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Medical Travel Caution - Superbug a 'consequence' of medical travel
Old 08-13-2010, 06:40 AM   #1
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Medical Travel Caution - Superbug a 'consequence' of medical travel

I found this on Yahoo News and thought it would be of interest to some.


Superbug a 'consequence' of medical travel - Yahoo! Canada News
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Old 08-13-2010, 07:13 AM   #2
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I found this on Yahoo News and thought it would be of interest to some.
Yeah, stay home and pout. Nothing can harm you here.

Methicillin-resistant Staphylococcus aureus - Wikipedia, the free encyclopedia
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Old 08-13-2010, 10:46 AM   #3
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I have never practicied outside the USA and have cared for patients with malaria, dengue fever, valley fever, parasites, hep A/B/C, AIDs, MRSA, trichinosis, syphilis, just to name a few.

Going to exotic lands is not required -- the germs will come to you unless you live in a bubble.
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Old 08-13-2010, 11:14 AM   #4
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Not to hijack the thread, but Rich - I would be interested in your opinion as to whether this type of thing should be fought by bombarding the germs with more variations of antibiotics or whether we should come up with an alternative - maybe just rest and fluids. It seems like we are accelerating the evolution of these germs and creating 'superbugs', as the article calls them. (As a disclaimer I've talked to friends that are less experienced MDs - 10 years or less out of med school - and they agree with superbugs, but never really have an alternative and maybe that is the problem.)

This may be an example of what some people believe is over-consumption of healthcare in the US.
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Old 08-13-2010, 12:00 PM   #5
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Not to hijack the thread, but Rich - I would be interested in your opinion as to whether this type of thing should be fought by bombarding the germs with more variations of antibiotics or whether we should come up with an alternative - maybe just rest and fluids. It seems like we are accelerating the evolution of these germs and creating 'superbugs', as the article calls them. (As a disclaimer I've talked to friends that are less experienced MDs - 10 years or less out of med school - and they agree with superbugs, but never really have an alternative and maybe that is the problem.)

This may be an example of what some people believe is over-consumption of healthcare in the US.
The problem is not the use of advanced antibiotics to treat serious diseases when no alternatives are ready, but rather, using high tech ABs when traditional antibiotics would suffice; even moreso, using antibiotics when none are necessary at all (most colds, most sinusitis cases, minor skin infections, undiagnosed abdominal pain, cough, viral infections, etc.). I have spent alot of time explaining to patients why they don't need antibiotics for a sore throat that is 90% plus due to a virus.

Of course every patient and illness is unique. But the available evidence calls for far less antibiotic use than is standard practice today. And multi-drug-resistant strains are the result, ranging from staph to TB.
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Old 08-13-2010, 05:49 PM   #6
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The problem is not the use of advanced antibiotics to treat serious diseases when no alternatives are ready, but rather, using high tech ABs when traditional antibiotics would suffice; even moreso, using antibiotics when none are necessary at all (most colds, most sinusitis cases, minor skin infections, undiagnosed abdominal pain, cough, viral infections, etc.). I have spent alot of time explaining to patients why they don't need antibiotics for a sore throat that is 90% plus due to a virus.

Of course every patient and illness is unique. But the available evidence calls for far less antibiotic use than is standard practice today. And multi-drug-resistant strains are the result, ranging from staph to TB.
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Old 08-13-2010, 06:47 PM   #7
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Going to exotic lands is not required -- the germs will come to you unless you live in a bubble.
Learned that the hard way. Couple of years ago I was working in the back yard burning limbs brought down by Hurricane Ike. Reached into the pile to grab more for the fire when I felt a pain in the back of my hand. Looked and had a small puncture between middle and ring finger knuckles. A little blood but nothing to worry about. Finished working a couple hours later and then cleaned up. Next day hand was sore and a little swelling. Next day it was looking uglier and not normal. Strange color. People said I had been bitten by a brown recluse spider. Called my physician and got the last appointment of the day on a Friday after telling receptionist it seemed really serious. Doc took one quick look at my hand and got on the phone and called another doctor who was a hand surgeon. Told him don't close up just yet, I'm sending an emergency over. Went to see this doc and he took one quick look and said we need to operate now. He cut a section of flesh out about the size of a dime and then replaced it with a skin graft taken from the side of my hand. Gave me a scrip for strong antibiotics. Turns out I had both staph and strep in the wound and it was acting similar to a flesh eating virus and spreading. The doc said it was a good thing I came in when I did. He said if I'd have waited another 24 hours I'd have probably been in the hospital fighting to save my arm. That was scary.

Moral of the story: Treat all pucntures, cuts and scrapes seriously even if they seem minor. Clean and disinfect the wound immediately and see a dcotor at the first sign of anything seeming unusual.
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Old 08-13-2010, 11:49 PM   #8
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It's not a problem as long as you keep your blood/alcohol ratio in balance properly. Never seen a staph germ that could stand up to a good shot of tequila.
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Old 08-14-2010, 08:32 AM   #9
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It's not a problem as long as you keep your blood/alcohol ratio in balance properly. Never seen a staph germ that could stand up to a good shot of tequila.
Oh so true. A professor demonstrating the effects of alcohol placed a worm in a glass of water and the worm crawled around normally. Placed in a glass of alcohol, the worm immediately died.

