rexresearch.com
Steven WURZBURGER
Magnesium Hydroxide vs
MRSA [ Methicillin-Resistant Staphylococcus Aureus ]
http://www.mrsa30day.com
Shannon Brown found the application of Wurzburger's solution vs
MRSA.
Here's his
free online booklet ( PDF )
Readers' Digest version : Apparently, this form of solubilized
MgOH thwarts the lactic acid metabolism upon which MRSA and the
like depend.
USP 5891320
Soluble Magnesium Hydroxide
Inventor: WURZBURGER STEPHEN R [US] ; OVERTON JAMES
EC: C01F11/46; C01F5/22; (+5)
IPC: C01F11/46; C01F5/22; C02F1/461; (+15)
1999-04-06
Also published as:
US6110379
US5698107
US6254783
Abstract -- A clear
solution and a method for preparing the solution which has a pH in
the range of from 10 to 13.9 and containing sulfate ions in a
concentration range less than 500 parts per million. The solution
is prepared by mixing two solutions in which one solution has one
equivalent of
magnesium sulfate
and an equivalent of
sulfuric
acid and the second solution has an equivalent of
Ca (OH)2 and two equivalents
of
K2OH. It is believed
that CaSO4 precipitates in the mixed solution and causes
coprecipitation of potassium, perhaps as double salt with the Ca
leaving OH stabilized by hydration and magnesium ions.
Description
FIELD OF THE INVENTION
This invention relates to methods of making aqueous magnesium
hydroxide solutions and particularly to a solution that is clear
of the magnesia sludge that characterizes typical industrial
aqueous magnesia solutions.
PRIOR ART AND INFORMATION
DISCLOSURE
Standard magnesium hydroxide is manufactured by crushing an ore
containing magnesium carbonate and calcium carbonate and putting
the ore through a kiln in order to drive off CO2 leaving magnesium
oxide (MgO) and calcium oxide (CaO).
Numerous chemical processes include steps that require strong base
solutions with a high pH. Such processes include, for example,
paint stripping operations where it is desirable to loosen and
remove an old coating on a steel or cast iron surface down to the
bare metal in order to repaint or replate the metal surface.
Another group of processes relates to the cleaning of an aluminum
surface in which it is required to remove aluminum oxide scale as
an initial step in the typical anodizing or alodining process.
Extreme care must sometimes be taken in these preliminary steps to
prevent etching of the base metal (aluminum) that can damage the
metal part.
Generally, solutions including sodium hydroxide (caustic
solutions) are used for these operations. The use of sodium
hydroxide has the advantage that the salt is very highly soluble
and is the agent for obtaining the very high pH necessary to
support the desired reaction with the coatings. Usually inhibitors
are added to the caustic solution which coat the metal as soon as
the offending coating of paint or oxide has been removed. The
inhibitors protect the newly exposed surface from further attack
by the caustic solution. However, the inhibiting agent, itself can
become a problem since it must be removed from the virgin metal
surface.
The use of sodium hydroxide in these processes has the advantages
that the salt is very highly soluble and provides the means for
obtaining the very high pH necessary to support the desired
reaction with the coatings and/or underlying oxides. However, an
important problem associated with using caustic solutions is the
difficulty in removing the sodium ion from the spent (waste)
solution. The only practical approach is by major dilution. The
presence of sodium in drinking water is not desirable because its
presence raises blood pressure.
Attempts have been made to substitute oxide compounds of calcium
or magnesium for sodium in order to overcome the problems with
sodium. However, such substitutions have not been successful
because of the strong tendency of oxide compounds of magnesium and
calcium to precipitate and form sludges. Removal of such sludges
and the following step of dewatering the sludge has proven to be
too expensive for practical application. Furthermore, the pH at
which such objectionable precipitation occurs is generally in the
range of 9.0 to 10.0 which is appreciably lower than can be
obtained with the caustic solutions or is actually required to
precipitate and remove heavy metal constituents to a level that is
acceptable according to present standards.
SUMMARY
In view of the these difficulties, it is an object of this
invention to produce a basic solution in a range between pH=10 to
pH=13.9 whose cation is primarily magnesium and which does not
form a sludge upon standing.
It is a further object that the basic solution of this invention
be non-reactive with human tissue and is much safer to handle than
compounds containing Na and K intended for the same applications.
It is another object that the solution be inexpensive to produce
and require no special equipment and that waste solutions of the
invention be neutralized by electrical chemical processes rather
than by the addition of acid neutralizing agents.
BRIEF DESCRIPTION OF THE FIGURES
FIG. 1 shows a flow chart
for producing high pH solutions of magnesia.
FIG. 2 shows shows an
apparatus for removing magnesium ions.
FIG. 3 shows the steps for
using the solution in a process requiring high pH.
DESCRIPTION OF A BEST MODE
Turning now to a discussion of the drawings, FIG. 1 is a flow
chart showing steps for producing the high pH magnesia solution of
this invention.
In step 1, a first solution was formed by adding concentrated
sulfuric acid containing one gram atomic weight of H2 SO4 and one
gram atomic weight of Mg SO4.7H2 O to two liters of deionized
water and agitating so that the resulting MgSO4 is completely
dissolved after 30 mins. of mild agitation.
In step 2 a second solution was formed by completely dissolving
one gram atomic weight of Ca(OH)2 and two grams atomic weight of
K(OH) in two liters of deionized water and agitating for 30 mins.
In step 3, the first and second solutions were mixed together
causing a precipitate to form.
In step 4, the solution was filtered through an 11 micron filter
thereby producing a filtrate that is the solution of this
invention.
The pH of the filtrate was measured and observed to be 13.7. The
filtrate was examined in a spectrometer and found to contain 54
parts per million of Ca@++, less than 500 parts per million of
SO4@++. Any concentration of K@+ in the first-rate was below the
limit of detection by the spectrometer.
By performing the steps in accordance with the method of the
invention, a solution containing Mg@++ was formed stabilized by
the presence of OH@-- such that the solution has a pH of about
13.7. Appropriate dilution of this solution can be used to reduce
the solution to any value in the range from 7@+ to at least 13.7.
