Talk:Methicillin-resistant Staphylococcus aureus/Archive 1

Archive 1

External link/Ad

Moved this external link/ad to Talk. If we can contextualize it better, I persoanlly have no problem with putting it back in the article. -- FEB 25, 2006 Tea tree oil verses MRSA —Preceding unsigned comment added by 201.51.235.44 (talk • contribs) 07:27, 25 February 2006

Linezolid is now felt to be the best drug for treating patients with MRSA pneumonia <-- Controversial

Statement is quite controversial. Many centres still use Vancomycin as first line, due to the safety profile and cost of Linezolid. Also mentionable that linezolid is bacteriostatic as opposed to vancomycin or alternatively, Ceftaroline.

2011 Infectious Diseases Society of America (IDSA) guidelines still recommends use of Vanco as first line for MRSA bacteremia. WRT MRSA pneumonia, Meta-analysis shows no difference in outcome, but Linezolid has increase risk of thrombocytopenia.

One point in support of linezolid would be in the ability to orally dose.

References

World Threat?

It is not clear from the article whether a sensationalistic claim about MRSA being "the next AIDS and worse" is true. This presentation of MRSA as a world threat is part of the advertisements a new journalism-based talk show is using to promote their first episode which is airing roght now but doing little to inform... So I came to find out for myself and I see there's not enough data on how contagion occurs (The ads suggested sexual intercourse and mere shaking of a hand)... Rather than being alarmist I guess proper information on the plausibility of major outbreaks of MRSA could get a place in the article, after all, detailing about its spread to other countries and control and any other data that might be conclusive. But well, this was just a thought...Undead Herle King (talk) 03:55, 24 February 2008 (UTC)

How is it transmitted?

Can someone with the knowledge add a section that specifically addresses how MRSA is acquired (like whether it can be acquired by shaking someone's hand or using the same bathroom or touching a doorknob)? I think there is a lot of conflicting information being thrown around by the media, and this is a topic that I think is important to readers. `68.248.159.57 (talk) 04:13, 6 December 2007 (UTC)

I agree 100%. I know wikipedia is not a howto and that it's probably mostly med students writing this but a simply "Transmission" section would improve legibility and usefulness and still keep it encyclopedic. chochem (talk) 11:45, 1 February 2008 (UTC)

I can't provide a reference for what I'm about to state but this is what I was taught. The general population has a nasal carriage rate of between 10-25% for S. aureus and microbiologists, hospital workerss, basically anyone that comes into contact regularly with the bacteria has a nasal carriage rate of between 10-40%. This does not mean that everyone that has it is sick, will ever get sick, and will spread it around and make everybody else sick. It simply means it lives happily in your nose with the other millions of bacteria stuck up there and colonising your body. It is part of the normal flora for humans, and it is meant to be there! Because this organism is part of the normal flora that means it is regularly exposed to antibiotics, and has developed resistance mechanisms through the transfer of plasmids to various antibiotics. Including methicillin. This is usually not an issue, unless the bacteria are also one of the strains that has various virulence mechanisms like surface proteins that promote colonisation, toxins that promote tissue spread, antiphagocytic capsule, immunological disguises, etc. Still usually not an issue. Then the S. aureus happens to colonise an area of the body which it doesn't normally live in, THEN you get the problems. So think of it as fine in your nose, fine on your skin, not so great in that open wound on your leg. That is when you get an infection. It's transmitted in the normal ways, skin to skin, surface to skin, etc. I've noticed a lot of panic and sensationalism in this article and thought it was important to state that this isn't the end of the world as we know it. You're more likely to pick it up in a hospital not only because hospital workers are carrying it, but also because YOU are probably carrying it. 131.170.90.2 (talk) 02:22, 15 April 2008 (UTC)

Introduction

This section does not cite the carrier rate of s. aureus. I thought every human carried s.aureus not just a third of the human population.

The "flesh eating bacterium" is most commonly Streptococcus pyogenes, not Staph.

http://www.emedicine.com/derm/topic743.htm

I suspect that what you mean is that everyone is capable of carryinng S aureus should they experience an acquisition event, and most people above a certain age have probably carried the bug for a while in the past. Like many other bacteria, S aureus is carried for a limited period of time (in the order of months to years) but is is not carried for ever: so while some people acquire S aureus, others lose it, leading to a dynamic equilibrium of 30% prevalence. Will you buy that? Best wishes, Pietro Coen —Preceding unsigned comment added by Pietrocoen (talk • contribs) 21:21, 26 November 2007 (UTC)

--eukaryotica 18:12, 26 February 2007 (UTC)

Actually S. aureus is carried by each and every person on the face of the planet. It is a part of the body's normal flora. What everyone does not carry is MRSA. This is an infectious form of the bacteria.

Most of what I've read cites 30% of the population carries staph on their skin or in nasal passages. (And, I've read a lot the past six months.) I contracted MRSA last fall after having only one sore on my back. My primary physician misdiagnosed me and sent me home with incorrect meds and no instructions to watch for rising fever. After my fever topped out at 104.3 the next afternoon, I called the dr. and was immediately admitted to the hospital. I required surgery to remove affected tissue, and I was in intensive care for four days--total time in hospital six days. New drug--Zyvox--helped tremendously once I was over affects of Toxic Shock Syndrome in the hospital. An unpleasant week for sure.

I've had one recurrent episode (after being otherwise healthy most of my life). This second go-round was much milder since I went straight to the doctor, and I knew what was wrong. My two rounds of MRSA both followed 3-4 weeks of penicillan use (connected with an abscessed root canal that is now being retreated/fixed). I'm convinced the penicillan usage was directly connected to both bouts of MRSA. The surgeon agrees; infectious disease dr. not so sure. (The 3 drs. who treated me in the hospital continually had differing opinions related to MRSA, so finding different views isn't unusual.) Time will tell cause I'm "done" with penicillan.

--MRSA Survivor 23:41, 23 April 2007 (UTC)MRSA Survivor

Community-acquired MRSA is not the same as hospital-acquired MRSA. Most important differences include antibiotic-susceptibility spectrum (ca-MRSA more sensitive to additional antibiotics than hospital acquired antibiotics) and virulence. From a clinical perspective, I would rewrite most of this article. Reflects common lumping of all MRSA infections when, at least clinically, ca vs. nosocomial are very different entities. —Preceding unsigned comment added by Rruggero (talk • contribs) 06:38, 9 September 2007 (UTC)

I also have never heard of "multiple resistant" staph aureus? (to clarify: there is multiple resistant MRSA, but MRSA does not refer to this entity) is this editor confusing multiple resistant TB? i think someone at wiki with more medical/microbiology background should really review this entire article Rruggero 06:42, 9 September 2007 (UTC)

looks like someone has added some great info differentiating ca and ha MRSA in last section. thanks. Rruggero 21:50, 9 September 2007 (UTC)

Sensationalism

I don't know anything much about the subject, but it looks to me as though you've summarized and quoted from a sensationalistic tabloid article. Mkweise 19:58 Mar 6, 2003 (UTC)

Did you follow the link, or is just that my writing reeks of POV? --Uncle Ed 19:59 Mar 6, 2003 (UTC)

I think you did a good job of summarizing a bad article. In particular, I think the comparison with AIDS is sensationalistic. If I'm not mistaken, MRSA is significant mainly as a secondary infection. Perhaps we can find some hard data at cdc.gov. Mkweise 20:18 Mar 6, 2003 (UTC)

Nonetheless , scary stuff this bug is. SniperSarge 16:21, 17 August 2006 (UTC)

90,000 people a year die from hospital acquired infections including MRSA. This has been happening long before the recent hysteria. It is a serious problem and executives in health care operations need to start acknowledging that a problem exists and putting the budget, knowledge and tools into play to stop it. The technology is available but the will is lacking. Chuck921 —Preceding unsigned comment added by Chuck921 (talk • contribs) 18:30, 23 November 2007 (UTC)

"Highly sexual active" vs "promiscuous"

"Highly sexual active" is a good euphemism for "promiscuous". Now let's try "idol worship" in place of "idolatry". --Uncle Ed 20:07 Mar 6, 2003 (UTC)

But "highly sexual active" does not in any way imply multiple partners, which is the key here. While promiscuity has gained some negative connotations, I don't know of a more value-neutral term with the same meaning or I would have used it. Mkweise 20:23 Mar 6, 2003 (UTC)

http://www.onelook.com/?w=promiscuous&ls=a

I think the word definately carries negative connotations - it implies not just having many sexual partners, but being indiscriminate in choice of partner. As far as I'm aware, STDs correlate with the number of sexual partners one has, rather than whether or not one suffers from the beer goggle effect... :) Martin

Thanks, Martin. My first roll of the dice did not live up to its promise. I'm glad for anything that brings neutrality to our writing :-) --Uncle Ed

There's lots of information on MRSA in the Wikipedia, but somehow this article uses none of that background, none of the informative material, but rather chooses to emphasize a single report of increased incidence of MRSA in a sub-population of gay men. Yet another example of Ed Poor writing his anti-gay bigotry into the Wikipedia. (anon)

A search for MRSA reveals no mass of informative material:[1] [2]. Also, please note wikipedia policy on no personal attacks. Thanks :) Martin

Bigoted or not, the article certainly places undue emphasis on the bug's impact on gay people. Compare the following results from Google:

MRSA and aureus: 20,200 hits

MRSA and aureus and (gay or homosexual): 390 hits

Statistically that means that only 1.9% of pages about MRSA mention gay people. I think our article should reflect that proportion. Perhaps the New Scientist quote is OK per se, but just needs to be surrounded by much more clinical info to put it in perspective. I see someone has started to do just that while I have been writing this comment. -- Heron

Well, a mini-epidemic among prison populations and other groups certainly looks a lot less "anti-gay". The only thing left to consider is why prison populations would be catching the disease so much. There wouldn't be a lot of sex with multiple partners in prisons, would there? I've heard disturbing stories about male rape and a "protection" system wherein a young or weak man takes on a "daddy". Hmm, seems like the "prison" group may include (or primarily consist of) the homosexually active group. Maybe the term gay disease wasn't so far off after all. --Uncle Ed 21:21 Mar 6, 2003 (UTC)

One problem with using the word 'gay' is that it means homosexual, ie, a person whose sexual orientation is based on sexual attraction to one's own sex. But there is another non 'gay' category, men who have sex with men. Such people are not homosexual in the standard sense, but for various reasons, though heterosexual, engage in same sex conduct. This includes:

• heterosexuals 'exploring' same sex experiences out of curiousity;
• men in exclusively male environments (eg, prison, monasteries) who have no other sexual outlet and no contact with women, and so while in that environment, opt to have sex with men, but once able to associate with women again revert exclusively to heterosexual sexual acts and an exclusively heterosexual orientation.

In addition, there are bisexuals who have attraction to both sexes and may pass STDs between the sexes, from female partners to male ones, and vice-versa. Using gay ignores such groups and as such is factually incorrect. JtdIrL 21:38 Mar 6, 2003 (UTC)

I think I see your point, and it centers on the meaning of the problematic term gay -- which has been used for dozens of decades in the English-speaking world to describe extramarital sex of various sorts. It is difficult to give a single definition that will satisfy all parties. Hence, the appearance of such terms as queer, gay men (when one needs to be specific), gay and lesbian (when trying not to exclude the ladies), and so on.

For those people who use "gay" in the sense of "any sex between people of the same sex", the term gay disease will have an immediately recognizable and usefull meaning, such as the doctors referenced in talk:gay disease. But I can see why others may object.

Gay is generally used simply to refer to people of a homosexual orientation. The phrase men who have sex with men is used to describe men of a heterosexual orientation would do not have homosexual feelings but who find homosexual sex acts the only way they have in the environment they are in to have sex. I don't know about in the US but certainly in Europe, 'safe sex' programmes dealing with sex acts involving people of the same gender explicitly make that distinction, not least because 'men who have sex with men' generally baulk at being described as gay when they are not. Indeed the fear is that many would not pay any attention to safe sex messages if they are targeted simply at gay people, a category they do not identify with, or indeed match the dictionary definition of. According to dictionary definitions, a homosexual is someone with feelings for, or attraction to, other men. That does not describe 'men who have sex with men', because their sexual acts are not based on attraction or orientation but simply on need and a pragmatic solution to their sexual needs in an environment where their normal focus of sexual attraction, women, are not available.

