MRSA - Methicillin-Resistant Staphylococcus Aureus is Exploding

While the waste industry has been spreading Staphylococcus {MRSA)  contaminated sludge and
reclaimed water in the communities since the sludge rule was released in 1993, farmers and doctors
are being blamed for the misuse of antibiotics. Doctors have not yet made a connection to
soft tissue infections and exposure to sludge biosolids / reclaimed water.

Jim Bynum                                                                                                10/27/2007
Retired safety Consultant                                                                                        Revised       12/23/2007

Figure 1. Hospital stays with methicillin–resistant Staphylococcus aureus (MRSA) infections, 1993–2005

About 1 in 20 (5%) of the MRSA infected individuals died. When MRSA involves soft tissue infections
and progresses to necrotizing fasciitis (i.e. flesh-eating bacteria syndrome, suppurative fasciitis,
Fournier's  gangrene, and necrotizing erysipelas), the mortality rate increases to as much as 73% for
senor citizens.

Some strains are capable of producing a highly heat-stable protein toxin that causes illness in humans.
Staphylococci exist in air, dust, sewage, water, milk, and food or on food equipment, environmental surfaces,
humans, and animals. Humans and animals are the primary reservoirs. Staphylococci are present in the nasal
passages and throats and on the hair and skin of 50 percent or more of healthy individuals. This incidence is even
higher for those who associate with or who come in contact with sick individuals and hospital environments.
Of the bacterial pathogens causing foodborne illnesses in the U.S. (127 outbreaks, 7,082 cases recorded in
1983), 14 outbreaks involving 1,257 cases were caused by S. aureus. These outbreaks were followed by 11
outbreaks (1,153 cases) in 1984, 14 outbreaks (421 cases) in 1985, 7 outbreaks (250 cases) in 1986 and one
reported outbreak (100 cases) in 1987.

May 22, 2009 study
Trends in the Incidence of Methicillin‐Resistant Staphylococcus aureus Infection in Children’s
Hospitals in the United States (2009) Results. "During this 6‐year study period, we identified 57,794 children
with S. aureus infection, 29,309 (51%) of whom had MRSA infection. The median age of patients with S. aureus
infection was 3.1 years (interquartile range, 0.8–11.2 years), and less than one‐third of these patients had
complex, chronic medical conditions. Over time, there was a significant increase in cases of MRSA infection (from
6.7 cases per 1000 admissions in 2002 to 21.1 cases per 1000 admissions in 2007;  , by test for trend), whereas
the incidence of methicillin‐susceptible S. aureus infection remained stable (14.1 cases per 1000 patient‐days in
2002 to 14.7 cases per 1000 patient‐days in 2007;  , by test for trend). Of the 38,123 patients whose type of
infection was identified, 23,280 (61%) had skin and soft‐tissue infections. The incidences of skin and soft‐tissue
infection, pneumonia, osteomyelitis, and bacteremia that were caused by S. aureus increased over time, and these
increases were due exclusively to MRSA. The mortality rate for hospitalized children with MRSA infection was 1%
(360 of 29,309 children)."

January 23, 2009
U.S. pigs and farmers carry MRSA but federal food safety agencies are doing little to see if the pork is safe

September 2008
Flesh-eating superbug confounds the experts
Known as the Queensland clone, a new mutation of the drug-resistant bacteria kills one out of every two patients
who acquire it, a medical summit has been told.

Nov -- 2007 NIH Press Release.
The National Institute of Health (NIH) press release states, "Up until a year ago, most  scientists studying S. aureus
believed they had narrowed their search for the cause of severe CA-MRSA  infections, focusing on the Panton-
Valentine leukocidin (PVL) toxin produced by certain strains. But then  last year, Dr. Otto and his RML colleagues
published a study indicating that PVL does not play a major role  in CA-MRSA infections."
Now, NIH states, "Newly described proteins in drug-resistant strains of the Staphylococcus aureus bacterium  
attract and then destroy protective human white blood cells—a key process ensuring that S. aureus  survives and
causes severe disease, according to scientists at the National Institute of Allergy and  Infectious Diseases (NIAID),
part of the National Institutes of Health."

March 2006 study, In certain patients, an analysis of data showed that the annual incidence of CA-MRSA
increased by 250% in 2004 and 500% in 2005 compared with the 2003 rate.

Methicillin-resistant Staphylococcus aureus infections, which are potentially deadly, are now responsible for an
estimated 12 million outpatient visits each year for skin infections, said Jeff Hageman, of the U.S. Centers for
Disease Control and Prevention. "MRSA is epidemic in some regions of the country," he said. "The highest rates
are in the southern parts of the U.S., including Atlanta, Los Angeles and Texas. We first began noticing MRSA in
1999 when there were four child deaths in Minnesota and North Dakota." MRSA infections are the leading cause of
skin and soft tissue infections among hospital patients, and can result in severe and even fatal disease. These
infections account for almost
19,000 deaths and more than 94,000 life-threatening illnesses each year in the
United States. (Oct. 19,2007)

MRSA infection is now endemic in nursing homes, long-term care facilities, and community hospitals. It's also seen
in patients who haven’t been hospitalized, as community-acquired MRSA infections are increasing.
Patients most at risk for MRSA infection include immunosuppressed patients, burn patients, intubated patients, and
those with central venous catheters, surgical wounds, or dermatitis. Others at risk include those with prosthetic
devices, heart valves, and postoperative wound infections. Other risk factors include prolonged hospital stays;
extended therapy with multiple or broad-spectrum antibiotics; and close proximity to those colonized or infected
with MRSA. Also at risk are patients with acute endocarditis, bacteremia, cervicitis, meningitis, pericarditis, and

According to the government's July 2007 HEALTHCARE COST AND UTILIZATION PROJECT, endocarditis,
bacteremia, cervicitis, meningitis, pericarditis, and pneumonia are all secondary diagnoses which accounted for  
about 368,600 hospital stays for infections with MRSA in 2005

The superbug
A nasty staph germ circulating in and out of hospitals produces a poison that can kill pneumonia patients
within 72 hours, researchers said on Thursday.
"The reason most patients die is that despite killing the bug, PVL toxins already formed continue to digest lung
tissue, so we desperately need some way of removing the toxins," Morgan said.