In order to compare these results with what would normally be the
most direct method of producing an aqueous solution of magnesium
hydroxide, the following procedures were performed.
Procedure 1--100.0 grams
of Premier Chemical Brucite 200 (MgO*H2 O) was added to 750 ml of
deionized water, stirred for two hours, then allowed to set
overnight. The solution was then filtered. The precipitate weighed
100.0 gms. indicating that most all of the MgO*H2 O originally
mixed into the water had settled out. The pH of the filtrate was
9.45.
Procedure 2 -- To 750 ml
of water was added conc. H2 SO4 such as to lower the pH to 3.0. To
this sample was added 100.0 gms. of Brucite and mixed and allowed
to stand overnight. The solution was filtered and the filtrate was
dried. The filtrate was weighed and found to weigh 99.6 gms
indicating that 0.4% of the original Brucite had dissolved.
Procedure 3.-- To 750 ml
of water was added conc. NaOH such as to raise the pH to 11.0. To
this solution was added 100.0 gms. of Brucite, mixed and allowed
to stand overnight. The solution was filtered and the filtrate
dried and weighed. The filtrate was weighed and it was found that
only 0.15% of the original magnesium compound had dissolved. The
end pH was found to be 10.1, lower than the initial 11.0 of the
NaOH solution in water.
Procedures 1, 2 and 3 demonstrate the difficulty in dissolving
magnesium oxide compounds in water such as to obtain a clear
solution with a pH greater than 9-10.
Although we do not wish to be bound by theory, it is believed that
the results presented above are in accordance with the following
discussion.
Magnesium Oxide is known to form a true hydroxide Mg(OH)2 which is
very soluble in water, and/or a hydrate, MgO*H2 O which is
relatively insoluble. Under the conditions prevailing in
procedures 1, 2 and 3, which are general conditions that typify
many industrial processes, insoluble MgO*H2 O is the dominant
species of magnesium hydroxde when the pH of the solution exceeds
10.0. so that additional amounts of added MgO simply result in
forming MgO*H2 O precipitate without further raising the pH.
Under the conditions prevailing according to step 2 of the
invention, the hydrated hydroxide ions are formed and remain after
the steps of adding the dissolved KOH and Ca(OH)2 to the solution
of H2 SO4 and MgSO4. CaSO4 is insoluble in water and KSO4 is
soluble in water only to the extent of 10 gms/100 ml water.
However, it is also known that potassium forms double sulfate
salts with alkali earth metals and so it is reasoned that any K@+
that would otherwise remain in solution will coprecipitate with
the precipitated CaSO4, thereby explaining the absence of K@+ in
the solution of this invention.
A major advantage for using the solution of this invention
compared to state of the art processes using caustic solution to
neutralize waste acid solutions is the ability to remove the
magnesium ions from waste solutions using electrochemical means
which is a method of this invention. FIG. 2 shows an apparatus for
removing the magnesium ion. There is shown a pair of iron anodes
12 between which the spent solution containing magnesium ions is
passed. A voltage from power supply 14 is applied between the
electrodes in the range 79 to 83 volts. This step causes a
precipitate of Mg(OH)3 to form which is filtered out of the
solution.
FIG. 3 lists the steps included in a typical process for applying
the principles of this invention to situations where the magnesium
containing solution is used such as in the neutralization of waste
acid solutions or in cleaning operations whereafter the magnesium
is removed.
In step 1, a first solution was
formed by adding concentrated sulfuric acid containing one gram
atomic weight of H2 SO4 and one gram atomic weight of Mg SO4.7H2
O to two liters of deionized water and agitating so that that
the resulting MgSO4 is completely dissolved after 30 mins. of
mild agitation.
In step 2 a second solution was
formed by completely dissolving one gram atomic weight of
Ca(OH)2 and two grams atomic weight of K(OH) in two liters of
deionized water and agitating for 30 mins.
In step 3, the first and second
solutions are mixed together causing a precipitate to form.
In step 4, the solution was
filtered through an 11 micron filter thereby producing the a
filtrate that is the solution of this invention.
In step 5, the solution from step
4 is used in the intended operation which is typically a metal
cleaning operation or acid neutralizing operation.
In step 6 the solution is passed
between electrodes with a voltage in the range between 79 to 83
volts providing that magnesium precipitate forms and removing
the magnesium ions from solution.
In step 7, the precipitate is
filtered out of the solution.
Other concentrations of H2 SO4, Ca(OH)2, KOH, and Mg SO4 have been
investigated in the course of reducing this invention to practice
which have produced solutions with characteristics similar to the
above example and the use of this range of compositions is within
the scope of the invention. These ranges are one quarter to three
quarter gram atomic weight of H2 SO4, Ca(OH)2, MgSO4 and one half
to one gram atomic weight of K(OH) in a liter of water.
However, it is presently believed that the conditions listed in
steps 1-4 are optimum for many situations.
The foregoing discussion discloses an example of the application
of principles of the invention to produce a solution having a high
pH and a heavy concentraion of magnesium ions. The solution is
useful in processes such as cleaning or neutralization where it is
desired to avoid the formation of sludge and be amenable to post
treatment utilizing electrochemical techniques. The principles of
the invention include adding a solution of a soluble salt of
magnesium (MgSO4) dissolved in an acid having an anion common with
the salt to a solution of a strong base (KOH) and a base (Ca(OH)2)
in which the cation (Ca@++) and the anion of the soluble salt
(SO4@--) precipitate out of soltuion and pull the cation (K@+) of
the strong base (KOH) out of solution by coprecipitation leaving,
in solution, hydrated (stabilized) hydroxyl ions (OH)*(H2 O)n and
Mg@++. Application of these principles thereby provides a solution
having a much greater concentration of Mg@++ and a greater pH than
has been disclosed by other related processes of the prior art.
Other elements can be substituted in the process of this invention
to which the same considerations can apply. For example, Barium
ions form insoluble precipitates with the sulfate ion and could be
a useful substitute for Calcium in some applications.