BTW, stricty speaking homosexual does not simply mean men but men or women. The 'homo' is not from the latin for 'male' but from the greek for 'same'. That is why is should not be pronounced as in 'ho-mo-sexual' but 'haum-o-sexual'. JtdIrL 22:36 Mar 6, 2003 (UTC)

The challenge is how to describe ideas despite the shifting and problematic meanings of our chief encyclopedia tool: the written word. --Uncle Ed

The fact you both seem to be missing, is that the "outbreaks" referred to in that paragraph were spread by skin contact, not by sexual intercourse. Surely you don't consider every man who shakes another man's hand gay, now do you? Mkweise 21:46 Mar 6, 2003 (UTC)

Are you saying that male prisoners shake each other's hands a lot, and that is how MRSA is spreading in prisons? --Uncle Ed 17:03 Mar 7, 2003 (UTC)

Surely you don't mean to suggest that the outbreaks among "Athletes, schoolchildren and newborns" mentioned in the paragraph you quoted were spread by gay orgies? Let's just stick to the facts: The infection is spread by skin contact, including indirect contact via shared towels and exercise equipment, and is not per se affected by which factors lead to skin contact. Mkweise 17:59 Mar 7, 2003 (UTC)

• rm answered question - thanks Mkweise

Jesus - have you all gone nuts? Why are you so obsessed with being pollitically correct? Just READ the article! It's about GAY MEN - NOT about straight people! These are epidemiologists doing the research. Who are you to misquote what they have done and misrepsresent it? Really... here it is again for ya: http://www.reuters.com/article/health-SP-A/idUSN1337175820080115?pageNumber=1&virtualBrandChannel=0 Angelatomato (talk) 14:40, 16 January 2008 (UTC)

--Way to fill up a talk page with useless information. This is an article about the disease. Despite the fact that gays, or homosexuals, or "men who prefer to dabble in the less-common areas of sexual orientation" might take offense to the fact that a disease might prefer to be transmitted through unprotected anal sex, this article needs to reflect the studies that show that how MRSA is transmitted outsite the hospital or prison setting. I am totally sorry if your google searches don't reflect that the two are connected (due to the relative newness of the disease), but you need to at least show that the studies are taking place and report their findings. I often fail to understand why homosexuals oppose science that can help them combat epidemics within their communities, but I do think that it would be for the betterment of the entire wiki community if we get past the linguistic argument of semiotics and try to make the article relfect the true causes of transmition.

Whatever you do, keep this section in the article, because it's really interesting. We're watching bacteria evolve into a STD right before our eyes. I sure hope the evolutionary biology of MRSA is getting well funded, not just because it's a major threat to public health but because if we're lucky the opportunity to watch human disease evolve like this may never come again. Wnt (talk) 15:14, 15 April 2008 (UTC)

Oh, and as for the semantic question, if there's a doubt just stick with the phrasing used in the source. Choosing a synonym is "original research" and can be challenged at any time, so that's actually the Wikipedia policy. Wnt (talk) 15:14, 15 April 2008 (UTC)

Lesser infxns

In the US, out of hospital MRSA, or CA (community-aquired) MRSA are still remarkably sensitive to rifampin, tetracyclines, and TMP/SMX (TRIMETHOPRIM-SULFAMETHOXAZOLE, which may be the same as your co-trimox)Sfahey 20:09, 21 January 2006 (UTC)

Also, rifampin is the USAN for rifampicin. -Techelf 02:18, 22 January 2006 (UTC)

This is true. Although, Rifampin is not the only line of antibiotic used to treat MRSA. Vancomycin is the most widely used antibiotic for nosocomial aquired MRSA today. When a patient is in the hospital for MRSA, the line of treatment is IV Vancomycin. Vancomycin attacks the microbe at it's cell wall, interfering with the peptidoglycan layer synthesis by binding to a precursor. Because of this, Vancomycin is capable of killing the staphylococcus aureus (the microbe reponsible for MRSA).(Methicillin-Resistant Staphylococcus Aureus Clinical Management and Laboratory Aspects; Mary T. Cafferkey pgs: 1,38-39, 107-116) Because Vancomycin is such a strong antibiotic, it is concidered the last resort to treating MRSA. ( NML 08:42, 22 November 2007) —Preceding unsigned comment added by 64.251.142.157 (talk)

MRSA and ORSA

Hi. I just opened a discussion on the Oxacillin-resistant Staphylococcus aureus page to discuss whether or not the content there is duplicating this (MRSA) content. That page recently was edited, and this page has had a recent active discussion, so please give some input if you have some. Maybe a merge would be a good idea. Thanks. Art desk 05:42, 31 January 2006 (UTC)

p.s. the best way to find the oxacillin-resistant S. aureus page is to search "ORSA". ThanksArt desk 05:45, 31 January 2006 (UTC)

Thanks Art desk, I've changed ORSA to redirect here. For all intents and purposes MRSA and ORSA refer to the same thing, since it the organism is resistant to all narrow-spectrum β-lactamase-resistant penicillins. I didn't move any new data from the ORSA here, however, because it was superfluous anyway. -Techelf 09:30, 31 January 2006 (UTC)

thanks Techelf! Also thanks for separating this thread under its own heading. Art desk 18:00, 31 January 2006 (UTC)

No worries. =) -Techelf 11:19, 1 February 2006 (UTC)

Name MRSA

I thought Methicillin Resistant..... was being phased out to be replaced by "Multi-Resistant...."

But then again, Google hits for Multi - 290, for methicillin >450,000

Panthro 16:08, 5 February 2006 (UTC)

Google vs Panthro 1-0.

But seriously, the resistance to methicillin is the defining characteristic of MRSA. JFW | T@lk 05:30, 6 February 2006 (UTC)

As I understand it, the term 'Multiply-Resistant Staph Aureus' is used by some clinicians and academics. It is of course a more accurate name. However, as methicillin resistance is the test most commonly performed in a lab its current name has become widespread. It isn't really a worry; it might be wise top include a brief mention of the alternative name in the article. Rob cowie 11:27, 24 February 2006 (UTC)

MRSA is specific to Methicillin/S.aureus, but has unfortunately evolved into shorthand reference to all multi-resistant pathogens, and is often simply referred to as "superbug" by much of the press. This enables some in authority (i.e. NHS) to disingenuously claim that "MRSA rates in such and such area have decreased over such and such period" when in fact, those cited infection rates (of multi-resistant pathogens) have indeed risen, and not declined - in some cases simply because more MRSA are showing Vancomycin resistance as well and are recorded as VISA and not MRSA. This rhetorical sleight-of-hand is not only confusing, but ultimately deadly; that's why its important to keep the terms clear.Istvan 20:10, 21 April 2006 (UTC)

Why is a name used under Discovery and History: "MRSA/Multidrug Resistant Staphylococcus aureus was discovered in 1961 in the UK. " but not used in the introduction? Should that be deleted? Jgiam (talk) 14:42, 22 April 2008 (UTC)

US vs British Language

The article contained a mix of US and British spellings. Inconsistency is of course to be avoided so I've standardised on British spellings. To save argument - I counted the occurences of British and American spelling variants. Britain 5, US 1. So, British it is. Rob cowie 11:40, 24 February 2006 (UTC)

Cultural References

It doesn't do much harm to the article, but is the 'Cultural References' section worth keeping? It just ends up as a list of games and films which happened to mention MRSA. Rob cowie 10:25, 30 March 2006 (UTC)

I agree, it doesn't really seem relevant. -Techelf 08:58, 31 March 2006 (UTC)

I'm going to remove it. If anyone disagrees, feel free to discuss it. Rob cowie 15:12, 7 April 2006 (UTC)

Botanical extract

An anonymous user has been repeatedly inserting material about a botanical extract combined with electrical current as a therapy for MRSA. The inclusion of this in the article seems to be mainly for advertising, and since the treatment seems to be quite dubious, it should not be incorporated into the article. Andrew73 18:07, 19 May 2006 (UTC)

Removed broken link

I removed the link to a CNN story about MRSA found in illegal tattoo customers. CNN did not have that story anymore. Jdominguez 18:00, 17 August 2006 (UTC)

MRSA mortality

The study by Wyllie is quoted as showing an excess mortality of 49% in patients with MRSA. This is untrue. In fact, the statistics cannot be analysed in this way (it is a cohort study and MRSA and MSSA patients are not matched or compared with each other); AND the authors of the study conclude that the rates are in fact SIMILAR between patients with MRSA and MSSA. The figure of 49% does not appear anywhere in the article (they quote an odds ratio of 1.49 but do not intend it to be interpreted in this fashion and it is not interpreted in this fashion in the accompanying editorial either). --Gak 16:16, 8 September 2006 (UTC)

This is a poor paragraph in the main article. One study talks about MRSA vs. nothing, the other MRSA vs MSSA. Sfahey 13:37, 9 September 2006 (UTC)

Duration

How long does the associated skin boils condition typically last? I've had a bunch of frickin' boils all over my face for over a year, and it still doesn't seem to be showing any signs of leaving! Scorpionman 18:51, 13 September 2006 (UTC)

MRSA usually becomes invasive rapidly. Other Staph more likely to linger. Sfahey 03:46, 15 September 2006 (UTC)

Death rate

Wyllie et al. report a death rate of 34 percent within 30 days among patients infected with MRSA

As a layperson, I'm assuming that this doesn't mean that 34% of people diagnosed with MRSA will die within 30 days, but maybe just in this one hospital in this one study. Am I right? If so, perhaps we should point this out. Otherwise, people will be told by their doctor that they have MRSA, come home, look it up in Wikipedia, and go, "OMG I'M GONNA DIE". Marnanel 16:37, 22 November 2006 (UTC)

The sentence leaves out a key word. The death rate was reported to be 34% among patients with MRSA bacteremia (MRSA infection of the bloodstream). The study excluded patients with other types of MRSA infections, such as MRSA infections of the skin. NighthawkJ 20:30, 8 December 2006 (UTC)

Stealth Spam

Hi, I'm just a wandering lurker, but when I see something blatantly wrong (egregious misspelling, obvious spam, etc) I'll just fix it. However, this spam is strange. When I look at the page, I see:

"HARRO CLASS Men Resist Smelly Apples (MRSA) (a.k.a. Golden Staphylococci) is a specific strain of the Staphylococcus aureus bacterium..."

...but when I go to edit it, it looks normal, i.e.:

"{three apostrophes}Methicillin-resistant Staphylococcus aureus{three apostrophes} ({three apostrophes}MRSA{three apostrophes}) is a specific strain of the {two apostrophes, two brackets}Staphylococcus aureus{two brackets, two apostrophes} {two brackets}bacterium{two brackets}..."

Even if I don't do a thing, when I hit the "preview" it looks normal again.

Such stealth spam is beyond my ability to fix; I shall leave it in your capable hands. —The preceding unsigned comment was added by 69.151.231.166 (talk) 03:23, 7 February 2007 (UTC).

• Strange - I can't get any text like you describe to appear in my browser.... So you only see this when viewing the article, but not when editing it? -- MarcoTolo 03:28, 7 February 2007 (UTC)

That's probably due to spy/adware on your computer, such as Gator, see Category:Spyware_removal. --MyOwnLittlWorld 18:16, 11 March 2007 (UTC)

Home Remedies

Is this really the place to list homeopathic treatment for boils? The last edit contains a large list of treatments/testing tips in the "Treatment" section that might be helpful, but does it belong in an encyclopedia? Wushupork 19:20, 30 April 2007 (UTC)

I just had the same thought as above. Not only is the "Treatment" section poorly written and repetitive, but its also a poor contribution to a good article. As a pharmacy intern in a hospital I can tell you that MRSA is not a bacteria to mess around with and there is no at-home diagnosis kit. If this sort of information needs to be presented somewhere let there be a "Home Remedies for Boils" article. Etherealmuse 00:24, 1 May 2007 (UTC)Etherealmuse 20:20, 30 April 2007 (UTC)

Dates

"Very recently the Dutch food association has discovered strains of the MRSA bacterium on pork meat." I've marked this with a "when?" tag on the grounds that using words like "recently", "currently" etc is a bad idea as they get old fast. It would be much more useful to write "In [month] [year], the Dutch food association..." 86.132.138.205 15:03, 3 October 2007 (UTC)

• I removed your {when} template and replaced it with a "citation needed" for the entire sentence. If a proper reference were provided then we would know when this occurred. On a somewhat related note, I do not like templates of that sort that exposes commentary and instructions meant for editors to the general reader. --Dan East 12:47, 17 October 2007 (UTC)

Poorly worded statement

Can someone more familiar with this topic please clarify the following statement from the article: "Because cystic fibrosis patients are often treated with multiple antibiotics in hospital settings, they are often colonized with MRSA, potentially increasing the rate of life-threatening MRSA pneumonia in this group."

To me this is stating "treating someone with multiple antibiotics often colonizes them with MRSA". Obviously that is not the case literally. Does it mean that treating someone with multiple antibiotics increases their susceptibility to MRSA? This needs to be clarified, but I do not know the intended meaning. --Dan East 12:54, 17 October 2007 (UTC)

• Okay, after reading it a few times I think this makes sense: Cystic fibrosis patients may have to visit hospitals often to receive treatments of multiple antibiotics, and the extra hospital visits simply increase exposure to MRSA. I've reworded the article accordingly. --Dan East 13:25, 17 October 2007 (UTC)

Confused...