"Class, what does this tell you about the effects of alcohol?"

A brighter-than-average student responded: "If you drink alcohol you'll never have worms."
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Old 08-14-2010, 02:04 PM   #10
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When I worked in SA it was commonly thought by Gringos, Europeans and locals that aguardiente rendered microbes helpless. From personal experience I can testify that this idea is false.

A guy who lived across the hall from me is from an Andean country. He says everyone there, including his upper class parents have worms of various sorts. Periodically they get wormed by their MDs, just like we get our dogs and cats wormed. If this is not appealing, perhaps best to stay home. In spite of having plenty money to live middle class and never eating street food or drinking tap water or using ice I have never spent any considerable time in an underdeveloped country (away from purely tourist destinations) that I didn't get sick at least for a few days, and sometimes more. One friend of mine contracted an amebiasis infection in Africa, which created a liver cyst which ruptured after she had returned to the US. She died. It might be that if her doctors were more experienced with tropical diseases they might have diagnosed her earlier and successfully treated her.

Usually it no worse than a few uncomfortable days in the bathroom, and as some have pointed out, some people get some of these things here. But IMO it is way easier to get them there.

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Old 08-14-2010, 06:44 PM   #11
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Years ago a friend's son returned from Central America and within days was having trouble breathing. He took him to Kaiser urgent care and they pulled out all the stops, brought in the resources of the CDC, saved his life. Turned out to be a fungus.

I really think a system such as Kaiser (Cleveland Clinic, probably others) is much better at identifying the cause of illness after travel to the developing world than a small practice.
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Old 08-16-2010, 08:13 AM   #12
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A guy who lived across the hall from me is from an Andean country. He says everyone there, including his upper class parents have worms of various sorts. Periodically they get wormed by their MDs, just like we get our dogs and cats wormed.
I have just learned that this is good practice in many parts of Mexico. Something to keep in mind.
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Old 08-16-2010, 02:21 PM   #13
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The problem is not the use of advanced antibiotics to treat serious diseases when no alternatives are ready, but rather, using high tech ABs when traditional antibiotics would suffice; even moreso, using antibiotics when none are necessary at all (most colds, most sinusitis cases, minor skin infections, undiagnosed abdominal pain, cough, viral infections, etc.). I have spent alot of time explaining to patients why they don't need antibiotics for a sore throat that is 90% plus due to a virus.

Of course every patient and illness is unique. But the available evidence calls for far less antibiotic use than is standard practice today. And multi-drug-resistant strains are the result, ranging from staph to TB.
I'm not an MD...

But I've read some very interesting experiments with very simple solutions to nosocomial (hospital borne) infections that the medical community/business seems to largely ignore. Most microbes cannot tolerate exposure to copper and die quickly on a surface containing copper. In the days when brass (a copper alloy) door knobs and push plates on hospital doors were the norm there were far fewer nosocomial infections. The stainless steel they use now looks clean and is easier to keep looking shiny but it is useless for antimicrobial action. Controlled experiments that measure the relative amount of bacteria on brass and stainless steel surfaces after exposure to air and touch in hospitals have been done for almost 3 decades and routinely find the brass more effective at killing things. Yet hospitals and building codes seem to completely ignore this. Perhaps if drug companies made brass door knobs we would experience a sea change in health care!
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Old 08-16-2010, 08:54 PM   #14
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I'm not an MD...

But I've read some very interesting experiments with very simple solutions to nosocomial (hospital borne) infections that the medical community/business seems to largely ignore. Most microbes cannot tolerate exposure to copper and die quickly on a surface containing copper.
I had heard that too. A google of the terms:

copper antimicrobial

gave lots of promising hits - the Science Friday one is probably what I recall.

I have heard that (w/o any studies) about silver cups/pitchers. Obviously more costly than copper, though. What did Paul Revere die of?

At some level of ingestion, copper becomes toxic, and the green stuff (verdigris) can be very toxic.

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Old 08-19-2010, 07:01 PM   #15
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At some level of ingestion, copper becomes toxic, and the green stuff (verdigris) can be very toxic.
Sure, but we're not eating it, were making door handles from it!
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Old 08-19-2010, 07:11 PM   #16
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You get Flesh Eating Bacteria from foreign doorknobs !



Either that or a weekend of heavy partying !
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Old 08-19-2010, 07:37 PM   #17
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Sure, but we're not eating it, were making door handles from it!
I understand, I was justing adding a little info about what happens if taken too far.

Heck, maybe I should make one of those cool 'steam punk' Victorian style computer keyboards with copper keys. Copper is kind of fun to work with.

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