Other variations of the invention may be suggested after reading
the specification that are within the scope of the invention. We
therefore wish to define the scope of our invention by the
appended claims.
http://en.wikipedia.org/wiki/MRSA
Signs and symptoms
S. aureus most commonly colonizes the anterior nares (the
nostrils), although the rest of the respiratory tract, opened
wounds, intravenous catheters, and urinary tract are also
potential sites for infection. Healthy individuals may carry MRSA
asymptomatically for periods ranging from a few weeks to many
years. Patients with compromised immune systems are at a
significantly greater risk of symptomatic secondary infection.
MRSA can be detected by swabbing most of the nostrils of patients
and isolating the bacteria found inside. Combined with extra
sanitary measures for those in contact with infected patients,
screening patients admitted to hospitals has been found to be
effective in minimizing the spread of MRSA in hospitals in the
United States,[1] Denmark, Finland, and the Netherlands.[2]
MRSA may progress substantially within 2448 hours of initial
topical symptoms. After 72 hours MRSA can take hold in human
tissues and eventually become resistant to treatment. The initial
presentation of MRSA is small red bumps that resemble pimples,
spider bites, or boils that may be accompanied by fever and
occasionally rashes. Within a few days the bumps become larger,
more painful, and eventually open into deep, pus-filled boils.[3]
About 75 percent of community-associated (CA-) MRSA infections are
localized to skin and soft tissue and usually can be treated
effectively. However, some CA-MRSA strains display enhanced
virulence, spreading more rapidly and causing illness much more
severe than traditional healthcare-associated (HA-) MRSA
infections, and they can affect vital organs and lead to
widespread infection (sepsis), toxic shock syndrome and
necrotizing ("flesh-eating") pneumonia. This is thought to be due
to toxins carried by CA-MRSA strains, such as PVL and PSM, though
PVL was recently found to not be a factor in a study by the
National Institute of Allergy and Infectious Diseases (NIAID) at
the NIH. It is not known why some healthy people develop CA-MRSA
skin infections that are treatable whereas others infected with
the same strain develop severe infections or die.[4] The bacteria
attack parts of the immune system, and even engulf white blood
cells, the opposite of the usual.[4]
The most common manifestations of CA-MRSA are skin infections such
as necrotizing fasciitis or pyomyositis (most commonly found in
the tropics), necrotizing pneumonia, infective endocarditis (which
affects the valves of the heart), or bone or joint infections.[5]
CA-MRSA often results in abscess formation that requires incision
and drainage. Before the spread of MRSA into the community,
abscesses were not considered contagious because it was assumed
that infection required violation of skin integrity and the
introduction of staphylococci from normal skin colonization.
However, newly emerging CA-MRSA is transmissible (similar, but
with very important differences) from Hospital-Associated MRSA.
CA-MRSA is less likely than other forms of MRSA to cause
cellulitis.
[edit] Risk factors
At risk populations include:
People with weak immune systems (people living with HIV/AIDS,
cancer patients, transplant recipients, severe asthmatics, etc.)
Diabetics
Intravenous drug users
Use of quinolone antibiotics[6]
Young children
The elderly
College students living in dormitories
People staying or working in a health care facility for an
extended period of time
People who spend time in coastal waters where MRSA is present,
such as some beaches in Florida and the west coast of the United
States[7][8]
People who spend time in confined spaces with other people,
including prison inmates, soldiers in basic training,[9] and
individuals who spend considerable time in changerooms or gyms.
Hospital patients
Prison inmates
People in contact with live food-producing animals
Diagnosis
Diagnostic microbiology laboratories and reference laboratories
are key for identifying outbreaks of MRSA. New rapid techniques
for the identification and characterization of MRSA have been
developed. This notwithstanding, the bacterium generally must be
cultured via blood, urine, sputum, or other body fluid cultures,
and grown up in the lab in sufficient numbers to perform these
confirmatory tests first, so there is no quick and easy method to
diagnose an MRSA infection, therefore initial treatment is often
based upon 'strong suspicion' by the treating physician, since any
delay in treating this type of infection can have fatal
consequences. These techniques include Real-time PCR and
Quantitative PCR and are increasingly being employed in clinical
laboratories for the rapid detection and identification of MRSA
strains.[19][20]
Another common laboratory test is a rapid latex agglutination test
that detects the PBP2a protein. PBP2a is a variant
penicillin-binding protein that imparts the ability of S. aureus
to be resistant to oxacillin.[21]
Strains
In the UK, where MRSA is commonly called "Golden Staph", the most
common strains of MRSA are EMRSA15 and EMRSA16.[22] EMRSA16 is the
best described epidemiologically: it originated in Kettering,
England, and the full genomic sequence of this strain has been
published.[23] EMRSA16 has been found to be identical to the
ST36:USA200 strain, which circulates in the United States, and to
carry the SCCmec type II, enterotoxin A and toxic shock syndrome
toxin 1 genes.[24] Under the new international typing system, this
strain is now called MRSA252. It is not entirely certain why this
strain has become so successful, whereas previous strains have
failed to persist. One explanation is the characteristic pattern
of antibiotic susceptibility. Both the EMRSA15 and EMRSA16 strains
are resistant to erythromycin and ciprofloxacin. It is known that
Staphylococcus aureus can survive intracellularly,[25] for example
in the nasal mucosa [26] and in the tonsil tissue ,.[27]
Erythromycin and Ciprofloxacin are precisely the antibiotics that
best penetrate intracellularly; it may be that these strains of S.
aureus are therefore able to exploit an intracellular niche.
Community-acquired MRSA (CA-MRSA) is more easily treated, though
more virulent, than hospital-acquired MRSA (HA-MRSA). CA-MRSA
apparently did not evolve de novo in the community but represents
a hybrid between MRSA that spread from the hospital environment
and strains that were once easily treatable in the community. Most
of the hybrid strains also acquired a factor that increases their
virulence, resulting in the development of deep-tissue infections
from minor scrapes and cuts, as well as many cases of fatal
pneumonia.[28]
In the United States, most cases of CA-MRSA are caused by a CC8
strain designated ST8:USA300, which carries SCCmec type IV,
Panton-Valentine leukocidin, PSM-alpha and enterotoxins Q and
K,[24] and ST1:USA400.[29] Other community-acquired strains of
MRSA are ST8:USA500 and ST59:USA1000. In many nations of the
world, MRSA strains with different predominant genetic background
types have come to predominate among CA-MRSA strains; USA300
easily tops the list in the U. S. and is becoming more common in
Canada after its first appearance there in 2004. For example, in
Australia ST93 strains are common, while in continental Europe
ST80 strains predominate (Tristan et al., Emerging Infectious
Diseases, 2006). In Taiwan, ST59 strains, some of which are
resistant to many non-beta-lactam antibiotics, have arisen as
common causes of skin and soft tissue infections in the community.
