Posted on 12/28/2009 5:19:14 AM PST by decimon
A sudden worldwide increase in an antibiotic-resistant bacterium is cause for concern, according to a review in f1000 Medicine Reports.
Faculty of 1000 member Dr Johann Pitout, of the Department of Pathology and Laboratory Medicine, University of Calgary, urges the medical community to monitor the spread of a multi-drug resistant bacterium before it becomes necessary to use more powerful antibiotics as a first response.
Extended-spectrum β-lactamases (ESBLs) are bacterially-produced enzymes that confer resistance to penicillin-type antibiotics. ESBLs have been commonly linked to nosocomial infections, which are generally treated with intravenously-administered antibiotics such as the carbapenems.
However, in recent years there has been a drastic increase in community-acquired infections, caused by a single strain of ESBL-producing E. coli. Dr Pitout suggests that the rapid spread of this particular strain is due, at least in part, to international travel through high-risk areas such as the Indian subcontinent.
Using carbapenems as the first response to such infections increases the risk of inducing resistance to them in the community, nullifying some of our most powerful anti-bacterial strategies. Dr Pitout recommends that the medical community should use existing methods to identify infections caused by ESBL-producing bacteria, and empirically test the efficacy of other antibiotics in treating community-acquired infections.
Dr Pitout concludes, "If this emerging public health threat is ignored … the medical community may be forced to use the carbapenems as the first choice for the empirical treatment of serious [community-acquired UTIs]."
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Notes to Editors
1. Dr Johann Pitout is a Faculty Member for f1000 Medicine, Infectious Diseases Section, and works at the Pathology and Laboratory Medicine, University of Calgary, Canada http://f1000medicine.com/member/5309018475971825
2. The full text of this article is available for subscribers at http://f1000medicine.com/reports/10.3410/M1-84/
3. Faculty of 1000, which comprises http://f1000medicine.com and http://f1000biology.com, is a unique online service that helps you stay informed of high impact articles and access the opinions of global leaders in medicine and biology. Our distinguished international faculty select and evaluate key articles across the sciences, providing a rapidly updated, authoritative guide to the literature.
4. Please name F1000 Medicine Reports and Faculty of 1000 Medicine in any story you write. If you are writing for the web, please link to the website (details below).
5. The F1000 Medicine Reports journal (ISSN 1757-5931), publishes short commentaries by expert clinicians focussing on the most important studies identified by Faculty of 1000 Medicine that are likely to change clinical practice. The commentaries summarise the implications of important new research findings for clinicians http:// f1000medicine.com/reports
6. Please contact Steve Pogonowski, PR Manager, for a complimentary journalist subscription to Faculty of 1000 press@f1000.com
You are welcome for the pings, as always, Alamo-Girl!
My mother was not prone to illness nor a pill-popper. She is 93 today and not on any regular Rx...only an occasional anti-biotic. I think she healthy because she never took a lot of meds....and certainly not prone to psychosomatic illnesses.
Could be you're projecting...your problem is psychosomatic?
You’ve misunderstood what I meant, probably because I used the wrong word. Placebo effect would be more appropriate. She believed, therefore it worked. That’s the opposite of psychosomatic, with an individual convincing himself or herself of sickness, when none is apparent medically.
There is an element of stress involved for many people who break out in shingles. Honestly, though, if that were the case with me, it would have happened a year and a half ago, when my business was failing, my dog had died and my father died, within months of one another. There was a period when I dreaded seeing the grey light of dawn, it was “oh no, not again.” Prayer got me through it. Basic holiday stress looks like a walk in the park by comparison.
You have a happy New Year, you hear? And do try not to find offense so easily.
Thanks for the suggestions, I’ll see about getting B-complex and L-Lysine.
The nerve pain has spread onto my forehead above my left eye. The rash hasn’t spread and seems to be throbbing a little less, though, and the swollen glands seem less pronounced this morning.
A friend suggested I put tea tree oil on the rash to prevent secondary infection, and also some antiviral action is attributed to it anecdotally. She brought it by along with some homemade soup, and I’ve been using it twice daily.
The reason she brought it by, is that I’ve been having a problem with lightheadedness to the point that I’m concerned about driving a car, that comes after my first dose of medication in the morning. I’ve blamed gabapentin for it, but what you’re saying about the length of time for it to have effect has me wondering.
I’m only taking it once per day, in the morning, and so I’ve been thinking it’s the culprit. The acyclovir is five times daily, but the wooziness fades later in the day, so it’s not that.
Maybe it’s just a symptom of shingles on the side of my head, lol.
Thanks for the suggestions and sharing your own experiences. It does help to understand what others have gone through. I’ve never had anything like it, and really thought it was MRSA at first.
I took you at your word.
And do try not to find offense so easily.
And now it's my fault! LOL!
Actually, I wasn't offended because I took it as you didn't know what you were talking about.
I hope things have improved in your life. And...
Happy New Year!
You still seem to be looking for offense where, honestly, none was intended.
My sincere apologies for upsetting you, by unintentionally implying that your 93 year old mother was experiencing psychosomatic illness 40 years ago.