Studies show EPA and its partners are destroying public health.
By 1989, (25)  Invasive group A streptococcal, Staphylococcus (MRSA), Clostridium, and E. coli 157 were just
beginnng their deadly transformation through the wastewater treatment plants. Only a few people had died from
these pathogenic sludge pollutants during the 1980s. In the past 15 years, Invasive group A streptococcal,
Staphylococcus,  Clostridium, (Necrotizing Fasciitis),  and E. coli 157 have become epidemic

Necrotizing fasciitis is the result of an invasive bacterial infection that destroys deep soft tissue in the body very
quickly.  As the tissue is invaded and destroyed gas gangrene sets in and the toxic gases generated by the
bacteria can create toxic shock causing death within a few days or in the worse cases, a matter of hours. While a
number of bacteria formerly known for causing relative mild diseases (such as Streptococcus and
Staphylococcus)  have taken on the invasive traits in the past 15 years, many writers simply refer to the multiple
cast of deadly organisms as the flesh eating bacteria. The literature suggests scientists are puzzled about the
nature of these bacteria and how they transformed themselves so quickly into the deadly toxin producing strains.

Research indicated an Air Force document, (13) by  Dr. Stephen F. Burgess and Dr. Helen E. Purkitt, dated  April
2001,  might supply the answer. They state there are specific bacteria that cause necrotizing fasciitis and gas
gangrene [Clostridium perfringens (formerly known as Clostridium welchii), Streptococcus and Staphylococcus --
three major foodborne contamination bacteria found in sewage sludge]. The document also indicated  South Africa
got the bacteria about 1984 and gave the bacteria and antidote to the US government in 1994.

However, the literature shows these super bugs and other are currently being created in our wastewater treatment
plants. The literature also shows that primary exposure routes of infections are through wastewater effluents into
waterways and waste residual disposal as a fertilizer or soil amendment and bioaersols from disposal sites and soil
amendment waste residual compost producing facilities.

In studies done by EPA's David Lewis,
Researchers found that affected residents lived within approximately one kilometer (0.6 miles) of land- application
sites and that they generally complained of irritation after exposure to winds blowing from treated  fields.
Staphylococcus aureus infections, which commonly accompany diaper rash, were found in the skin and  
respiratory tracts of some individuals. Approximately 25 percent of the individuals surveyed were infected, and  two
died.  The 54 individuals surveyed lived near 10 land-application sites in Alabama, California, Florida, New
Hampshire,  Ohio, Ontario, Pennsylvania and Texas. S. aureus is commonly found in the lower human colon and
tends to  invade irritated or inflamed tissue.

Infections with Methicillin-Resistant Staphylococcus Aureus (MRSA) in U.S. Hospitals,
1993–2005   Government figures for 2004

Methicillin-Resistant Staphylococcus aureus (MRSA)
The S. aureus bacterium, commonly known as staph, was discovered in the 1880s. During this era, S. aureus
infection commonly caused painful skin and soft tissue conditions such as boils, scalded-skin syndrome, and
impetigo.More serious forms of S. aureus infection can progress to bacterial pneumonia and bacteria in the
bloodstream—both of which can be fatal. S. aureus acquired from improperly prepared or stored food can also
cause a form of food poisoning

In the 1940s, medical treatment for S. aureus infections became routine and successful with the discovery and
introduction of antibiotic medication, such as penicillin.

From that point on, however, use of antibiotics—including misuse and overuse—has aided natural bacterial
evolution by helping the microbes become resistant to drugs designed to help fight these infections.
In the late 1940s and throughout the 1950s, S. aureus developed resistance to penicillin. Methicillin, a form of
penicillin, was introduced to counter the increasing problem of penicillin-resistant S. aureus. Methicillin was one of
most common types of antibiotics used to treat S. aureus infections; but, in 1961, British scientists identified the
first strains of S. aureus bacteria that resisted methicillin. This was the so-called birth of MRSA.

The first reported human case of MRSA in the United States came in 1968. Subsequently, new strains of bacteria
have developed that can now resist previously effective drugs, such as methicillin and most related antibiotics.

MRSA is actually resistant to an entire class of penicillin-like antibiotics called beta-lactams. This class of antibiotics
includes penicillin, amoxicillin, oxacillin, methicillin, and others.

S. aureus is evolving even more and has begun to show resistance to additional antibiotics. In 2002, physicians in
the United States documented the first S. aureus strains resistant to the antibiotic, vancomycin, which had been
one of a handful of antibiotics of last resort for use against S. aureus. Though it is feared that this could quickly
become a major issue in antibiotic resistance, thus far, vancomycin-resistant strains are still rare at this time.

How our hospitals unleashed a MRSA epidemic MRSA, a drug-resistant germ, lurks in Washington
hospitals, carried by patients and staff and fueled by inconsistent infection control. This stubborn
germ is spreading here at an alarming rate, but no one has tracked these cases — until now.