MRSA Symptoms

Vancomycin

Vancomycin, for many of the people who have fallen victim to Methicillin-resistant Staphylococcus aureus (MRSA), it is a final solution. Vancomycin is a glycopeptide antibiotic. It is the solution of last resort but highly effective.

Vancomycin is used to treat bacterial infections by stopping or killing the bacteria responsible. When treatment using other antibiotics has failed, Vancomycin is the strongest option available. The antibiotic is available in capsule and injection form, although oral Vancomycin is not effective against MRSA.

The advantage of capsules is that generally they are not absorbed into the blood stream. It is argued that because of this Vancomycin in capsule form is unlikely to cause any severe side effects. However, this is precisely where the problem lies. Should the side-effects occur, they have the potential to become quite severe.

Problems Associated With Vancomycin

Nausea, dizziness, feeling cold, flushing, pain, muscle spasms, bruising, the development of a rash, ringing in the ears, hearing difficulties, or breathing problems are all potential risks.

The severity of these side-effects can be variable and immediate medical attention should be sought if any one of the above become apparent whilst taking Vancomycin.

In addition to the above side-effects, Vancomycin is also criticised for being practically and economically troublesome.

The Practical Problem Of Vancomycin

Non-serious MRSA infections, which may include urinary-tract infections (UTI’s), wounds and skin problems, are difficult to treat with Vancomycin. Slow cure rates and even failure cloud the Vanconycin success story.

The Financial Problem Of Vancomycin

Financially, Vancomycin and its course of treatment are somewhat expensive. Particularly in recent years, increasing incidence of MRSA is adding to the National Health Services budgetary commitments. Contributing to the argument against Vancomycin is the toxic issue.

Vancomycin – The Toxic Problem

A particularly significant issue for patients receiving Vancomycin treatment is that the therapy is more toxic than other methicillin-type drugs. Consequently, a patient’s blood levels must be continually monitored.

The Replacement Case – Vancomycin and Linezolid

Rarely does a credible article draw upon the successes and failings of Vancomycin without making some kind of reference to the drug Linezolid. This is because with the emergence of Vancomycin-resistant organisms, increasingly Linezolid has displaced Vancomycin as the drug of last resort. It has always been a concern amongst healthcare leaders and professionals that increasing use of Vancomycin would result in the energence of resistant organisms and this danger has become a reality.

The Case for Linezolid Explained

Linezolid is part of the Oxazolidone antibiotics. It is highly active in vitro against MRSA and additionally it can be taken orally. It is this oral dosing that may permit an earlier discharge of hospitalised patients and what is more Linezolid and Vancomycin have similar clinical efficacy for MRSA infections. So what are the issues surrounding Linezolid?

Problems Associated With Linezolid

With the use of Linezolid comes the risk of haematological abnormalities, including Myelosuppression and Thrombocytopenia. To compound the problem Linezolid is extremely expensive, sometimes more so the Vancomycin.

The prevailing argument appears to be that Linezolid should not be used routinely. That is, to avoid the emergence of Linezolid-resistant Vancomycin-resistant enterococcus (VRE).

The Way Forward for Vancomycin

Vancomycin is a successful drug but with side-effects and associated problems. The spreading of MRSA and the increasing usage of Vancomycin make the drug more susceptible to failure from Vancomycin-resistant organisms. Furthermore, we cannot rely on Linezolid to completely fill the role of Vancomycin. Ultimately, a return to the idea that prevention is better than cure must be encouraged. MRSA prevention programmes are rolling out across the country with the expectation that this will, in time, reduce our dependence on Vancomycin. It is the drug of last resort and should remain so if its effectiveness is to be maintained.

Zinc Zipper

A team of University of Cincinnati (UC) researchers is exploring a “zinc zipper” that holds bacterial cells together and plays a key role in such infections. It is hoped that these studies will lead to new ways to prevent this growing public health danger.

Researchers in UC’s department of molecular genetics, biochemistry and microbiology have found that the presence of zinc is crucial to the formation of infection-causing biofilms. Their findings appeared in the December 1st 2008 online edition of Proceedings of the National Academy of Sciences.

UC researchers working with Andrew Herr, PhD, an assistant professor and Ohio Eminent Scholar in structural biology, found that zinc causes a protein on the bacterial surface to act like molecular Velcro, allowing the bacterial cells in the biofilm to stick to one another. Zinc chelation, or removal, prevented biofilm formation by Staphylococcus epidermidis and Staphylococcus aureus. The researchers used a chelation agent called DTPA (diethylenetriamine pentaacetic acid) to remove the zinc from a sample biofilm.

Herr explains, “We’ve shown that if you remove the zinc, you prevent the biofilm from forming, and if you add zinc back, the biofilm can grow. So we’re hopeful that we can use this sort of approach to prevent these biofilms from ever taking hold in the first place.”

The Evolution Of Medical Device Coatings

Staphylococci are remarkably adhesive and can grow on many surfaces, including implanted medical devices. These new findings could be used to develop new coatings for implanted medical devices, or rinses that a surgeon could use to clear the area around the implant.

Because DTPA is approved by the U.S. Food and Drug Administration only for people with radio isotope poisoning, systemic removal of zinc, such as through an intravenous injection, is currently impractical.

Read more about zinc removal fighting MRSA.

New research has found a direct correlation between the amount of alcohol handwash supplied to a ward and reductions in the rate of hospital acuqired MRSA infections.

A study by University College London (UCL), in collaboration with the Health Protection Agency, London School of Hygiene and Tropical Medicine, and the Hand-Hygiene Liaison Group, discovered that rates of MRSA infection are cut by 1% with each extra millilitre of alcohol hand rub supplied per patient per day.

These findings are the results of an independent evaluation of the cleanyourhands campaign to boost hygiene on hospital wards and were presented at this year’s Federation of Infection Societies conference in Cardiff.

The National Patient Safety Agency started co-ordinating this campaign in 2004 and rolled it out to 187 acute NHS trusts in England and Wales.

Dr Sheldon Stone, lead author of the evaluation at UCL, said: “Our study shows that hand hygiene lowers hospital superbugs, and our message to healthcare workers is: ‘one ml. one percent’.

He added, “The findings also serve as a reminder that we should be washing our hands in the home and workplace. Winter is the season when colds and flus abound, and people can protect themselves and stop germs from spreading by frequently washing their hands.”

So, this research tells us what we knew already. Greater levels of hygiene reduce infection. Common sense really, isn’t it?