to antibiotics. Therefore, whilst the symptoms may be the same, if there is a very limited or no method of addressing the effects of infection, the prognosis must necessarily be less optimistic.

I agree with you, if the infection is susceptible to antibiotics there is no problem; by definition MRSA is resistant to many antibiotics, including meticillin after which it is named, and therein lies the problem.
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Re: mrsa in bloodstream
Reply #11 by Peter
Posted: May 11, 2006 at 12:30
Well said Bev, I could not agree more. X
Ruth, I kind of agree with you. I understand by the fact of the name means that they are resistant to certain antibiotics and in the not too distant future there may well be infections that are resistant to all antibiotics. It will down to our own bodies to fight these infections. The problem there lies in the fact that patients who are already unwell will not be able to fight enough.
However, when an infection is susceptible to an antibiotic it still may not work, but that could be because where the infection is (i.e. bloodstream, joint infection etc), how unwell the patient is or even the renal function. Now that infection which cannot be treated with an antibiotic which has already been shown to be susceptible will still be hard to treat whether it is VRSA, MRSA or "normal" Staff A. I do agree that there may well be less choice because of VRSA and MRSA but some old fashioned antibiotics are being shown to be useful because we do not use them as much these days and may be our savour. Of course, until they are overused again and the bacteria become resistant again!!!!
Peter
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Re: mrsa in bloodstream
Reply #12 by MRSA
Posted: May 12, 2006 at 05:08
Ruth,
Why such a big debate? MRSA is a staph infection and "Staph infections KILL" This was about sasha not YOU, why on this site do you always make it about yourself???
Maybe it's time for some "THERAPY"
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Re: mrsa in bloodstream
Reply #13 by Ruth Wollacott
Posted: May 12, 2006 at 07:24
The question posed by Sasha is as follows:

"Do you know what the prognosis is for mrsa in the bloodstream? My brother in law is presently in icu with this. Is there anything they can give him for this. They are saying it is antibiotic resistant. He has multiple problems besides this. They say he is a very sick man. Please help."

My straight answer to the question, in my opinion and experience is as follows:

"The prognosis for MRSA bloodstream infection is quite likely death."

Does that help?

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Re: mrsa in bloodstream
Reply #14 by Bev
Posted: May 12, 2006 at 09:05
reply#12 thats quite a harsh remark to someone who has had a family members life turned upside down ~ if you read the postings ALL of them then it was'nt actually Ruth who sparked the debate ~ and at least she doesnt hide behind a false name
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Re: mrsa in bloodstream
Reply #15 by Ruth Wollacott
Posted: May 12, 2006 at 12:09
Thank you Bev.

To answer #12 more fully:

1. Why such a big debate?

Maybe because this is a discussion forum?? 'Debate' and 'discussion' are usually interchangeable terms with very similar meanings. Both words mean an interaction of ideas and knowledge between several people - you put your point of view, I will put my point of view.

2. MRSA is a staph infection and staph infections kill.

Indeed, both of these statements are true. However, it presumably is useful if everyone is aware of the differences between staph infections. In this instance, Sasha states that the staph infection about which she is concerned is MRSA in the bloodstream. She is asking the prognosis of MRSA staph infection in the bloodstream specifically, rather than the prognosis for staph infections generally. So, for example, you could contrast the staph infection of impetigo with the staph infection of bloodstream MRSA. Both are staph infections. From which would you rather suffer? Impetigo or MRSA? Which do you think poses the greater threat?

3. Why on this site do you always make it about yourself?

I have found a great deal of difficulty finding where on this particular thread I have made it about myself. I have engaged in this discussion because I have a fundamental difficulty in accepting the premise that all staph infections have a similar prognosis; as above, compare the prognosis for impetigo with the prognosis for MRSA bloodstream infection, exacerbated by the staff admitting that the patient is 'very unwell'. This staph infected patient surely has a much worse prognosis than the patient with a impetigo staph infection.

Anyone who would like to offer me some therapy will be very well received. My contact details are incredibly easy to find, just type my name into Google and everything you could ever wish to know about me will be very easily accessible.

Can you say the same MRSA??


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Re: mrsa in bloodstream
Reply #16 by Peter
Posted: May 12, 2006 at 12:10
Post#12
What is the problem with having a debate? Is this not what forums like this are for? If during the debate Sasha's gets an answer all well and good. We have hopefully got the point across that all blood born infections are hard to treat and that although there is no difference in symptoms between the different Staff A infections there is a reduced choice of treatment.
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Re: mrsa in bloodstream
Reply #17 by Peter
Posted: May 12, 2006 at 14:28
Hi Ruth,
Firstly I am enjoying our debate and hopefully others are too. I am learning during this process as well, so thanks.
With regards to your rely No.15 I have to ask would you prefer to have MRSA impetigo or "normal" Staff A blood stream infection? It all comes down to where the infection is and maybe not so much if it is MRSA or a pencillin sensitive infection. As long as there is an antibiotic treatment for the infection, although I understand these are getting fewer and fewer.
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Re: mrsa in bloodstream
Reply #18 by Ruth Wollacott
Posted: May 12, 2006 at 14:46
Impetigo is a contagious skin infection that usually produces blisters or sores on the face and hands and is generally caused by one of two bacteria: group A streptococcus or staphylococcus aureus. Impetigo is generally treated with bactericidal ointment, fusidic acid (Fucidin) or mupirocin (Bactroban), but in more severe cases oral antibiotics, flucloxacillin (Floxapen) or erythromycin (Erythrocin) are used. It used to be treated with a liberal application of gentian violet, which made it very apparent who was suffering, and served as a warning to avoid that person as being infectious.

This suggests that impetigo is not resistant to antibiotics and is, therefore, a 'normal' staph A infection and easily treated by a variety of remedies. I have not heard the standard treatment for impetigo to be barrier nursing, in isolation and on IV drip teicoplanin, which is usual in bloodstream MRSA infection, nor do I believe that under-reporting of deaths from impetigo are causing a crisis in the NHS. I also believe impetigo does not leave a legacy of permanent disability, which is the case for those victims lucky enough to survive MRSA bloodstream infection.

You cannot escape the conclusion that if an infection is resistant to almost all treatments it must, by necessity, be more of a risk than an infection which is easily eradicated by a number of topical applications and, therefore, if the risk is higher the chances of a good prognosis must be lower.

And yes, I am also enjoying the debate.

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Re: mrsa in bloodstream
Reply #19 by linda mccafferty
Posted: May 12, 2006 at 16:32
Dear mrsa, i have been on this site a year now, getting support, i have never known ruth wollacott to " always make it about herself" she is a person who is very knowledgeable, and tells it how it is , she is very straight to the point ,(WHICH I ADMIRE) she also is very witty and funny, i love when a post is debateable that is what this forum is about, i think you should apologize to ruth, you are well out of order .
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