In a remote region of Alaska, unlike most of the continental U.
S., USA300 was found rarely in a study of MRSA strains from
outbreaks in 1996 and 2000 as well as in surveillance from 200406
(David et al., Emerg Infect Dis 2008).
Surface sanitizing
NAV-CO2 sanitizing in Pennsylvania hospital exam room
Alcohol has been proven to be an effective surface sanitizer
against MRSA. Quaternary ammonium can be used in conjunction with
alcohol to extend the longevity of the sanitizing action.[37] The
prevention of nosocomial infections involves routine and terminal
cleaning. Non-flammable Alcohol Vapor in Carbon Dioxide systems
(NAV-CO2) do not corrode metals or plastics used in medical
environments and do not contribute to antibacterial resistance.
In healthcare environments, MRSA can survive on surfaces and
fabrics, including privacy curtains or garments worn by care
providers. Complete surface sanitation is necessary to eliminate
MRSA in areas where patients are recovering from invasive
procedures. Testing patients for MRSA upon admission, isolating
MRSA-positive patients, decolonization of MRSA-positive patients,
and terminal cleaning of patients' rooms and all other clinical
areas they occupy is the current best practice protocol for
nosocomial MRSA.
Hand washing
At the end of August 2004, after a successful pilot scheme to
tackle MRSA, the UK National Health Service announced its Clean
Your Hands campaign. Wards were required to ensure that
alcohol-based hand rubs are placed near all beds so that staff can
hand wash more regularly. It is thought that even if this cuts
infection by no more than 1%, the plan will pay for itself many
times over.[citation needed]
As with some other bacteria, MRSA is acquiring more resistance to
some disinfectants and antiseptics. Although alcohol-based rubs
remain somewhat effective, a more effective strategy is to wash
hands with running water and an anti-microbial cleanser with
persistent killing action, such as Chlorhexidine[38]
A June 2008 report[citation needed], centered on a survey by the
Association for Professionals in Infection Control and
Epidemiology, concluded that poor hygiene habits remain the
principal barrier to significant reductions in the spread of MRSA.
Essential oil diffusion
An in vitro study on the inhibition of MRSA by essential oil
diffusion found that 72 of 91 investigated essential oils
exhibited zones of inhibition in soy agar plates streaked with
MRSA (strain ATCC 700699). The most effective being lemongrass oil
(Cymbopogon flexuosus), lemon myrtle oil (Backhousia citriodora),
mountain savory oil (Satureja montana), cinnamon oil (Cinnamomum
verum), and melissa oil (Melissa officinalis) essential oils. Of
these, lemongrass essential oil was the most effective, completely
inhibiting all MRSA colony growth.[39]
Tea tree oil also kills
all MRSA strains that have been tested.[40]
Decolonization
After the drainage of boils or other treatment for MRSA, patients
can shower at home using chlorhexidine (Hibiclens) or
hexachlorophene (Phisohex) antiseptic soap from head to toe, and
apply mupirocin (Bactroban) 2% ointment inside each nostril twice
daily for 7 days, using a cotton-tipped swab. Household members
are recommended to follow the same decolonization protocol.
Doctors may also prescribe antibiotics such as clindamycin,
doxycycline or trimethoprim/sulfamethoxazole. However, there is
very little evidence that using more antibiotics actually has the
effect of preventing recurrent MRSA skin infections.[41]
Proper disposal of hospital gowns
Used paper hospital gowns are associated with MRSA hospital
infections, which could be avoided by proper disposal.[42]
Isolation
Current US guidance does not require workers in the general
workplace (excluding medical facilities) with MRSA infections to
be routinely excluded from going to work.[43] Therefore, unless
directed by a health care provider, exclusion from work should be
reserved for those with wound drainage that cannot be covered and
contained with a clean, dry bandage and for those who cannot
maintain good hygiene practices.[43] Workers with active
infections should be excluded from activities where skin-to-skin
contact is likely to occur until their infections are healed.
Health care workers should follow the Centers for Disease Control
and Prevention's Guidelines for Infection Control in Health Care
Personnel.[44]
To prevent the spread of staph or MRSA in the workplace, employers
should ensure the availability of adequate facilities and supplies
that encourage workers to practice good hygiene; that surface
sanitizing in the workplace is followed; and that contaminated
equipment are sanitized with Environmental Protection Agency
(EPA)-registered disinfectants.[43]
Restricting antibiotic use
Glycopeptides, cephalosporins and in particular quinolones are
associated with an increased risk of colonisation of MRSA.
Reducing use of antibiotic classes that promote MRSA colonisation,
especially fluoroquinolones, is recommended in current
guidelines.[6][10]
Treatment
Both CA-MRSA and HA-MRSA are resistant to traditional
anti-staphylococcal beta-lactam antibiotics, such as cephalexin.
CA-MRSA has a greater spectrum of antimicrobial susceptibility,
including to sulfa drugs (like
co-trimoxazole/trimethoprim-sulfamethoxazole), tetracyclines (like
doxycycline and minocycline) and clindamycin, but the drug of
choice for treating CA-MRSA has is now believed to be Vancomycin,
according to a Henry Ford Hospital Study. The study was presented
on October 23, 2010, at the 48th annual meeting of the Infectious
Diseases Society of America in Vancouver. HA-MRSA is resistant
even to these antibiotics and often is susceptible only to
vancomycin. Newer drugs, such as linezolid (belonging to the newer
oxazolidinones class) and daptomycin, are effective against both
CA-MRSA and HA-MRSA.