The boy who died of staph in Bedford a few days ago (mentioned in the article) has been big news here in Virginia, the news stations are still talking about it, and the school system of that county being shut down.

How can this reaction possibly square with 19,000 deaths a year? If it were that common, people would surely be much more used to it by now -- that's an average of almost 400 annual deaths per state - or 50 people a day, every day. If reactions of this sort happened for each mortality, wouldn't the whole country be shut down? Slide Maintenance 02:31, 22 October 2007 (UTC)

Common occurrences do not make news. If a person is already quite ill and thus hospitalized, it is not newsworthy that he becomes infected with MRSA and dies. This is a known risk of hospitalization. But healthy (even athletic) school children are not expected to die from MRSA. So when it happens, it makes news and parents (i.e. virtually everyone) pay attention and consider removing their children from school. JRSpriggs 17:55, 22 October 2007 (UTC)

Lexington, KY and Woodford County Jail

Possible cases of resistant Staph: http://kentucky.com/181/story/210416.html

Copy of the letter they sent home with students http://www.lafayette.fcps.net/

74.131.225.55 23:01, 23 October 2007 (UTC)

Allicin

Is allicin, as found in garlic, still of interest for MRSA treatment? Horatio 08:54, 27 October 2007 (UTC)

Pronunciation

It might be worth including that in the UK it's pronounced M-R-S-A but in America it's pronounced "Mersa" like a word. Don't know about Canada etc. —Preceding unsigned comment added by 86.131.27.191 (talk) 01:58, 1 November 2007 (UTC)

People call it Mersa here in the state of Washington.209.91.61.223 06:23, 6 November 2007 (UTC)

Panic in Washington state

I've been watching the news recently, and many people are concerned about preventing MRSA. It's not so much the hospital kind, but the community spread MRSA. The news encourages better health standards and safe practices, such as washing hands regularly, using hand sanitizer(as long as children do not swallow it), clean shared equipment, and avoid touching other people's wounds. A school even shut down for a day to wash out the locker room. Today I remember a teacher and a highschool football player being diagnosed with MRSA. This is also currently the talk of the day at schools. People are finally being better about their health when only a danger is present.209.91.61.223 06:23, 6 November 2007 (UTC)

Interesting story on CNN that shows that MRSA actually explodes immune system cells

I found an interesting story about MRSA showing that this strain actually attacks the immune system itself. This would be valuable information for this article, but could someone find the source paper for the actual study? I believe that this information should be incorporated into this article, but something sourced to a medical journal would be a better source than an article written by the Associated Press. Jesse Viviano 03:04, 12 November 2007 (UTC)

Added Colloidal Silver and the FDA

Since "maggot" and "phage" therapies were mentioned, I see no reason why colloidal silver wasn't, especially since independent lab tests indicate that the silver colloidal solutions tested eliminated both MRSA AND VRSA, which is the end of the line for synthetic antibiotics. Rather than include it in the mainstream treatment section, I decided to add a separate paragraph and mention some of the debate/controversy, which is actually quite extensive.

If Vancomycin resistance becomes common and other options start running out, this information could very well save lives, so I trust that it's not gonna be messed with, especially without some serious discussion and certainly not by anyone who's even remotely related to the criminals who foisted billions of dollars of Celebrex/Vioxx on the public before it killed an estimated 60,000 people.

Thank you in advance. BTW, if you've got good nutrition and a strong immune system -- like most Americans don't -- you'll never have to worry about stuff like this.

68.108.29.239 18:42, 12 November 2007 (UTC)

At the least, the marketing speak needs to be purged from the addition. From a Google search, the primary research mentioned in the addition appears (although not confirmed at this stage), to be paid by the marketer of the trade-named produyct listed, no independant research is listed. I'm purging the majority of the added content as it's clearly marketing material. With what remains, I'll add a linkk to the colloidal silver article, but I question if even that much should still be in this article. --- Barek (talk • contribs) - 18:51, 12 November 2007 (UTC)

An entire paragraph of pertinent, well-cited material was eliminated and condensed into two lines directly beneath the "maggot" and "phage" therapies. This edit was solely based on an accusation of "market speak", which it certainly wasn't except for an attempt to quote the exact language of the research results. I notice this line didn't bother anyone:

"On 18 May 2006, a team of researchers from Merck Pharmaceuticals reported in Nature that they had discovered an entirely new type of antibiotic, called platensimycin, and had demonstrated its successful use against MRSA."

So why is Merck's new product mentioned and where's their research? Is it not true that EVERY penny of research for EVERY pharmaceutical is paid for by Big Pharma? Is it also not possible that this somehow represents a dual standard?

And based on nothing but a Google search, it appears (although not confirmed at this stage), that the research cited was paid for by the marketer of the product? Setting aside these extraordinary powers of perception, that would justify removing the name of the product, which I felt uncomfortable about and should have done. What's your justification for removing the rest of the paragraph?

I would like to hear an explanation why this massive unilateral edit isn't a massive violation of Wikipedia's Information suppression policy?

A common way of introducing bias is by one-sided selection of information. Information can be cited that supports one view while some important information that opposes it is omitted or even deleted. Such an article complies with Wikipedia:Verifiability but violates NPOV. A Wikipedia article must comply with all three guidelines (i.e. Verifiability, NPOV, and No original research) to be considered compliant.

Some examples of how editors may unwittingly or deliberately present a subject in an unfair way:

Biased or selective representation of sources, eg:

Explaining why evidence supports one view, but omitting such explanation in support of alternative views.

Making one opinion look superior by omitting strong and citable points against it, comparing it instead with low quality arguments for other POVs (strawman tactics).

Not allowing one view to "speak for itself", or refactoring its "world-view" into the words of its detractors.

Editing as if one given opinion is "right" and therefore other opinions have little substance:

Entirely omitting significant citable information in support of a minority view, with the argument that it is claimed to be not credible.

Ignoring or deleting significant views, research or information from notable sources that would usually be considered credible and verifiable in Wikipedia terms (this could be done on spurious grounds).

Concealing relevant information about sources or sources' credentials that is needed to fairly judge their value.

Thus, verifiability, proper citation and neutral phrasing are necessary but not sufficient to ensure NPOV. It is important that the various views and the subject as a whole are presented in a balanced manner and that each is summarized as if by its proponents to their best ability?

68.108.29.239 20:24, 12 November 2007 (UTC)

Background on colloidal silver belongs in the article on collodial silver. That in itself justifies a large amount of the data removed. A link to that article was added when that background material was purged, allowing for what wiki's do best - links to secondary articles on related but different subjects.

The remaining edits made summarized the remaining relevant content - the paragraph cited specific tables and confusing dosage information, which was not meaningful as a direct quote - those are more meaningful within the study itself. The source links to the study remained completely untouched. While I questioned its suitability above, I did not purge those references. I also removed the reference to the specific marketed product, which you acknowledge questioning yourself.

I do not believe that my summarization of the test results altered the meaning of the findings - if you believe otherwise, please explain what you mean, as it certainly was not intended to alter the meaning of the stated results, only to simplify readability by making the fixes I mentioned above. --- Barek (talk • contribs) - 20:42, 12 November 2007 (UTC)

I didn't want to intrude on the existing treatment paragraph and felt it would be better if I added a section that explained the background and controversy, which as I said, is more extensive than I realized. I thought this in itself justified a separate paragraph, which is probably what led me to add information that you consider more appropriate elsewhere. But I was taking my cue from the amount of detail contained in the CA-MRSA and HA-MRSA explanations in the first paragraph. Can you honestly say that level of detail is justified? Even the maggots have more space than what was left. My argument is, if you're gonna crack down on the name of a product quoted in a study, how can you leave what sounds like a sponsored ad for Merck? I think the overall weight of that paragraph leans heavily toward technical explanations of CA/HA-MRSA that are even less interesting or informative than what I quoted.

I'm not pushing for anything except to make sure a leading source of information doesn't leave anything out that might reduce people's options if the mainstream antibiotics suddenly become useless. During my research, I never found any information about maggot or phage therapies. Not even about any new antibiotics in the pipeline. This hasn't been reported in any MSM either. I did however, find a lot of websites with a whole lotta accusations about the relationship between the FDA and pharmaceutical companies. I felt that if a significant controversy like this was reported fairly and accurately, it would certainly end up with more exposure than beneath therapies which could only be considered fringe. If the amount of space is proportional to the number of websites who claim there's something to this, then that would be a significant discussion -- way more than the nothing I found when I got here.

As in anything, I guess it comes down to who or what Wikipedia represents. You'll have to excuse me if I still get confused and think it's the people. Old habits die hard.

68.108.29.239 21:43, 12 November 2007 (UTC)

You appear to be trying to justify a detailed description here about colloidal silver based upon the information provided about CA-MRSA and HA-MRSA. I find this a confusing argument, as this article's subject is MRSA and CA-MRSA and HA-MRSA are strains of MRSA. If you wish to take up how WP discusses colloidal silver, then it appears to me that it would be more appropriately discussed in the colloidal silver article. Have you checked the link, do you feel its portrayal is fair? If not, that discussion belongs on that article and related talk page.

If this article were to add detail about what is cooloidal silver, then to be fair it would also need to include explanations on what is doxycycline or minocycline, clindamycin, and all the other clines mentioned, not to mention explaining what are maggots and their historical relevance to medicine. Naturally, these are all discussed in their own articles, as should colloidal silver.

The study that you referenced appears most relevant to the treatment section, which is why I moved a summary of the study's results to within the treatment section. While multiple pharmaceutical products remain listed, no single one has as much listed as still remains about colloidal silver. I agree that the reference to Merck Pharmaceuticals could easilly be edited out while maintaining the reference and relevancy to the study listed.

As for the claim "Even the maggots have more space than what was left", just a quick word count shows this claim to be false.

The remaining paragraph on the colloidal silver study appears a fair statement to me about what the study showed. You have not challenged that, is it fair to say that you agree? Beyond that, reference to what is colloidal silver and any potential medicinal uses belongs in its own already existing article, just as is done with the other treatments listed - although I could certainly agree that adding a one-sentence summary of past use (similar to the summary of past maggot use) could be relevant - but certainly not the large two paragraphs of detailed historical information on it that existed previously. --- Barek (talk • contribs) - 22:08, 12 November 2007 (UTC)

Note: I've made the additional modifications that I mentioned above. --- Barek (talk • contribs) - 22:42, 12 November 2007 (UTC)

As have I -- minor rephrasing and the brief background history you offered. 68.108.29.239 23:55, 12 November 2007 (UTC)

I think the short summary of historical use of Silver would be better placed after the mention of the study, that way there's relevant context leading into why it's being mentioned. --- Barek (talk • contribs) - 23:59, 12 November 2007 (UTC)

I see it as just the opposite. Is all that pig correlation material yours? Never heard that anywhere... —Preceding unsigned comment added by 68.108.29.239 (talk) 00:19, 13 November 2007 (UTC)

No, I was actually thinking of trying to cleanup that stuff next, as well as a few other sections in the article - but got sidetracked. --- Barek (talk • contribs) - 00:22, 13 November 2007 (UTC)

I'm with you on that one. Crazy-sounding stuff doesn't serve Wikipedia and people are confused enough with all this bird flu/pig bacteria transmission silliness. 68.108.29.239 00:34, 13 November 2007 (UTC)

I don't have time to look at it now today - so hopefully you or someone else will have time.

Oh, and if you have a chance, as you appear to have an interest in it, please take a look at the colloidal silver article. I think it already covers most if not all of what you had originally added here, just using alternate sources. But you seem to know that material better, so you would be a better judge of if anything is missing. --- Barek (talk • contribs) - 00:46, 13 November 2007 (UTC)

It definitely needs improvement. I'll take a stab at it, but this is something I kinda stumbled on. There are lots of true believers along with some real skeptics and conflicting claims from both sides. What impressed me was the sheer number of websites and vehemence of the believers. When there's that much smoke, there's usually fire, which is why I was pushing so hard to get some credible info on here so everyone could decide for themselves. BTW, I removed all the swine transmission stuff for now. If that turns out to be a conclusive factor, it can be reinstated, but it's too early.—Preceding unsigned comment added by 68.108.29.239 (talk) 01:11, 13 November 2007 (UTC)

controversy y/n?