I used the wrong word, the opposite of what I intended actually, and admitted that. Please don’t continue making this personal. This was a nice and very helpful thread. You were trying to be helpful yourself. My reply to you had no ill intent.
I'm not upset or offended! Never was upset by anything you said.
I can't imagine being upset by anything that somebody I don't know would say in a chat room...and can't imagine why it's a big deal to you. Get over it. Peace.
Have a Happy New Year!
So long as you’re OK, I’m over it.
Happy New Year to you and yours, too. I can remember thinking how futuristic and almost alien the year 2000 sounded when I was a kid, and here we are, a decade into it.
And I still don’t have a flying car, darn it.
I use one of those jet back-pacts to fly around...in good weather!
Thanks for the ping.
I will post a link on the thread for others.
Did your husband have this with his case of shingles?
First off, this is a guess so take it for what it's worth. I don't really think swollen nymph lodes would necessarily mean there's an infection. Lymph nodes act as filters to clean out any infection. Because your body is inflamed due to the shingles it could be they're responding to your body being out of whack.
Are you running a fever? Also did the doc on the box prescribe an antibiotic? Because if he did then unless there's a secondary infection which is bacterial in nature, the actibiotics won't work on viruses.
Unfortunately for my husband he had very few lymph nodes which weren't swollen. Leukemia keeps the body's infection fighters, in this case white blood cells, at a high count so his lymph nodes worked overtime even when he said he felt fine. One of the things they used on him was prednisone, in addition to chemotherapy. There was a time when he was getting 2 units of platelets every day. We could tell when he'd had an an infusion because his energy level would go up some.
The best advice I can give you is to keep a close watch on your break out and if need be, get to the ER (today) or to your regular doctor first thing tomorrow.
We were faced with a hard decision at the time. It was additional stress in a time when we were both stressed to the max. I caught a lot of grief because our oncologist told us we had one of two options. We could get rid of our cats or we could declaw them. My cats weren't kittens (9 yrs and 7 yrs old) and were just like the hundreds of unwanted cats one sees at the local adoption center. There was nothing special about our cats other than they were loved. I'd had the older one before my husband and I married. He gave me the youngest one as a peace offering after we'd had a few heated words. The cat he gave me was part of a group of feral cats his Mom had living on her property.
Off and on I was the main bread earner (actually more on). My ex was one of those truck drivers no one likes to be behind. Usually he was carrying equipment to different build sites. Many is the time he'd be hauling mining equipment whose tires were taller than he was. It was extremely rare for him to be routed on the highways because his load would be too high to make it under the overpasses.
Your advice is sound up until you mention using a dab of a triple antibiotic. The first time his arm developed staph, he had no bleeding and the scuff just looked like a small area where he'd scuffed his hand. Heck, he pulled off the little bit of skin where he'd scuffed it. The skin was about like what would happen after you'd get a sunburn and start to peel.
The second time was when he got a small scratch, something you and I would think nothing of. He was on the road and so he washed his hands washed pretty regularly. Even though it wasn't a deep scratch it was one that was in a place where it irritated him.
His oncologist told him to never use the triple antibiotic because it would hasten healing on the top layer of skin but the underlying skin had no way to drain off any of the clear liquid or blood cells. The underlying wound would wind up getting infected because the neosoporin worked so well curing up the top layers of skin and the underlying scratch had no place to go so would get infected.
It's not much fun to be called in the middle of the night and asked for my permission to amputate his arm because he was too delirious to make sense. Thankfully I opted to take a wait and see option.
Warning to all:
ALL:
Please be careful when using triple antibiotics especially on a puncture type wound.
I’ve been on acyclovir and gabapentin going on a week, now. The rash appears to be receding somewhat, never did spread beyond the quarter sized area on my left temple, behind the hairline. The nerve pain did spread, though. The hair in my left eyebrow hurts, lol.
The swollen glands are gone down. Pain in general is not as bad overall as it was, just different, more spread out to areas that, at least visually, weren’t affected. Something’s making me lightheaded for half the day, I suspect the gabapentin since it comes on an hour or two after I take it, and only take it once a day.
Been putting tea tree oil on the rash, which seems to have been of benefit. Strong stuff, like turbocharged camphor or something.
Thanks for replying, btw. It helps to understand what to expect, and what others have experienced.
Well, one has to follow recommendations and medications for various types of wounds. Scrapes are often worse than people think because they expose a larger area of flesh and also scrapes can have dirt embedded in them. Puncture wounds are different and certain medicines/treatments are not recommended. I did state to use an antiseptic before the antibiotic. Obviously it may do little good to apply an antibiotic on a deep dirty wound. Additionally people tend to judge injury severity by pain and may initially take care of something but then if it feels better they stop taking care of it.
I'm not sure where the puncture wound you referred to came from as he had a small scratch and not a puncture. When his hand started to turn red and to swell we knew to take him to the hospital. The doctor treating him for this staph infection was the one who told us about not using neosoporin.
I think it would probably be termed an abrasion. About the puncture wound I went back and reread and I don’t know where I got that from lol
Sometimes crap happens and even in hindsight you don’t know where it went awry.
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