
rexresearch
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