The anon above had removed reference to silver being controversial, yet from the provided link which the user removed, there is controversy about its use. I restored the mention and the link. --71.227.151.51 16:18, 14 November 2007 (UTC)

I deleted the link and mention. The fact that the brackets that link colloidal silver keep getting removed demonstrates a definite non-NPOV by the user above. There is absolutely nothing controversial about the use of colloidal silver. Not being approved by the FDA and controversial are two entirely different things. Controversial is when the FDA approves Vioxx and it kills 60,000 people. Controversial is when the FDA approves Avandia, discovers that it increases the risk of heart attack by 43% and still allows it to be sold. Colloidal silver has never killed anyone. It has been repeatedly proven that the FDA is not an independent entity that works on behalf of the public. 68.108.29.239 20:09, 15 November 2007 (UTC)

I don't have an opinion yet either way - still considering the views ... but I wanted to comment that the anon who added the controversy link did not remove the link to colloidal silver. He/she moved it to the sentence that mentioned a controversy. That particular accusations of non-NPOV is baseless. --- Barek (talk • contribs) - 20:36, 15 November 2007 (UTC)

OK, I understand. But if a new sentence that mentions colloidal silver replaces one where it was linked, the effect is the same. Everything I've read suggests that colloidal silver is the least toxic substance in this entire article. But everything I've read also leads me to believe that it will be the most attacked. Every sentence in that short paragraph is cited and provable. I hope as an independent observer, you'll use your administrative authority to prevent information that threatens powerful economic interests from being discredited or removed. That's one of the things that makes Wikipedia unique. 68.108.29.239 21:21, 15 November 2007 (UTC)

I'm not an admin here - but when there's disagreement on article content I try to help resolve to a neutral point that all contributors may not be thrilled with, but can at least accept. I was an admin on two other wikis, but I resigned from that position on both of those - if you knew me from those, that status does not carry over. If anything from our prior discussion came across as admin-like, I appologize for giving you that impression. --- Barek (talk • contribs) - 21:28, 15 November 2007 (UTC)

After thinking about it more, I agree with it being controversial, so I re-inserted the text (copied from the anon's earlier version). HOWEVER, I do feel that the wording could be cleaned up or moved elsewhere in the paragraph (maybe to the end of the paragraph). For now, I've re-inserted it to the start until it can be cleaned up.

Note that the link to colloidal silver does still exist, it's in the earlier sentence that was inserted, which fits wikipedia standard of wikifying the first occurance, not every occurance of a wiki-linkable term.

I base this opinion on the multitude of debate that I've found on if it's an accepted treatment. The reference link could likely be more to-the-point, but it does adequately express the opposing view (which isn't spelled out in the article, only mentioned to exist). --- Barek (talk • contribs) - 17:28, 17 November 2007 (UTC)

Continual use of colloidal silver results in irreversible skin damage. I believe user 68.108.29.239 20:09, 15 November 2007 is a merchant of this product. Which IS harmful, and DOES cause harm. read this article Argyria then view the discussion page as much scientifically relevant information on this syndrome caused by colloidal silver is periodically stripped from this page. Any pubmed search will also give you plenty of well researched scientifically proven articles that show the damage this product causes. 131.170.90.4 (talk) 02:01, 15 April 2008 (UTC) [3] this is a link from the Australian Therapeutic Goods Association (Australian version of FDA) with reports of adverse reactions caused by taking colloidal silver. Note the 5 year old boy with abnormal hepatic function. That's liver damage. 131.170.90.2 (talk) 02:40, 15 April 2008 (UTC)

The above IP is correct. We don't want to be sued because some guy decided to use silver and got argyria! DarkestMoonlight (talk) 14:26, 17 April 2008 (UTC)

Gays hit by MRSA infection spread

A DRUG-resistant strain of potentially deadly bacteria is being transmitted among gay men during sex in the US. —Preceding unsigned comment added by 62.195.218.222 (talk) 21:30, 15 January 2008 (UTC)

I just added that to the epidemiology section per this article. I noticed that it was previously written to say that MRSA has become a general STD... when the article only said it was spreading among gay men in 3 cities. Was someone trying to distort the facts to sound pollitically correct? That's kind of sad. I think facts are more important than your fear of appearing homophobic. The study demonstrated that MRSA is spreading among gay men... generalizing it weakens the message for people who really need to be concerned. I am sure my edits will be reverted as they usually are when something is not politically correct (though 100% factually accurate) on here. Thank god for google so people can actually read the truth.Angelatomato (talk) 14:37, 16 January 2008 (UTC)

http://www.reuters.com/article/health-SP-A/idUSN1337175820080115?pageNumber=1&virtualBrandChannel=0 Angelatomato (talk) 14:32, 16 January 2008 (UTC)

I have no intention of being politically correct, but I did slightly reword your version (which was indeed more accurate than mine)to reflect the conclusions of the authors (who noted the limitations of the data at this early stage of research. Their conclusion was " Infection with multidrug-resistant USA300 MRSA is common among men who have sex with men, and multidrug-resistant MRSA infection might be sexually transmitted in this population." Boodlesthecat (talk) 16:41, 16 January 2008 (UTC)

thanks - sorry didnt mean to sound bitchy...lol. i have just noticed a lot of PC editing on here that distorts facts. i appreciate your work!! :) Angelatomato (talk) 00:09, 17 January 2008 (UTC)

Advice for boils?

The Texas Department of State Health has a beautiful (and ugly) set of MRSA pictures. [4] Some of them are truly terrible infections, but some are just one or two ordinary looking boils. Of course, Wikipedia cannot give advice, but it should report on advice -- what course of action has been recommended for people who have one or a few small boils, if they burst and resolve normally, but perhaps repeat every once in a while? Should a person like this think of himself as a Typhoid Mary or is he not much worse than one of the 25% asymptomatic carriers who picks his nose? I'll come back and see what I can do to answer this but just wanted to see how the question is received. Wnt (talk) 15:27, 15 April 2008 (UTC)

Found this about manuka honey-

http://www.accessscience.com/content.aspx?id=SN13350&searchStr=MRSA#searchTerm

DarkestMoonlight (talk) 14:28, 17 April 2008 (UTC)

Paradoxical?

Aren't gram-positive bacteria supposed to be easier to treat than their opposite, gram-negative?

DarkestMoonlight (talk) 14:36, 17 April 2008 (UTC)

Well, for example, anthrax is gram-positive, and ordinary E. coli is gram-negative. People may be prone to make generalizations because the gram negative bacterium uses lipopolysaccharide or has an "extra" membrane, but in truth the difference between safe and troublesome (for example enteropathogenic E. coli) is rather small and much more recent than these ancient structural differences. In the case of MRSA the part that is so troublesome is really just a few specific genes that let it neutralize antibiotics. Wnt (talk) 06:41, 23 April 2008 (UTC)

Gram-positive and -negative refer to staining characteristics of the bacteria using Gram's stain. That is, it's a tool to categorize and diagnose bacterial diseases. There is not a direct correlation between Gram-staining characteristics and virulence in humans. Either Gram-positive or Gram-negative bacteria can be harmless, pathogenic but treatable, or deadly. Gram-positives include Staph and strep (and all their subtypes of varying virulence), not to mention the bacteria responsible for anthrax, botulism, tetanus, and listerosis as well as acne, and many of the bacteria which live harmlessly in your mouth. It's a pretty diverse and broad category. MastCell ^Talk 22:31, 23 April 2008 (UTC)

Okay, clearer now. I'll go back to the gram stain article or wherever I found that and revert it. Lunakeet 18:31, 26 April 2008 (UTC)

Should we archive?

This has thirty-three topics including this one.

Lunakeet 14:12, 16 May 2008 (UTC)

Yes - Unless consensus against, can I suggest we set up a Wikipedia:Archive#Automated archival (my preference is for User:MiszaBot/Archive HowTo#Example 2 - incremental archives) with say archiving after 1 month of thread inactivity ? Below is the coding to use and generation of an Archive box.

{{User:MiszaBot/config
|algo = old(30d)
|archive = Talk:Methicillin-resistant Staphylococcus aureus/Archive %(counter)d
|counter = 1
|maxarchivesize = 250K
}}
{{Archive box|auto=yes}}

David Ruben ^Talk 21:59, 16 May 2008 (UTC)

I agree, that sounds like a good idea.

Lunakeet 17:31, 21 May 2008 (UTC)

Ok, so added to top of this talk page. Now just sit back and wait - I hope :-) David Ruben ^Talk 00:53, 23 May 2008 (UTC)

Polysan commercial

This article seems infested with "Polysan ads"? Here's the first, which immediately felt ad-like: "Polysan (with TEFLEX) is a non-toxic, odourless, alcohol free, polymeric water-soluble disinfectant that is also effective as a surface sanitizer against MRSA. Unlike alcohol it drys on the surface and creates a polymer boundary that continuies to kill for up to seven days.". Here's the second, which convinced me that this isn't just a slip: "Although alcohol-based rubs are somewhat effective, a more effective strategy is to wash hands with an anti-microbial cleanser with persistent killing action, such as Polysan ... ". Stolsvik (talk) 11:17, 10 December 2008 (UTC)

Useless information supposed to drive my imagination (detergents and useless facts needing a new home)

Who put the data dump of uselss statistics into the Prevention section? Can we put the statistics that are not a product of referenced reseach into it's own catagory? It waters down the preventiona and treatment section which should have brevity and accuracy as a goal. At risk populations, in a word - you!

As for detergents, they are used to desolve, surround and disperse lipids-based soils. Sanitizers kill pathogens. Not all sanitizers are not detergents and not all detergents contain sanitizers. Alcohol is a sanitizer but not a detergent, Peroxide is a sanitizer but not a detergent. Many soaps kills germs but are not hospital grade sanitizers. MRSA requires a sanitizer or disinfectant product with an EPA registration number that documents that it has been tested for a 5-log kill in five minutes vs. MRSA. —Preceding unsigned comment added by Faust921 (talk • contribs) 21:43, 23 May 2008 (UTC)

Section on progression of infection in humans

Could someone write up a section describing the life cycle of MRSA in people? It is really confusing, because it sounds like a regular staph infection, but this page mentions that people can 'carry it' (for how long without symptoms??) in their nostrils? 15% of health workers 'carry it' what does this mean? Will they suddenly fall ill if their immune system becomes compromised for any reason? Is there such a thing as a body wide, blood borne MRSA infection or does it stay in specific wounds?

All this is really ambiguous from the way this page is written, and from the fact that it killed more people than aids last year in the US it seems pretty important. 208.94.78.1 (talk) 03:33, 29 March 2009 (UTC)

Ceftobiprole against MRSA?

"New antibiotic beats superbugs at their own game" [5] Brian Pearson (talk) 03:00, 5 July 2008 (UTC)

Cannabinoids against MRSA

Findings referenced under Cannabaceae, where it is listed under 2^ Appendino, Giovanni; Simon Gibbons, Anna Giana, Alberto Pagani, Gianpaolo Grassi, Michael Stavri, Eileen Smith and M. Mukhlesur Rahman (06 August 2008). "Antibacterial Cannabinoids from Cannabis sativa: A Structure−Activity Study" (PDF). Journal of Natural Products 71 (8): 1427–1430. doi:10.1021/np8002673. PMID 18681481 69.158.93.168 (talk) 00:17, 14 July 2009 (UTC)

A Question of Style: Multidrug vs. Multiple?

The first paragraph of the article abstract contains the auto-definition I'd expect, "Methicillin-resistant Staphylococcus aureus…" (and is followed by "It may also be referred to as multiple-resistant Staphylococcus aureus or…") while the first paragraph of Section 1 begins with "MRSA/Multidrug Resistant Staphylococcus aureus was discovered…"

From a stylistic standpoint, this seems inconsistent. The problem could be remedied by changing the second sentence of the abstract from "multiple-resistant" to "multidrug-resistant" but I wanted to toss it out for discussion. The latter form is the one I've most often seen but there may be good reasons to use the "multiple-resistant" term.

Uncle Bubba (talk) 13:34, 16 November 2008 (UTC)

Well, several months have passed without anyone objecting to my suggestion (above), so I'm gonna change the article. Based on the number of occurrences of "multiple-" (zero) vs. "multidrug-" (three) in the References section, "multidrug-" wins.

Uncle Bubba (talk) 18:23, 6 March 2009 (UTC)

References section broken?

Viewing w/ IE7, in a school environment. References section is non-existant, footnotes link nowhere. Crad0010 (talk) 15:05, 26 February 2009 (UTC)

Commas matter

"However, in a 2010 report about MRSA, many cases were children who required hospitalization." . Unfree (talk) 20:04, 8 September 2009 (UTC)

Salendinescopy

Should a Salendinescop procedure be preformed on an individual that has contracted MRSA? —Preceding unsigned comment added by 99.175.80.247 (talk) 02:38, 8 January 2010 (UTC)

ITS WHAT LADY GAGA HAVE

Does anti-bacterial soap contribute to the problem?

Karl gregory jones (talk) 14:28, 27 January 2010 (UTC)

Article does not explain what MRSA actually is

I came to wikipedia looking for information on what MRSA actually is - as in what are the symptoms and what it does to the body. Perhaps this is considered by some to be "common knowledge", but aside from learning that it kills a lot of people, I didn't find out what the effect of having MRSA actually does to a person (besides kill them in some unspecified manner).