Vancomycin and teicoplanin are glycopeptide antibiotics used to
treat MRSA infections.[54] Teicoplanin is a structural congener of
vancomycin that has a similar activity spectrum but a longer
half-life.[55] Because the oral absorption of vancomycin and
Teicoplanin is very low, these agents must be administered
intravenously to control systemic infections.[56] Drugs are
administered via a Peripherally inserted central catheter, or a
Picc Line, which is inserted by radiologists, doctors, physician
assistants (in the U.S.), radiologist assistants (in the U.S.), or
specially trained certified registered nurses.[57] Treatment of
MRSA infection with vancomycin can be complicated, due to its
inconvenient route of administration. Moreover, many clinicians
believe that the efficacy of vancomycin against MRSA is inferior
to that of anti-staphylococcal beta-lactam antibiotics against
MSSA.[58][59]
Several newly discovered strains of MRSA show antibiotic
resistance even to vancomycin and teicoplanin. These new
evolutions of the MRSA bacterium have been dubbed Vancomycin
intermediate-resistant Staphylococcus aureus (VISA).[60] [61]
Linezolid, quinupristin/dalfopristin(synercid), daptomycin, and
tigecycline are used to treat more severe infections that do not
respond to glycopeptides such as vancomycin.[62]
There have been claims that bacteriophage can be used to cure
MRSA. [63]
The psychedelic mushroom
Psilocybe
semilanceata has been shown to strongly inhibit the
growth of Staphylococcus aureus.[citation needed]
Initial studies at the University of East London have demonstrated
that
allicin (a compound
found in garlic) exhibits a strong antimicrobial response to the
bacteria, indicating that it may one day lead to more effective
treatments.[64]
Research
Clinical
It has been reported that maggot therapy to clean out necrotic
tissue of MRSA infection has been successful. Studies in diabetic
patients reported significantly shorter treatment times than those
achieved with standard treatments.[78][79][80]
Many antibiotics against MRSA are in phase II and phase III
clinical trials. eg:
* Phase III : ceftobiprole, Ceftaroline, Dalbavancin, Telavancin,
Aurograb, torezolid, iclaprim...
* Phase II : nemonoxacin.[81]
Pre-clinical
An entirely different and promising approach is phage therapy
(e.g., at the Eliava Institute in Georgia[82]), which in mice had
a reported efficacy against up to 95% of tested Staphylococcus
isolates.[83]
On May 18, 2006, a report in Nature identified a new antibiotic,
called platensimycin, that had demonstrated successful use against
MRSA.[84][85]
Ocean-dwelling living sponges produce compounds that may make MRSA
more susceptible to antibiotics.[86]
Cannabinoids (components of Cannabis sativa), including
cannabidiol (CBD), cannabinol (CBN), cannabichromene (CBC) and
cannabigerol (CBG), show activity against a variety of MRSA
strains. [87]
References
1. ^ Study at the Veterans Affairs hospital in Pittsburgh:
"Science Daily".
http://www.sciencedaily.com/upi/index.php?feed=Science&article=UPI-1-20070727-15235200-bc-us-infections.xml.
[dead
link]
2. ^ McCaughey B. "Unnecessary Deaths: The Human and Financial
Costs of Hospital Infections" (PDF). Archived from the original on
July 11, 2007.
http://web.archive.org/web/20070711030535/http://www.tufts.edu/med/apua/Patients/ridbooklet.pdf.
Retrieved
2007-08-05.
3. ^ "Symptoms". Mayo Clinic.
http://www.mayoclinic.com/health/mrsa/DS00735/DSECTION=symptoms.
4. ^ a b "MRSA Toxin Acquitted: Study Clears Suspected Key to
Severe Bacterial Illness". NIH news release. National Institute of
Health. 2006-11-06.
http://www3.niaid.nih.gov/news/newsreleases/2006/staphtoxin.htm.
5. ^ a b c Raygada JL and Levine DP (March 30, 2009). "Managing
CA-MRSA Infections: Current and Emerging Options". Infections in
Medicine 26 (2).
http://www.consultantlive.com/infection/article/1145625/1393856.
6. ^ a b c Tacconelli, E.; De Angelis, G.; Cataldo, MA.; Pozzi,
E.; Cauda, R. (Jan 2008). "Does antibiotic exposure increase the
risk of methicillin-resistant Staphylococcus aureus (MRSA)
isolation? A systematic review and meta-analysis.". J Antimicrob
Chemother 61 (1): 2638. doi:10.1093/jac/dkm416. PMID 17986491.
http://jac.oxfordjournals.org/cgi/content/full/61/1/26.
7. ^ Reuters (2009-02-16). "Study: Beachgoers More Likely to Catch
MRSA". FoxNews.com.
http://www.foxnews.com/story/0,2933,493604,00.html.
8. ^ Marilynn Marchione (2009-09-12). "Dangerous staph germs found
at West Coast beaches". AP.
http://www.foxnews.com/story/0,2933,549601,00.html.
9. ^ Zinderman, C.; Conner, B.; Malakooti, M.; LaMar, J.;
Armstrong, A.; Bohnker, A. (May 2004). "Community-Acquired
Methicillin-Resistant Staphylococcus aureus Among Military
Recruits". Emerging Infectious Diseases.
http://www.medscape.com/viewarticle/474843.
10. ^ a b Muto, CA.; Jernigan, JA.; Ostrowsky, BE.; Richet, HM.;
Jarvis, WR.; Boyce, JM.; Farr, BM. (May 2003). "SHEA guideline for
preventing nosocomial transmission of multidrug-resistant strains
of Staphylococcus aureus and enterococcus.". Infect Control Hosp
Epidemiol 24 (5): 36286. doi:10.1086/502213. PMID 12785411.
11. ^ Staph (MRSA) Infection Eradicated For 14 Months
12. ^ "Joint scientific report of ECDC, EFSA and EMEA on
meticillin resistant Staphylococcus aureus (MRSA) in livestock,
companion animals and food". 2009-06-16.
http://www.efsa.europa.eu/EFSA/Report/biohaz_report_301_joint_mrsa_en,0.pdf.
Retrieved
2009-09-19.
13. ^ "New England Journal of Medicine".
http://content.nejm.org/cgi/content/full/352/5/468.
14. ^ Epstein, Victor (21 December 2007). "Texas Football Succumbs
to Virulent Staph Infection From Turf". Bloomberg.
http://www.bloomberg.com/apps/news?pid=newsarchive&sid=alxhrJDn.cdc.