Perhaps a new section is needed and/or an update to the article's summary at the top. —Preceding unsigned comment added by 69.50.194.179 (talk) 17:46, 2 April 2010 (UTC)

Yes, actually it does, if you read past the first paragraph. Please see Section 2, Clinical Presentation and Concerns as well as Section 3, Treatment for more information. Uncle Bubba (talk) 20:07, 8 April 2010 (UTC)

Comment about pronunciation

In Ireland and the UK it is always said as M.R.S.A. However in the US people appear to say mersa as a word. Worth noting ? Gnevin (talk) 22:26, 28 April 2010 (UTC)

I don't think so--it would probably be tantamount to opening a large can of worms. Besides, Wikipedia isn't a dictionary. UncleBubba (Talk) 01:29, 29 April 2010 (UTC)

I don't see how, I would think it would be worth noting as a side note Absolutejoker (talk) 13:41, 17 June 2010 (UTC)

Allicin

I read in the article about Allicin on wikipedia that it is currently being tested out as a possible way of fighting MRSA in the future showing what seemed to be promising results. Do you think this is something to be added to the "pre-clincal research" section?

/Per —Preceding unsigned comment added by Beldrun (talk • contribs) 20:42, 17 May 2010 (UTC)

Can the immune system of a healthy person develop proper immunity?

Many of the news stories describe staph as causing boils. Question: what is the favored advice for people who have had boils in the past, but haven't had symptoms since. Should they assume they are still infectious? Or can a healthy person defeat the bacteria once and for all? And what are the odds that someone who has had boils was actually infected with staph and not a different bacterium? The thing that is most disturbing is that some references give the idea that MRSA boils all have some standard appearance, while others suggest they could look like all kinds of bizarre things. (Potential refs [6][7][8]) FWIW my particular curiosity concerns the appearance marked simply as "boil" in the third reference, at left and seventh from the bottom. Wnt (talk) 03:48, 19 May 2010 (UTC)

MRSA

June 2, 2010

Is it possible for MRSA to be contained in one's urine and that person not be contagious to those around her? Is it ok for her to be out around other folks with this? She does not have any open wounds. Thanks for your help.

P Maxie —Preceding unsigned comment added by 74.163.16.45 (talk) 09:58, 2 June 2010 (UTC)

garbled sentence

The following sentence appears to be self-contradictory. The writer should check it and fix it if required:

"It is known that Staphylococcus aureus can survive intracellularly,[25] and these 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." WilliamSommerwerck (talk) 14:53, 10 September 2010 (UTC) Yes it is i have it i would like to know the same thou —Preceding unsigned comment added by 174.130.228.248 (talk) 02:31, 20 September 2010 (UTC)

What is notable research

I had added "An anti-microbial XF-73 has completed a phase I clinical trial." to Research but it was removed as 'not notable' despite the clinical trial results being reported in the UK national press and the MRSA article already including far less notable (in the context of MRSA) preclinical work and conjectures. Is XF-73 not relevant enough to MRSA, or should we remove the pre-clinical stuff ? Rod57 (talk) 08:27, 28 September 2010 (UTC)

correcting the Golden part

Golden Staph means (any) Staph Aureus, not MRStaphAureus. Note: Other languages call it that too (e.g. "stafilococ auriu" in Romanian). Literally golden grape-cluster-like cocus. —Preceding unsigned comment added by 76.10.152.87 (talk) 00:52, 26 November 2010 (UTC)

Misstating and mis-emphasizing study results

It is improper and non-neutral to misstate study results (or to emphasize one finding of a study over others). Text was added that used a mention in some studies of the efficacy of hydrogen peroxide (by itself and as a component of honey) against MRSA to conclude that hydrogen peroxide is a be-all, end-all solution to the bug (or something like that; I can't tell for sure).

Regardless, this seems like part of a marketing plan. ("Hey, buy this!" "Wikipedia says it works!") Wikipedia is not for promotion or free advertising, so I made the text as NPOV as I could. If consensus here is to delete it, great. I'll do so myself if nobody objects but I'll give it a few days. — UncleBubba ^{( T @ C )} 00:57, 9 April 2011 (UTC)

Thanks for your effort on this. Definitely agree that there were some POV issues with the previous edit. I moved a couple pieces to the "surface sanitizing" section, since it seemed more appropriate than "treatment." mcs (talk) 01:54, 9 April 2011 (UTC)

Saw the changes you made to my additions on MRSA. Just wanted to clarify that I was not writing an 'ad' for hydrogen peroxide - you have misinterpreted my intentions. I'm a doctor, and have recently been working with a patient with an ongoing MRSA infection that wasn't responding to antibiotic treatment - the additions I made were based on research I had done to help treat this patient. These were written in good faith in an effort to improve the content of wikipedia. I have no ties to any companies of any sort. I'm ok with the changes you made, but would like to provide more detail - I'd like to include the substances mentioned in citation 72, as well as the active compounds mentioned in citation 74. Is that OK with you? Kpaddock (talk) 19:45, 9 April 2011 (UTC)

Altering Wording/Suggesting Removal

Scientists estimate that around 2 billion people, some 25-30 percent of the world's population, have a form of the Staphylococcus aureus bacteria. [5] [6]

this is the second sentence under the epidemiology section

Link 6 is dead, I tried it multiple time, SO ODNT'T CLICK ON THEM!! is estimated that 25% to 30% of people have the staph bacteria either on their skin or in their nose" it does not state that these staph bacteria are staphylococcus aureus. I am changing "Staphylococcus aureus bacteria" to "staph bacteria" and leaving it in as a courtesy to whomever wrote it, but I am recommending that this sentence be removed from the article as it will now be talking about staphylococcus in general and as such is not pertinent to this article which is focusing on the more specific Staphylococcus Aureus. —Preceding unsigned comment added by 139.67.205.176 (talk • contribs) 22:09, 5 September 2006

Worldwide, an estimated 2 billion people carry some form of S. aureus; of these, up to 53 million (2.7% of carriers) are thought to carry MRSA.[55] - The source doesn't specify this information at all. —Preceding unsigned comment added by 124.149.122.147 (talk) 03:56, 11 April 2011 (UTC)

I agree, this reference isn't credible, someone more experienced than me should remove/fix this part, please! —Preceding unsigned comment added by 134.174.140.208 (talk) 16:28, 5 May 2011 (UTC)

MRSA changes

Hey, Everyone: I messed up. I wasn't paying close attention and had this fairly long conversation regarding article changes on my personal Talk page. That was an error and I apologize to you for it. The entire contents of the MRSA section on my page is inserted below, warts and all. Please feel free to read, comment, edit, whack me with a herring, etc. Once again, sorry about that! — UncleBubba ^{( T @ C )} 20:51, 10 April 2011 (UTC)

Hi - Saw the changes you made to my additions on MRSA. Just wanted to clarify that I was not writing an 'ad' for hydrogen peroxide. I'm a doctor, and have recently been working with a patient with an ongoing MRSA infection that wasn't responding to antibiotic treatment - the additions I made were based on research I had done to help treat this patient. These were written in good faith in an effort to improve the content of wikipedia. I'm ok with the changes you made, but would like to provide more detail - I'd like to include the substances mentioned in citation 72, as well as the active compounds mentioned in citation 74. Is that OK with you? Kpaddock (talk) 19:46, 9 April 2011 (UTC)

Moved to MRSA section - didn't see you had written there. Kpaddock (talk) 19:46, 9 April 2011 (UTC)

Hi! I watch a bunch of pages to try to help keep entropy to a manageable level. What I saw looked like promo language I'd seen before.

For examples (forgive me for paraphrasing; supper is in the oven and I don't want to look up the article texts right now):

• One study tested ~18 agents against several hundred MRSA cultures. IIRC, the authors were hoping one of them (I forget which) would be a useful substitute (or adjunct) to vancomycin for IV administration and netilmicin and hydrogen peroxide appeared efficacious for topical application, yet only hydrogen peroxide was mentioned in the addition to Wikipedia.

• Another PubMed article described tests of honey for it antimicrobial activity (esp., IIRC, against b-lactamase producing S. aureus and E. coli, plus a couple more bugs). As I read it, there were three substances found in the honey which, if neutralized, rendered the honey much less effective at killing the target bacteria. Only one of these substances, hydrogen peroxide, was mentioned in the Wikipedia addition.

• Another report described tests of two types of honey against S. aureus, E. coli and P. aeruginosa (I don't remember if they were resistant or not). The more effective honey was one with a higher concentration of hydrogen peroxide which, IIRC, the authors said "merits further study" (or something to that effect).

• Two cited studies discussed the action and effectiveness of H peroxide vapor in disinfecting medical treatment rooms. IIRC, the vapor was effective but took longer than traditional methods. Only high-traffic areas were mentioned, too. (Was this because of low residual bactericidal action? I can't say from the study I read.) IIRC, the Wikipedia additions talked only about the effectiveness of the peroxide, saying little to nothing about the caveats mentioned in the PubMed papers.

Also (but it may not matter), I think one of the cited studies was over 20 years old.

Regarding re-adding the material, we (I believe I can safely speak for the Wikipedia community on this subject) welcome the addition of neutrally worded, well-sourced, factually balanced and notable material to the encyclopedia. I'm just an editor; I don't own the article. If your additions meet the standards of WP:N, WP:V, WP:NPOV, WP:PROMO, etc., I'd love to see them back there.

I hope I've answered your question. I've been told I tend to ramble a bit--if I've not done a good job of explaining my actions, please let me know so I can fix it. Thanks! — UncleBubba ^{( T @ C )} 00:02, 10 April 2011 (UTC)

Thanks for your complete response. It's important to guard against product-based changes, as they don't contribute much if anything. Also, the hydrogen peroxide people can be a bit nuts, what with the claims that you can increase your blood's oxygen by drinking H2O2, etc etc.

I admit that my addition was shaped by the fact that I was focusing on using hydrogen peroxide as a topical anti-septic and debriding agent (as that's what I was interested in when I did the research), so I'll broaden my language to include all of the results published. I emphasized H2O2 as re the honey article because I didn't want to encourage people to go out and smear themselves with store-bought honey, thinking they'd cure themselves of MRSA - better they at least use a USP-recognized antiseptic, right? Also, I'll make sure to mention that the one study is older - resistance is obviously a major issue with this bug, and MRSA strains may be resistant to some of these compounds now, but god help us if bacteria become resistant to H2O2, because then our neutrophils won't work... Anyway, it's Saturday evening, I'm headed out, so I'll put my alterations here tomorrow - they'll be minor.

Also, the information about H2O2 vapor was moved and altered, and I'm satisfied with how it looks and reads.

Thanks! Kpaddock (talk) 02:14, 10 April 2011 (UTC)

Sounds good to me. I'll take a look at it later (it's on my Watch List). If I can help you with anything, please holler! (And, if you think the Hydrogen Peroxide people are nutty, you oughta' visit the Oxyhydrogen folks...)

What concentration of H2O2 were you using for debriding? If over 20-30%, were you able to get around its oxidant/irritant properties? — UncleBubba ^{( T @ C )} 02:34, 10 April 2011 (UTC)

Here are my proposed changes --

A 1990 study tested MRSA isolates obtained from veterans and found they could be killed by several substances, including bacitracin, nitrofurantoin, hydrogen peroxide, novobiocin, netilmicin and vancomycin. The study went on to conclude that netilmicin might be useful as an alternative to intravenous vancomycin, and suggested that topical applications of hydrogen peroxide may be useful to reduce MRSA on skin and some mucous membranes.

A 2010 study noted significant antimicrobial action of Ulmo 90 and manuka UMF 25+ honey against several microorganisms, including MRSA. The investigators noted the superior antimicrobial action of Ulmo 90 honey, and suggested it be investigated further. A separate 2010 study examined the use of medical-grade honey against several antibiotic-resistant strains of bacteria, including MRSA. The study concluded that the antimicrobial action of the honey studied was due to the activity of hydrogen peroxide, methylglyoxal, and a novel compound named bee defensin-1.

Hope that looks good. As re your question, I was just using store-bought low-strength H2O2 - it was part of a plan to keep the area as clean as possible, as it's effective at cleaning out pus and gunk. I was having her clean it, debride it, re-dress it regularly, and use basic antibiotic cream to keep OTHER bugs out. Anyway I did the research to see if H2O2 had any effect against the bug itself, or if it was just helping by keeping dead tissue out of the infected area. High-strength H2O2 just doesn't seem safe in unskilled hands. Kpaddock (talk) 16:53, 10 April 2011 (UTC)

Those additions sound great to me! (I assume the PubMed refs go with 'em.) Thanks for the answer. I was really wondering if you'd learned some way to keep high-concentration H2O2 from messing with everything in sight. (Heck, at 70% or more, it can be used as a component in hypergolic rocket fuel, IIRC. Not exactly user-friendly stuff.)

I did get a really good chuckle from the mental image of patients being dipped in honey. People McNuggets? That made my day. Thanks! Holler if I can help. — UncleBubba ^{( T @ C )} 18:17, 10 April 2011 (UTC)

Changes done and done. Glad that cooperation ruled the day! Kpaddock (talk) 18:51, 10 April 2011 (UTC)

Hey, Doc! Looks good! Going back through my notes here, it occurred to me that I should have started this conversation on the article's Talk page, not my personal one. That was my mistake (and has nothing to do with you) but I would like to move this text to the article Talk page so other editors can see and comment or whatever. I'll do so unless you have an objection. Lemme know, please; thanks! — UncleBubba ^{( T @ C )} 19:39, 10 April 2011 (UTC)

That's fine with me - I thought you preferred to discuss it here, but it probably belongs in the MRSA discussion section. I don't edit a lot, so I sometimes forget protocol, forget to sign in, etc.. BTW, here's a cartoon that's germane to the topic: http://funcorner.eu/misc/ill-have-some-h2o-too/ Kpaddock (talk) 20:35, 10 April 2011 (UTC)

Store-bought meat

I've un-done quite a bit of the recent addition about the putative dangers of store-bought meat contaminated with S. aureus. The main thrust of the cited work involved overuse of antibiotics in farming. From the text: "'Now we need to determine what this means in terms of risk to the consumer,' said Dr. Keim, a co-author of the paper."

If he doesn't say how dangerous it is to the consumer, we shouldn't be embellishing quotes to say something we wish he had said. Besides, this is an article on resistant Staph, not animal husbandry practices. Sorry... — UncleBubba ^{( T @ C )} 00:24, 17 April 2011 (UTC)

Nosocomial infections in the US

The paragraph I edited is a little misleading because it refers to all nosocomial infections in the US, not specifically MRSA. Many of those infections are caused by non-MRSA bacteria. To bring it back to MRSA, I added a sentence about MRSA prevalence among US nosocomial infections reported to the CDC (Hidron 2008, ref 56). Also I clarified the first sentence of the paragraph and added a reference - the particular numbers used in the article refer to estimates for US nosocomial infections in 2002 alone. AnnaJune (talk) 16:05, 17 April 2011 (UTC)

New strain of MRSA discovered in Ireland

New Strain of MRSA dicovered http://www.irishtimes.com/newspaper/frontpage/2011/0603/1224298323851.html somebody please put it in, I dont know anything about this — Preceding unsigned comment added by Feljin J (talk • contribs) 11:55, 3 June 2011 (UTC)

Removal of unsupported assertions

I removed the following unsourced, unsupported treatment advice from the Treatment section:

A five minute warm water soak before applying topical medicine softens the skin and increases the ability of the medicine to penetrate into the skin. This has great potential for increasing the effectiveness of topical medicines.

The Treatment section will likely be used as treatment advice by some number of persons; we must carefully vet what appears here. — UncleBubba ^{( T @ C )} 17:40, 6 September 2011 (UTC)

Social Implications?

The following text reads more like an op-ed column than an encyclopedic entry. Making matters worse, the author makes several sweeping assertions and draws a few conclusions, all without citing any reliable sources..

== Social Implications and Summary ==

Although the rate of MRSA-related deaths is higher than that of AIDS (see above), it is unclear why many government health agencies appear to assign a low priority to this disease. Although the general public may be aware of drug-resistant staph in hospitals, few are aware that it has entered the community (i.e. CA-MRSA). De-colonization of a household can be very expensive (especially without health insurance), require a vigilant attitude, and be physically and mentally exhausting. Many have not tried de-colonization, or been unsuccessful. Therefore, it appears that a fatalistic attitude of "building up your immunity" has developed as the only solution to the problem. However, this approach does not express concern for the many individuals with compromised immune systems that will die or become maimed because of inattention.

Thoughts, anyone? — UncleBubba ^{( T @ C )} 07:15, 19 November 2011 (UTC)

Yeah, I know. I put it in there to see what it would do. I'll try to support the above and see what I come up with. — Preceding unsigned comment added by 99.50.123.70 (talk) 01:27, 20 November 2011 (UTC)

Potential sources of MRSA in human food chain

MRSA also appears in "treated" sewage sludge and secondary treated waste water . Sewage Sludge (aka biosolids) are spread on farm land pasture where animals graze . Policy/regulations state animals are to stay off land for 30 days, but there is little to no enforcement of regulation. — Preceding unsigned comment added by 151.151.109.11 (talk) 18:24, 27 November 2011 (UTC)

Sure, you can state that it's present or whatever. You cannot, however, say that it isn't enforced without some kind of reliable, NPOV source to back it up. I would think. Sebastian Garth (talk) 21:53, 27 November 2011 (UTC)

Of the refs listed above, one is a WP article (not a reliable source), one leads to a South Carolina (USA) page (iffy), and one to a PDF of a Master's degree thesis discussing farm workers' occupational exposure to MRSA and VRE (published? peer-reviewed?). All in all, the sources sound a bit weak to me (but I'd love to hear other opinions). — UncleBubba ^{( T @ C )} 03:45, 28 November 2011 (UTC)

Countries that have successfully controlled MRSA

As evident on the published map, the Netherlands, Iceland, Norway and Sweden have maintained remarkably low rates of MRSA prevalence despite high rates in neighboring countries. The Netherlands, in particular, adopted a very aggressive isolation policy nationwide in the 1980s. This "search and destroy" policy involves testing anyone at risk for MRSA colonization (i.e. foreigners, those with prior MRSA infections, etc) and decolonizing those who are positive, isolating all those with MRSA infections and making sure nursing homes follow the policy as well . Hospitals in the United States have started adopting some of these measures, but it is likely a case of "closing the door after the horse is out of the barn." Some limited success in reducing hospital MRSA infection rates has been reported.

MRSA policy in the Netherlands Bugdoc3 (talk) 18:15, 4 February 2012 (UTC)

Miscellaneous notes

In the treatment section, Vancomycin has always been the drug of choice for treating MRSA infections. It is only during the last 10 years that viable alternatives have been developed. With increasing resistance to vancomycin, us doctors are finding daptomycin, linezolid and ceftaroline are preferable in many situations (personal observations- this is an evolving topic with limited clinical studies). Also, vancomycin can be administered through any intravenous catheter, such as a heparin lock. PICC lines and central lines are only needed for long-term administration of the antibiotic and patients who run out of veins. Bugdoc3 (talk) 18:53, 4 February 2012 (UTC)

MSSA?

In the mBio article that explains how MRSA in humans has arisen as a consequence of prophylactic use of antibiotics in intensive animal farming, specifically of pigs (see mBio at 'Staphylococcus aureus CC398: Host Adaptation and Emergence of Methicillin Resistance in Livestock' [sumarised in New Scientist at 'Farmyard antibiotics linked to superbugs' ]. The mBio article explains the path whereby MSSA in humans transfers to livestock where, after mutation under minimally controlled use of methicillin, it returns to humans as MRSA.

So here is my question: what is MSSA? Why doesn't Wikipedia have an article about it? Even a para in this article might do? — Preceding unsigned comment added by 88.97.11.54 (talk) 13:30, 23 February 2012 (UTC)

MSSA is methicillin-sensitive Staphylococcus aureus, or S. aureus that can still be killed (or controlled, at least) by methicillin. WP probably doesn't have an article about it for the same reason it doesn't have an article about many topics: no one has written it yet. §everal⇒|Times 16:39, 23 February 2012 (UTC)

Well, technically Staphylococcus aureus covers everything that would be included in an MSSA article. Someone may want to add the term to this article (MRSA) since it is obviously always used within the context of methicillin resistance/susceptibility. --AlphaEta 19:47, 23 February 2012 (UTC)

Done. §everal⇒|Times 23:47, 23 February 2012 (UTC)

Nomenclature section needed

As it stands, much of the article is a seemingly indecipherable maze of acronyms, numbers and Roman numerals. Either add in a section explaining what all these terms mean, or change every name to "MRSA or "MSSA", because right now half the article is quite literally written in code. — Preceding unsigned comment added by 86.183.150.203 (talk) 18:51, 15 March 2012 (UTC)

• Can you provide some more details about some sections you're having difficulty understanding? Which terms are hard to understand? §everal⇒|Times 20:31, 15 March 2012 (UTC)

Unsupported Medical Claims

Under Risk Factors, the populations at risk are so broad they appear to cover a very large part of the planet's population (and the quinolone reference is incomplete and misleading). If these assertions cannot be reliably sourced, they need to be removed.

Thoughts, anyone? — UncleBubba ^{( T @ C )} 05:20, 9 May 2012 (UTC)

Drugs in clinical trials

Someone should go through this list. At least one of them, Telavancin, seems to have been approved. Kendall-K1 (talk) 02:31, 6 December 2013 (UTC)

Essential Oils treating MRSA

I tried to look into the subject and found that the subsection had been deleted with a reference to a study that shows teatree oil as ineffective. But whats with the other options mentioned in the original text? Has lemongrass oil also been proven ineffective? Are there studies for it?

I just found this http://www.sciencedirect.com/science/article/pii/S0048357510000829 but Im not yet experienced in researching studies.

I worked at a hospital that had good experiences with lemongrass-oil diffusion treating MRSA.

Anyway, I dont think the matter should be deleted completely. I am refering to the Revision as of 19:40, 13 November 2011. — Preceding unsigned comment added by 77.184.33.11 (talk)

It seems that some in vitro studies showed effectiveness of tea tree oil against MRSA. — Preceding unsigned comment added by 5.87.4.122 (talk) 05:37, 28 December 2013 (UTC)

University of Notre Dame

It's been a while since I dropped in to Wikipedia yet I noticed a section on "University of Notre Dame" was reverted under "good faith" with no explanation that I was able to find. Would the editor who reverted that describe what was wrong with the "University of Notre Dame" text, please? I'm merely curious -- lack of suitable references and citations, perhaps? Thank you. BiologistBabe (talk) 17:34, 12 March 2014 (UTC)

It's a copyright violation, having been copied verbatim from the given source. Kendall-K1 (talk) 03:50, 18 March 2014 (UTC)

alternative treatments of MRSA

Has anyone looked into the efficacy of colloidal silver, nature's antibiotic? It was the main antibiotic a little over 100 years ago, and has been used for centuries to keep liquids and foods from spoiling. At last count, the number of pathogens (viruses, molds/fungi, bacteria) susceptible to silver is over 350. All have been shown to die in, at most, six hours.

97.116.73.235 (talk) 06:47, 29 April 2014 (UTC)

• I'm not going to get involved in this particular discussion but I do want to note that antibiotics are, in fact, "nature's antibiotic." Antibiotics have likely been used by microbes against other microbes for long before humans even existed. JHCaufield - talk - 14:34, 29 April 2014 (UTC)

This article does a great job on covering multiple important topics regarding Methicillin-resistant Staphylococcus aureus (MRSA), but I would like to identify a few suggestions that could help provide additional information.

Possible Suggestions: 1.) I believe that with the additional information regarding some new research of Methicillin-resistant Staphylococcus aureus (MRSA), would provide readers with updated strategies of how we as a population are trying to treat the problematic infection. For example, discussion on the research of phytochemical therapy and it’s use/importance of found flavanoids could be insightful. (Citation): Alcaráz L, Blanco S, Puig O, Thomás F, Ferretti F. Antibacterial activity of flavonoids against methicillin- resistant Staphylococcus aureus strains. National Center for Biotechnology Information [Internet]. 2000 Jul 21 [cited 2014 Sep 30]. Available from: http://www.ncbi.nlm.nih.gov/ pubmed/10873434

Day AW. Activity of Plant Extracts used in Northern Nigerian Traditional Medicine Against methicillin- Resistant Staphylococcus Aureus (MRSA). Nigerian Journal of Pharmaceutical Sciences. 2008 Mar 1 [cited 2014 Sep 30];7(1): 1-8.

2.) I also think that additional information for other natural remedies of oils should be made. For example: Critricidal, tea tree and geranium oil. After testing with agar plates, researchers were able to conclude that a certain combination of both Critricidal and geranium oil displayed favorable effects against MRSA, serving as a possible alternate natural treatment. (Citation): Edwards-Jones V, Buck R, Shawcross S, Dawson M, Dunn K. The effect of essential oils on methicillin-resistant Staphylococcus aureus using a dressing model. National Center for Biotechnology Information [Internet]. 2004 Dec 30 [cited 2014 Oct 1]. Available from: http:www.ncbi.nlm.nih.gov/pubmed/15555788

3.) A last possible suggestion would be to give more information regarding the subcategory “Restricting antibiotic use”. With the provided antibiotic classes and light touch on the possible associated risk increase of colonization of MRSA, I think further information on the dangers of this possibility could be beneficial to the reader. Perhaps research and provide supplementary information of the possible outcome of misuse or overuse of these classes of antibiotics.