Retrieved 10 June 2010.
15. ^ "SVSD410".
http://svsd410.org/districtinfo/newspubs/news.asp?DistrictNewsID=262.
[dead link]
16. ^ MRSA: the problem reaches paediatrics Archives of Disease
in Childhood
17. ^ Community-associated Methicillin-resistant Staphylococcus
aureus in Hospital Nursery and Maternity Units CDC
18. ^ Association for Professionals in Infection Control &
Epidemiology (June 25, 2007). "National Prevalence Study of
Methicillin-Resistant Staphylococcus aureus (MRSA) in U.S.
Healthcare Facilities". Archived from the original on September 7,
2007.
http://web.archive.org/web/20070907201425/http://www.apic.org/Content/NavigationMenu/ResearchFoundation/NationalMRSAPrevalenceStudy/MRSA_Study_Results.htm.
Retrieved
2007-07-14.
19. ^ Francois P and Schrenzel J (2008). "Rapid Diagnosis and
Typing of Staphylococcus aureus". Staphylococcus: Molecular
Genetics. Caister Academic Press. ISBN 9781904455295.
http://www.horizonpress.com/staph.
20. ^ Mackay I M (editor). (2007). Real-Time PCR in Microbiology:
From Diagnosis to Characterization. Caister Academic Press. ISBN
9781904455189. http://www.horizonpress.com/rtmic.
21. ^ Seiken, Denka. "MRSA latex test for PBP2".
http://www.hardydiagnostics.com/catalog2/hugo/MRSALatexTest.htm.
22. ^ Johnson AP, Aucken HM, Cavendish S, et al. (2001).
"Dominance of EMRSA-15 and -16 among MRSA causing nosocomial
bacteraemia in the UK: analysis of isolates from the European
Antimicrobial Resistance Surveillance System (EARSS)". J
Antimicrob Chemother 48 (1): 1434. doi:10.1093/jac/48.1.143. PMID
11418528. http://jac.oxfordjournals.org/cgi/content/full/48/1/143.
23. ^ Holden MTG, Feil EJ, Lindsay JA, et al. (2004). "Complete
genomes of two clinical Staphylococcus aureus strains: Evidence
for the rapid evolution of virulence and drug resistance". Proc
Natl Acad Sci USA 101 (26): 978691. doi:10.1073/pnas.0402521101.
PMID 15213324.
24. ^ a b Diep B, Carleton H, Chang R, Sensabaugh G,
Perdreau-Remington F (2006). "Roles of 34 virulence genes in the
evolution of hospital- and community-associated strains of
methicillin-resistant Staphylococcus aureus". J Infect Dis 193
(11): 1495503. doi:10.1086/503777. PMID 16652276.
25. ^ von Eiff C, Becker K, Metze D, et al. (2001). "Intracellular
persistence of Staphylococcus aureus small-colony variants within
keratinocytes: a cause for antibiotic treatment failure in a
patient with Darier's disease". Clin Infect Dis 32 (11): 16437.
doi:10.1086/320519. PMID 11340539.
26. ^ Clement S, Vaudaux P, Franηois P, et al. (2005). "Evidence
of an intracellular reservoir in the nasal mucosa of patients with
recurrent Staphylococcus aureus rhinosinusitis". J Infect Dis 192
(6): 10238. doi:10.1086/432735. PMID 16107955.
27. ^ Zautner AE, Krause M, Stropahl G, et al. (2010).
"Intracellular persisting Staphylococcus aureus is the major
pathogen in recurrent tonsillitis". PloS One 5 (3): e9452.
doi:10.1371/journal.pone.0009452. PMID 20209109.
28. ^ "Community-Associated meticillin-resistant
Staphylococcusaureus: an emerging threat" (PDF). The Lancet.
http://coe.ed.uidaho.edu/uploads/9/documents/MRSA%20review%207-05.pdf.
29. ^ R Wang et al. "Identification of novel cytolytic peptides as
key virulence determinants of community-associated MRSA". Nature
Medicine DOI: 10.1038/nm1656 (2007).
30. ^ Tacconelli E, De Angelis G, de Waure C, et al. (2009).
"Rapid screening tests for meticillin-resistant Staphylococcus
aureus at hospital admission: systematic review and
meta-analysis". Lancet Infect Dis 9 (9): 546554.
doi:10.1016/S1473-3099(09)70150-1.
31. ^ "To Catch a Deadly Germ," New York Times opinion
32. ^ CDC Guideline "Management of Multidrug-Resistant Organisms
in Healthcare Settings, 2006"
33. ^
http://www.halifaxcourier.co.uk/latest-york-and-humberside-news/New-checks-in-hospitals-to.5123093.jp
34. ^ "MRSA test for surgical patients". BBC News. 2009-03-31.
http://news.bbc.co.uk/1/hi/health/7974964.stm. Retrieved
2010-04-05.
35. ^ http://www.mrsatest.co.uk
36. ^ Fritz SA, Garbutt J, Elward A, et al. (2008). "Prevalence of
and risk factors for community-acquired methicillin-resistant and
methicillin-sensitive Staphylococcus aureus colonization in
children seen in a practice-based research network". Pediatrics
121 (6): 10901098. doi:10.1542/peds.2007-2104. PMID 18519477.
37. ^ Angela L. Hollingsworth. "AOAC Use Dilution Test Health
Care" (PDF). http://www.sanisys.com/pdf_epa_salmo.pdf. Retrieved
2003-09-26.
38. ^ Demarco, E.; Cushing, A.; Frempong-Manso, E.; Seo, M.;
Jaravaza, A.; Kaatz, W. (Sep 2007). "Efflux-Related Resistance to
Norfloxacin, Dyes, and Biocides in Bloodstream Isolates of
Staphylococcus aureus" (Free full text). Antimicrobial Agents and
Chemotherapy 51 (9): 3235. doi:10.1128/AAC.00430-07. ISSN
0066-4804. PMID 17576828. PMC 2043220.
http://aac.asm.org/cgi/pmidlookup?view=long&pmid=17576828.
edit
39. ^ Inhibition of methicillin-resistant Stapphulococcus aureus
(MRSA) by essential oils; Sue Chao, Gary Young, Craig Oberg, and
Karen Nakaoka; Flavour and Fragrance Journal, 2008; 23: 444449
40. ^ Susceptibility of methicillin-resistant Staphylococcus
aureus to the essential oil of Melaleuca alternifolia
41. ^ Buckingham, SC (December 2008). "Prevention of Recurrent
MRSA Skin Infections: What You Need to Know". Consultant 48 (13).
http://www.consultantlive.com/display/article/10162/1360561.