Kimble.82 (talk) 05:28, 14 October 2014 (UTC) Nataya Kimble

Assessment comment

The comment(s) below were originally left at Talk:Methicillin-resistant Staphylococcus aureus/Comments, and are posted here for posterity. Following several discussions in past years, these subpages are now deprecated. The comments may be irrelevant or outdated; if so, please feel free to remove this section.

Comment(s)

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This section is very poorly written and only the 3rd and 4th paragraphs have any citing. Paragraph one should not say biocides "help spead bacteria" they dont help to spread, they exert selective pressure in favour of those most resistant and in doing so increases the resistance of subsiquent generations of the bacterial population. Must also disambiguate between between disinfectant/antiseptic resistance, and antibiotic resistance as these concepts are easily confused by the public. Also incorrect to call MRSA hospital bacteria in paragraph 2 as it is not limited to hospitals, nor are disinfectants. Also should not claim that "bacteria that survive attacks by biocides are becoming ultra resistant superbugs" again disinfectant resistance and antibiotic resistance are 2 different things, when they occur in conjunction (ie. antibiotic resistant strains, which are pathogenic and showing decreased susceptability to disinfectant treatment) you might get away with the term "ultra resistant superbugs" but no mention of antibiotic resistance is mentioned in this section. Paragraph 3 is okay as is 4. 5 is terrible, "increased bacterial count IN hands" should say "on" as this is external surface. What study found "dry nurses' hands were twice as likely to be colonized by bacteria"? compared to what other group? nurses without dry hands? general public? "twice as likely to be colonized by bacteria" doesnt make any sense whatsoever as EVERYBODY's hands are colonized by bacteria especially strains of staph aureus, do they mean there are twice as many colonies? or that they are twice as likely to have MRSA or other antibiotic resistant bacterial colonies? The next sentence suggests that antibiotic resistant bacteria have a better chance of surviving antiseptic techniqes like handwashing over bacteria without antibiotic resistance. Again antiseptic/disinfectant vs antibiotic resistance needs disambiguation. Also citations are neccesary. I suggest this section be deleted and rewritten using more specific and precise wording, including sources for all claims, and being clear about the different types of resistance being discussed and the importance the combination of these two phenomena have on the evolution of very hardy antibiotic resistant pathogens. "Problems with disinfectants, antiseptics and hand-wash Biocides are the bacteria-killing chemicals in disinfectants and antiseptics. They are universally used in hospitals to clean surfaces, sterilize medical instruments and equipment, and decontaminate skin before surgery. The use of these biocides are said to inadvertently help spread bacteria that are resistant to their effects.[citation needed] Hospital bacteria such as MRSA are becoming resistant to most disinfectants and antiseptics used in hospitals. Bacteria which survive attacks by biocides are becoming ultra resistant superbugs.[citation needed] Although aseptic technique is critical to obtain reliable results, it is infrequently taught and audited. Skin cleaning is often incomplete, and many attendants still palpate the venipuncture site with non-sterile gloves before needle insertion. 58% of healthcare workers are said to be colonized with MRSA. (Aseptic technique is often incomplete. BMJ, 2008)[3] It's “All In How You Wipe”, says a study examining antibacterial products. In a study that focused solely on wipes, researchers concluded that instead of preventing hospital-acquired infections, the wipes could actually be spreading bacteria due to improper use by hospital staff. (Telegraph UK April, 2008 & BBC News 2008)[citation needed] Hand washing has now been linked to dermatitis, increased bacterial count in hands and colonization of antibiotic resistance developing in the hands of healthcare workers. Study found that dry nurses' hands were twice as likely to be colonized by bacteria. Some bacteria with a genetic pre-disposition to resistance to antibiotic properties will survive. When these resistant bacteria divide, they pass their resistance on, creating entire colonies of antibiotic-resistant bacteria colonized in the healthcare worker’s hands (Health column: Washing hands carries little-publicized risks).[citation needed]"

Last edited at 01:18, 29 April 2009 (UTC). Substituted at 15:22, 1 May 2016 (UTC)

First appearance of CA-MRSA

The article gives 2 different dates for the first appearance of CA-MRSA--1981 and the mid-1990s.

If there is a distinction between what these times signify (ten plus years apart), this ought to be made plain to the reader. — Preceding unsigned comment added by 104.174.0.229 (talk) 22:39, 3 December 2014 (UTC)

Is the BBC a reliable source?

"Here is a report from the BBC about how a medieval medicine has been found to kill MRSA".. The same report, from the BBC website was removed from The MRSA page, as "not a reliable source". I disagree; the BBC is a reliable news source. I would like to ask other editors of they think the BBC is a reliable enough source for it reports to be used on this page. Its too soon to say if this experiment will yield an effective treatment, but it is a notable event in MRSA research. Please note that the reliable sources guideline says that "news organizations". are 'reliable sources. Thank you. 50.159.6.134 (talk) 23:10, 5 April 2015 (UTC)

someone reverted you before i did. i was going to revert because the content is already in the article Jytdog (talk) 23:59, 5 April 2015 (UTC)

Okay. That's a good reason. Please excuse my oversight. 50.159.6.134 (talk) 18:36, 6 April 2015 (UTC)

According to WP:MEDPOP "The popular press is generally not a reliable source for scientific and medical information in articles." Ruslik_Zero 20:18, 6 April 2015 (UTC)

NorA Efflux Pump and Staphylococcus aureus

The page NorA Efflux Pump and Staphylococcus aureus has been written, but is really too narrow a topic to stand alone. It may contain content suitable for this page. Graeme Bartlett (talk) 09:14, 25 June 2015 (UTC)

User:Graeme Bartlett this is copied and pasted form [9] Doc James (talk · contribs · email) 12:13, 25 June 2015 (UTC)

I will delete it then, I have also deleted another article coped from the same journal earlier today. I had better check who is doing this. Graeme Bartlett (talk) 12:15, 25 June 2015 (UTC)

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Use of Spelling: 'Methicillin'

Use of Spelling: 'Methicillin'

One could argue that the appropriate spelling ought to be Meticillin, chiefly to be co-ordinated with the Wiki Article of said drug, titled 'Meticillin'. Also, the spelling Meticillin is the International nonproprietary name spelling, rather than the US and Australia's national spellings. Asigkem (talk) 19:14, 28 April 2016 (UTC)

It's a bit confusing now as the spelling of the antibiotic in this page name differs from that used in the article introduction. JHCaufield - talk - 18:03, 2 May 2016 (UTC)

i reverted the change throughout the article. is this name change being picked up? we have to balance WP:COMMONNAME Jytdog (talk) 22:55, 2 May 2016 (UTC)

[10]a PubMed search...--Ozzie10aaaa (talk) 09:25, 3 May 2016 (UTC)

Your search is misleading - see my results below. If you don't put a term in quotes, it will be remapped to more common terms - in this case, "methicillin". — soupvector (talk) 15:44, 3 May 2016 (UTC)

your right(fixed[11])--Ozzie10aaaa (talk) 16:57, 3 May 2016 (UTC)

Interesting how WHO reports continue to use methicillin. It seems clear from current searches that "methicillin" is the common name. — soupvector (talk) 14:02, 3 May 2016 (UTC)

If no one uses meticillin neither should we. Which ref say WHO uses meticillin? Doc James (talk · contribs · email) 15:17, 3 May 2016 (UTC)

Pubmed searches for 2016 publications using:

• "meticillin" - 33 results.
• "methicillin" - 811 results.

So, this isn't even common among experts. In my reading (as an infectious disease expert) I see methicillin far more often, but that's probably because I don't work in the UK. My guess is that adoption of the new spelling will be slow. — soupvector (talk) 15:33, 3 May 2016 (UTC)

• just as note, the Meticillin article was renamed in 2008 in this dif. Wow. 8 years ago. Jytdog (talk) 19:44, 3 May 2016 (UTC)

Inmate risk factors

"...few risk factors were more strongly associated with MRSA infections than infections caused by methicillin-susceptible S. aureus." Tautological statement. Or am I missing something? 75.149.149.81 (talk) 13:11, 21 June 2016 (UTC)

Evaluation

Content The content of the article is organized well. It begins with an overview of MRSA infection and then touches on specifics such as treatments and research in an organized manner.The article contains much information on the topic, but more still can be added. The "Hospital patients" section should include information on SSIs or surgical site infections as they are a common form of nosocomial MRSA. There is also new research for alternative treatment options being done that can be included in the "Research" heading such as, the addition of herbs such as Daphne genkwa to traditional antibiotics and use of silver nanoparticles to combat MRSA. Most claims the article made were well cited, however the "Prison Inmates, Military Recruits, and Homeless" stated statistics on rising infection rates in county jails in both Los Angeles and San Francisco without citing a source to back up data. This section also contained a grammatical error in the 5th sentence of the first paragraph as it starts with a lowercase letter and is somewhat confusing.

Quality The article has a quality introduction that outlines the issue of MRSA infection, how antibiotic resistance in the organism developed and types of infection such as LA-MRSA HA-MRSA and CA-MRSA. There are many headings that offer a wide variety of information, but there are some headings that could be expanded on, such as the "Proper Disposal of Hospital Gowns" section, that only contains one short sentence. Overall the writing is unbiased and does not try to force an opinionated view of the subject onto the reader. The article has a variety of reliable sources to back up content but a few of them were not from scholarly sources such as, 16 - foxnews.com 39 - webMD.com 74 - newyorktimes.com (Article labeled as "opinion") 160 - cnn.com — Preceding unsigned comment added by Bm910713 (talk • contribs) 02:47, 16 March 2017 (UTC)

bleach baths

Why does this article say to take bleach baths to combat MRSA skin colonization!? "Alternatively, a dilute bleach bath can be taken at a concentration of 2.5 μL/mL dilution of bleach (about 1/2 cup bleach per 1/4-full bathtub of water". A source given for this statement clearly explains that they are using bleach to decontaminate a bathtub, not to take baths... This kind of information is dangerous! People might actually want to do this. [1]

http://aapgrandrounds.aappublications.org/content/21/1/3.full — Preceding unsigned comment added by 143.167.220.181 (talk) 00:18, 21 May 2017 (UTC)

new content

The new content below is not appropriately sourced:

Animals

MRSA may develop in pets as a consequence of treatment with penicillin. MRSA is present in nasal samples taken from pet dogs and cats. Mrsa can be present in the saliva and then bites of dogs and cats.Dog bites are also another vector of transmission. Dog bite prevention can help to recognize the potential of being infected by a dog with MRSA. Cats are also able to transmit MRSA. Those households that were included in two studies found that 12% of dogs and 7% of cats were colonized. The sites of colonization sometimes occurred in more than one body area on the children in the studies. In 54% of the families sampled, pet dogs or cats were present. The median number of pets in the sampled households was two and were reported to be in good health. The same strain of MRSA that was recovered from the children was also recovered from the pets. The presence of cats was "significantly associated" with the sampling and identification of MRSA in the household environment.

Cases of MRSA have increased in livestock animals. CC398, a new variant of MRSA, has emerged in animals and is found in intensively reared production animals (primarily pigs, but also cattle and poultry), where it can be transmitted to humans as LA-MRSA (livestock-associated MRSA). Though dangerous to humans, CC398 is often asymptomatic in food-producing animals. According to findings of a study conducted in 2014, infection with another MRSA strain (ST 398) accounts for up to 25 per cent of total MRSA infections in some parts of the world and has been found to be more prevalent in people with occupational exposure to poultry and cattle. In a single study conducted in Denmark, MRSA was shown to originate in livestock and spread to humans, though the MRSA strain may have originated in humans and was transmitted to livestock.

A 2011 study reported 47% of the meat and poultry sold in surveyed U.S. grocery stores was contaminated with S. aureus, and of those, 52% — or 24.4% of the total — were resistant to at least three classes of antibiotics. "Now we need to determine what this means in terms of risk to the consumer," said Dr. Keim, a co-author of the paper. Some samples of commercially sold meat products in Japan were also found to harbor MRSA strains.

An investigation of 100 pork samples purchased from major UK retailers conducted by the Guardian in 2015 showed that some 10% of the samples were contaminated.

Domestic pets can harbor and transmit MRSA. Dairy cattle can also be a reservoir.

References

This is a pain in the butt as PMIDs were not used, but here is the analysis:

1. This is PMID 24825010 , a primary source
2. This is a low quality magazine, not even close to OK
3. This is BBC, popular media, not even close to OK
4. This is the 2nd time this CDC source about rabies has been cited here. As already noted when I removed this before, in this diff, use of this ref here is fraudulent. It does not mention MRSA. Not once.
5. PMID 17354344 is a case report, not a review.
6. PMID 25200331 is a primary source
7. This is PMID 23526809; it is a primary source
8. The joint report on livestock is OK. The reference is not - the link is dead.
9. This is PMID 25366200. This is a review, albeit from a very low quality journal. but OK.
10. PMID 23526809 is a primary source
11. PMID 23554168 is a "comment"
12. this is a press release
13. PMID 22307310 is a primary source
14. this is popular media
15. PMID 28435193 is a review as it says.