42. ^ "Simple techniques slash hospital infections: meeting".
Reuters. 2009-03-21.
http://www.reuters.com/article/healthNews/idUSTRE52K1O920090321.
43. ^ a b c "NIOSH MRSA and the Workplace". United States National
Institute for Occupational Safety and Health.
http://www.cdc.gov/niosh/topics/mrsa/. Retrieved 2007-10-29.
44. ^ CDC (1998). "Guidelines for Infection Control in Health Care
Personnel, 1998". Centers for Disease Control and Prevention.
http://www.cdc.gov/ncidod/dhqp/gl_hcpersonnel.html. Retrieved
December 18, 2007.
45. ^ Cooper BS, Medley GF, Stone SP, et al. (2004).
"Methicillin-resistant Staphylococcus aureus in hospitals and the
community: stealth dynamics and control catastrophes". Proceedings
of the National Academy of Sciences 101 (27): 102238.
doi:10.1073/pnas.0401324101. PMID 15220470.
46. ^ Bootsma MC, Diekmann O, Bonten MJ (2006). "Controlling
methicillin-resistant Staphylococcus aureus: quantifying the
effects of interventions and rapid diagnostic testing". Proc Natl
Acad Sci USA 103 (14): 56205. doi:10.1073/pnas.0510077103. PMID
16565219.
47. ^ Johnson AP, Pearson A, Duckworth G (2005). "Surveillance and
epidemiology of MRSA bacteraemia in the UK". J Antimicrob
Chemother 56 (3): 45562. doi:10.1093/jac/dki266. PMID 16046464.
48. ^ Inquirer.net, Cases of RP maids with 'superbug' infection
growing in HK
49. ^ "MRSA Infections". Keep Kids Healthy.
http://www.keepkidshealthy.com/welcome/infectionsguide/mrsa.html.
50. ^ Graham P, Lin S, Larson E (2006). "A U.S. population-based
survey of Staphylococcus aureus colonization". Ann Intern Med 144
(5): 31825. PMID 16520472.
51. ^ Jernigan JA, Arnold K, Heilpern K, Kainer M, Woods C, Hughes
JM (2006-05-12). "Methicillin-resistant Staphylococcus aureus as
community pathogen". Symposium on Community-Associated
Methicillin-resistant Staphylococcus aureus (Atlanta, Georgia,
U.S.). Cited in Emerg Infect Dis. Centers for Disease Control and
Prevention. http://www.cdc.gov/ncidod/EID/vol12no11/06-0911.htm.
Retrieved 2007-01-27.
52. ^ First study finds MRSA in U.S. pigs and farmers,
seattlepi.com, 4 June 2008
53. ^ Our Pigs, Our Food, Our Health, The New York Times, 12 March
2009
54. ^ Schentag JJ, Hyatt JM, Carr JR, Paladino JA, Birmingham MC,
Zimmer GS, Cumbo TJ (1998). "Genesis of methicillin-resistant
Staphylococcus aureus (MRSA), how treatment of MRSA infections has
selected for vancomycin-resistant Enterococcus faecium, and the
importance of antibiotic management and infection control". Clin.
Infect. Dis. 26 (5): 120414. doi:10.1086/520287. PMID 9597254.
55. ^ Rybak MJ, Lerner SA, Levine DP, Albrecht LM, McNeil PL,
Thompson GA, Kenny MT, Yuh L (1991). "Teicoplanin pharmacokinetics
in intravenous drug abusers being treated for bacterial
endocarditis". Antimicrob. Agents Chemother. 35 (4): 696700. PMID
1829880.
56. ^ Janknegt R (1997). "The treatment of staphylococcal
infections with special reference to pharmacokinetic,
pharmacodynamic, and pharmacoeconomic considerations". Pharmacy
world & science : PWS 19 (3): 13341.
doi:10.1023/A:1008609718457. PMID 9259029.
57. ^ Kirsten Edwards
58. ^ Chang FY, Peacock JE Jr, Musher DM, et al. (2003).
"Staphylococcus aureus bacteremia: recurrence and the impact of
antibiotic treatment in a prospective multicenter study.".
Medicine (Baltimore) 82 (5): 3339.
doi:10.1097/01.md.0000091184.93122.09. PMID 14530782.
59. ^ Siegman-Igra Y, Reich P, Orni-Wasserlauf R, Schwartz D,
Giladi M. (2005). "The role of vancomycin in the persistence or
recurrence of Staphylococcus aureus bacteraemia". Scand J Infect
Dis 37 (8): 5728. doi:10.1080/00365540510038488. PMID 16138425.
60. ^ Sieradzki K, Tomasz A (1997). "Inhibition of cell wall
turnover and autolysis by vancomycin in a highly
vancomycin-resistant mutant of Staphylococcus aureus". J.
Bacteriol. 179 (8): 255766. PMID 9098053.
61. ^ Schito GC (2006). "The importance of the development of
antibiotic resistance in Staphylococcus aureus". Clin Microbiol
Infect 12 Suppl 1: 38. doi:10.1111/j.1469-0691.2006.01343.x. PMID
16445718. }
62. ^ Mongkolrattanothai K, Boyle S, Kahana MD, Daum RS (2003).
"Severe Staphylococcus aureus infections caused by clonally
related community-associated methicillin-susceptible and
methicillin-resistant isolates". Clin. Infect. Dis. 37 (8):
10508. doi:10.1086/378277. PMID 14523769.
63. ^ [1]
64. ^ Cutler R.R. (2004). "Antibacterial activity of a new,
stable, aqueous extract of allicin against methicillin-resistant
Staphylococcus aureus.". British journal of biomedical science.
PMID 15250668. }
65. ^ Klein E, Smith DL, Laxminarayan R (2007). "Hospitalizations
and Deaths Caused by Methicillin-Resistant Staphylococcus aureus,
United States, 19992005". Emerg Infect Dis 13 (12): 18406. PMID
18258033.
66. ^ Klevens et al. (2007), "Invasive Methicillin-Resistant
Staphylococcus aureus Infections in the United States". JAMA.
Retrieved on 2007-10-31.
67. ^ Centers for Disease Control and Prevention (October 17,
2007), "MRSA: Methicillin-resistant Staphylococcus aureus in
Healthcare Settings
68. ^ Stein R (October 17, 2007), "Drug-resistant staph germ's
toll is higher than thought." Washington Post. Retrieved on
2007-10-19.
69. ^ UK Office for National Statistics Online (February 22,
2007), "MRSA Deaths continue to rise in 2005"
70. ^ Hospitals struck by new killer bug An article by Manchester
free newspaper 'Metro', May 7, 2008
71. ^ Blot S, Vandewoude K, Hoste E, Colardyn F (2002). "Outcome
and attributable mortality in critically Ill patients with
bacteremia involving methicillin-susceptible and
methicillin-resistant Staphylococcus aureus". Arch Intern Med 162
(19): 222935. doi:10.1001/archinte.162.19.2229. PMID 12390067.
72. ^ Liu et al., A population-based study of the incidence and
molecular epidemiology of methicillin-resistant Staphylococcus
aureus disease in San Francisco, 20042005. Clin Infect Dis. 2008
Jun 1;46(11):163746)
73. ^ Noskin GA, Rubin RJ, Schentag JJ, Kluytmans J, Hedblom EC,
Smulders M, Lapetina E, Gemmen E (2005). "The Burden of
Staphylococcus aureus Infections on Hospitals in the United
States: An Analysis of the 2000 and 2001 Nationwide Inpatient
Sample Database". Arch Intern Med 165 (15): 17561761.
doi:10.1001/archinte.165.15.1756. PMID 16087824.
74. ^ Cosgrove SE, Qi Y, Kaye KS, Harbarth S, Karchmer AW, Carmeli
Y (2005). "The impact of Methicillin Resistance in Staphylococcus
aureus Bacteremia on Patient Outcomes: Mortality, Length of Stay,
and Hospital Charges" ( Scholar search). Infection Control and
Hospital Epidemiology 26 (2): 166174. doi:10.1086/502522. PMID
15756888.
http://www.journals.uchicago.edu/ICHE/journal/issues/v26n2/9885/9885.html.
[dead
link]
75. ^ Hardy KJ, Hawkey PM, Gao F, Oppenheim BA (2004).
"Methicillin resistant Staphylococcus aureus in the critically
ill". British Journal of Anaesthesia 92 (1): 12130.
doi:10.1093/bja/aeh008. PMID 14665563.
76. ^ Wyllie D, Crook D, Peto T (2006). "Mortality after
Staphylococcus aureus bacteraemia in two hospitals in Oxfordshire,
19972003: cohort study". BMJ 333 (7562): 281.
doi:10.1136/bmj.38834.421713.2F. PMID 16798756. PMC 1526943.
http://bmj.bmjjournals.com/cgi/content/abstract/333/7562/281.
77. ^ Okuma K, Iwakawa K, Turnidge J, et al. (2002).
"Dissemination of new methicillin-resistant Staphylococcus aureus
clones in the community". J Clin Microbiol 40 (11): 428994.
doi:10.1128/JCM.40.11.4289-4294.2002. PMID 12409412.
78. ^ Bowling FL, Salgami EV, Boulton AJ (2007). "Larval therapy:
a novel treatment in eliminating methicillin-resistant
Staphylococcus aureus from diabetic foot ulcers". Diabetes Care 30
(2): 3701. doi:10.2337/dc06-2348. PMID 17259512.
79. ^ "Maggots help cure MRSA patients". BBC News. 2007-05-02.
http://news.bbc.co.uk/2/hi/uk_news/england/manchester/6614471.stm.
80. ^ "Maggots rid patients of MRSA". EurekAlert!/AAAS.
2007-05-03.
http://www.eurekalert.org/pub_releases/2007-05/uom-mrp050307.php.
81. ^ http://clinicaltrials.gov/ct2/show/NCT00685698
82. ^ Murphy, Clare (2007-08-13). "'Red Army' virus to combat
MRSA". BBC News. http://news.bbc.co.uk/2/hi/health/6943779.stm.
83. ^ Matsuzaki S, Yasuda M, Nishikawa H, Kuroda M, Ujihara T,
Shuin T, Shen Y, Jin Z, Fujimoto S, Nasimuzzaman MD, Wakiguchi H,
Sugihara S, Sugiura T, Koda S, Muraoka A, Imai S (2003).
"Experimental protection of mice against lethal Staphylococcus
aureus infection by novel bacteriophage phi MR11". J. Infect. Dis.
187 (4): 61324. doi:10.1086/374001. PMID 12599078.
84. ^ Bayston R, Ashraf W, Smith T (2007). "Triclosan resistance
in methicillin-resistant Staphylococcus aureus expressed as small
colony variants: a novel mode of evasion of susceptibility to
antiseptics". J. Antimicrob. Chemother. 59 (5): 84853.
doi:10.1093/jac/dkm031. PMID 17337510.
85. ^ Wang J; Soisson, SM; Young, K; Shoop, W; Kodali, S; Galgoci,
A; Painter, R; Parthasarathy, G et al. (May 2006). "Platensimycin
is a selective FabF inhibitor with potent antibiotic properties".
Nature 441 (441): 358361. doi:10.1038/nature04784. PMID 16710421.
86. ^ Sponge's secret weapon restores antibiotics' power
87. ^ Appendino G, Gibbons S, Giana A, Pagani A, Grassi G, Stavri
M, Smith E, Rahman M (2008). "Antibacterial Cannabinoids from
Cannabis sativa: A Structure-Activity Study". J. Nat. Prod. 71
(8): 142730. doi:10.1021/np8002673. PMID 18681481