I have reverted this again. Will restore content that is based on OK refs and format them appropriately. -- Jytdog (talk) 02:23, 21 May 2017 (UTC)

Jytdog,

Thank you for posting your concerns on the talk page. References do not need to be removed because they lack a PMID. The bots and the editors with their AWBs use their tools by fixing such things. I encourage this since I don't use AWB and the bots are pretty efficient. I use a template and if doesn't pick up the pmids, the appropriate link to the article is still available in the ref.

Veterinary references do not have to conform to MEDRS. I cannot find any such guidelines and review articles on veterinary topics are few and far between. The veterinary MOS allows the use of the WP MOS. The sources you have deleted would have been appropriate if you had let them remain. I suppose the encyclopedia can do without information about animal infections and how children can end up with meningitis from their pets. I appeal to Caesar.

Best Regards,

Barbara (WVS) ✐ ✉ 03:03, 21 May 2017 (UTC)

There is no place where i said that refs needed to be removed b/c they lacked a pmid. Never said that. The content was almost all OFF TOPIC and the refs were mostly terrible, as noted above. The section where you added this content is "Risk factors". Jytdog (talk) 03:21, 21 May 2017 (UTC)

• I saw the message at Jytdog's user talk, and from there I read the DRN request, so I decided to look over this discussion and offer a third opinion, in case that helps. I think that both of you are acting in good faith, and there's just a disagreement about content. If this page were purely about veterinary issues, I'm not sure whether WP:MEDRS would apply – but here that is not the case anyway, because the content is about potential transmission from animals to humans. That puts it squarely into MEDRS territory, which means we need to cite scholarly review articles. Period. That means that references 9 and 15 in the list above are the only ones that are suitable here. And that, in turn, means that the text on the page should be relatively brief. At the time that I write this comment, the Animals section of the page looks about right to me. I hope that helps. --Tryptofish (talk) 23:51, 21 May 2017 (UTC)

Thank you so much for weighing in on the discussion. I tend to agree with you. There is something about bacteria articles that I would like to discuss and that is this:

• This is not just an article about MRSA infection.
• This is an article about the bacterium.
• Bacteria articles are not required to follow MEDRS.
• If clinical content is to be part of the bacteria article, then MEDRS applies to that clinical content.
• In bacteria articles the question "Where is it found?" is to be answered but not necessarily with references following the MEDRS guidelines.
• An example of this would be the historical section, but MEDRS is still better even in this section.
• Content and references relating to the presence of the bacterium in animals does not require MEDRS, according to the Project Veterinary Medicine, they have adopted WP referencing.
• Clinical content related to animal transmission to humans would require MEDRS.

Comments?

Best Regards,

Barbara (WVS) ✐ ✉ 12:32, 22 May 2017 (UTC)

Although the page is unquestionably about, in part, a bacterium, and the animal section is unquestionably, in part, about veterinary issues, that section is also very explicitly about transmission to humans. In fact, both sentences actually refer to human transmission. Once we are talking about transmission of a pathogen to humans, we do indeed go into MEDRS territory. (By comparison, if there were reliably sourced information along the lines of: microbiologists found this very interesting genetic variant of MRSA in livestock that tells us something new about bacterial genetics, but this variant cannot be transmitted to humans, then that would not be subject to MEDRS. But that is nothing like the content on the page, nor like the reverted content above.) --Tryptofish (talk) 23:10, 22 May 2017 (UTC)

I accept your interpretation of the requirements and will edit accordingly. I found the oddest reference and content today (MEDRS of course) and the article is just about word-for-word about the bacterial genetics. It turns out, like the flu virus, when two strains have infected an animal, there is some recombinant process that occurs that may effect the virulence. Is there any chance you saw this same article - is it just a coincidence? for a moment I thought I was being given a kind-hearted poke. I think I will be able to sort things out. It turns out that review articles have just about the same content that was deleted. I'll work a little more slowly - I start to make mistakes if I write too fast. Thank you so much for your input. Best Regards,

Barbara (WVS) ✐ ✉ 23:25, 22 May 2017 (UTC)

Editing explanation

Per my usual habit, I am going through the article and checking the references. I am finding them generally not to meet the guidelines described in WP:MEDRS while understanding that the guidelines weren't in place when most of the content was added. Unfortunately this has resulted in much of the content being removed. If other editors are able to find references that I deleted but they feel is appropriate, then please feel free to re-insert the reference with its content.

In addition, I found the strangest thing when I was editing information about the surface decontamination. The reference at first seemed to only be a primary source. I followed the link to the reference anyway hoping that it would be good. I found that the company that manufactured the disinfecting equipment had created a 'dummy journal'. In this fabricated on line publication, they explained the marvels of their equipment in a journal format. The articles contained in the journal even had a pmid and doi! The articles were blantant advertising along accompanying hype and puffery. PubMed has indexed the articles, also. What an ingenious ploy. My next clue was to discover that it also was a place where others could leave a comment, i.e. a blog.

I don't think that I have ever removed so much content. I actually feel badly because some from the UK (based upon the spellings put a lot of time in editing it. Well that's all for now, folks.

Best Regards,

Barbara (WVS) ✐ ✉ 11:34, 25 May 2017 (UTC)

Assymptomatic carriers

this diff is not supported by the source. Jytdog (talk) 20:54, 27 May 2017 (UTC)

Sorry, it was Gopal.

Barbara (WVS) ✐ ✉ 00:26, 29 May 2017 (UTC)

MRSA infection vs SA infection

Am thinking about this. Too much of this article is about SA infection generally and not about MRSA specifically. For example the "sign/symptoms" of an infection that is specifically MRSA is that it doesn't respond to certain antibiotics. The stuff that is here now is just SA infection. Am going to do some major revisions accordingly.... Jytdog (talk) 00:43, 28 May 2017 (UTC)

All the sources (the ones I have been using) are only about MRSA, and not S.aureus infections that are not MRSA. As far as I know, and I haven't gotten through all the references yet, each reference is only related to MRSA and not S.aureus. The antibiotic therapy to treat MRSA infections varies significantly from the treatment of run-of-the-mill Staph infections. S. aureus is controlled with standard antibiotics. I've not used any sources about S. aureus infections only. In addition, there is no such thing as CA-SA, HA-SA and LA-SA infections. Staph infections are common in the community, hospital ad among livestock. These are common and are not mentioned in the sources. Readers are coming to the article (every two seconds, btw) to learn about MRSA not staph infections. Regards,

Barbara (WVS) ✐ ✉ 00:22, 29 May 2017 (UTC)

ps - MRSA is genetically different from 'normal' staph organisms, though I haven't gotten that info into the article yet.

Yes the treatment is different - that is the entire issue and as far as I have seen, the only way that infection with SA resistant to methicillin is different from SA that is not resistant to methicillin. And people should not leave this article with an understanding that the signs of MRSA infection are different from signs of SA infection - you cannot know until you test the bacteria. You have entirely missed the point. Jytdog (talk) 05:54, 29 May 2017 (UTC)

I haven't even begun to work on the signs and symptoms section so have a go. Good observation and sorry for missing the point. Barbara (WVS) ✐ ✉ 09:37, 29 May 2017 (UTC)

Favor

Is there any reason to keep changing the ref names? I begin to edit from a source and memorize the ref names. Then, much to my surprise, they get changed without me knowing until I see that the ref formatting isn't working out. And then the new ref names are so long that I can't memorize them anymore. It has made my editing more difficult and just because something is from Cochrane doesn't make the original ref name incorrect. Minor point, but another roadblock for me. Barbara (WVS) ✐ ✉ 09:37, 29 May 2017 (UTC)

Don't know how to answer that - it is a style thing. In my view ref names should signal at some high level what they are. If a ref is Cochrane that should be in the ref name. Can simplify the IDSA refname, sure. Jytdog (talk) 20:59, 29 May 2017 (UTC)

Thank you

You've got style, that's for sure. Barbara (WVS) ✐ ✉ 23:08, 29 May 2017 (UTC)

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Bdellovibrio bacteriovorus

Perhaps that the following may be added to the article, if additional (and better) references are added

• Bdellovibrio bacteriovorus is being looked at as an antimicrobial agent, in some cases able to defeat antibiotic-resistant bacteria.

KVDP (talk) 08:13, 29 June 2017 (UTC)

References

Combatting MRSA in the Netherlands

The BBC is currently broadcasting The Dutch Antibiotic Revolution which describes the success of measures taken in the Netherlands to diminish risks of MRSA on humans by cutting back on its use in pig farming. Perhaps this can be included in this article or be presented independently. There is also interesting information on Farm antibiotic use in the Netherlands. Similar results have been obtained in Denmark. Perhaps Barbara (WVS) could look at this.--Ipigott (talk) 13:01, 5 September 2017 (UTC)

Too high-level article, not for laypersons

This article is much too specialized for ordinary, non-scientific persons who just want to know what "MRSA" is about.

Yet they are automatically redirected here if they search for "MRSA". 178.117.109.135 (talk) 14:10, 12 October 2017 (UTC)

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Review

doi:10.1128/CMR.00020-18 JFW | T@lk 18:55, 20 September 2018 (UTC)

Refs

Trimmed a bunch of stuff that was poorly references. Most of the sources were either primary in nature or were from a known predatory publisher. Doc James (talk · contribs · email) 20:44, 20 September 2018 (UTC)

Skin infections

MRSA skin infections are very common and the most common presenting manifestation of cases. User:Graham Beards you apparently don't see these cases in your line of work according to your edit summary where you write you have seen 1 case in 10 years, but the medical literature is full of reports of ever increasing frequency of community-acquired MRSA skin infections. You see 1 case in a decade. Twenty years ago, I'd see a case every few months. Now I see several cases a week, and it reflects what is reported in the medical and lay literature. MRSA UTI, pneumonia, and other infections are a minority by comparison, and it's consistent with MRSA usually primarily being an asymptomatic colonizer on people's skin. MartinezMD (talk) 19:57, 20 September 2018 (UTC)

• https://cmr.asm.org/content/28/3/603
• https://www.medscape.com/viewarticle/498770
• https://www.uptodate.com/contents/methicillin-resistant-staphylococcus-aureus-mrsa-in-adults-epidemiology
• https://www.webmd.com/skin-problems-and-treatments/understanding-mrsa#1
• https://www.medicalnewstoday.com/articles/10634.php
• https://www.medicalnewstoday.com/articles/322903.php
• https://www.mycentraljersey.com/story/news/local/how-we-live/2018/05/28/what-mrsa/597789002/

All of these are questionable with regard to WP:MEDRS. The photograph in question is a selfie of a boil. The legend says that MRSA "often presents" as such. Where is the evidence? Graham Beards (talk) 07:39, 21 September 2018 (UTC)

It’s already in the beginning of the article if you read the “Signs and symptoms” section. Second paragraph “About 75 percent of CA-MRSA infections are localized to skin and soft tissue and usually can be treated effectively.[4]”. Where reference 4 currently pis: Liu, Catherine... (2011). "Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children". Clinical Infectious Diseases. 52 (3): e18–e55, which is a pretty reliable source to satisfy WP:MEDRS 2600:1003:B119:38B2:8430:177D:4EC0:4FAB (talk) 03:01, 22 September 2018 (UTC)

Adding Phage Therapy in treatment

Riffstilde (talk) 08:27, 21 September 2018 (UTC)

Please Doc James (talk) explain why you reverse all attempts to open a "Phage Therapy" subsection of section "Treatment". Maybe we can discuss this here? Thank you. Riffstilde (talk) 08:42, 22 September 2018 (UTC)

The ref says it is being studied, not that it works. Doc James (talk · contribs · email) 14:55, 22 September 2018 (UTC)

Thanks. The ref says " the Soviet Union invested heavily in the use of bacteriophages — viruses that kill bacteria — to treat infections", "Phage therapy is still widely used in Russia, Georgia and Poland" and "Kutateladze, who is the head of the scientific council at the Eliava Institute in Tbilisi, which has been studying phages and using them to treat patients for nearly a century". Which means it is being used there to treat people; it is not merely studied as you say.

Maybe we can agree to change the section "Treatments" to "Treatments available in the US" and add another section "Treatments available elsewhere" ?

or within "Treatments" we could add a sub title "Treatments not available in the US" or "Not FDA approved" or "Treatments that require FDA emergency exemption [21 CFR 56.104(c)]" or "Phage Therapy (requires FDA emergency exemption)" Riffstilde (talk) 16:03, 22 September 2018 (UTC)

That is a news source. (yes Nature;s news, but news.) Not MEDRS. We could generate content in the society and culture section using it. Not making biomedical claims but about usage. Jytdog (talk) 18:56, 22 September 2018 (UTC)

We need sources that meet WP:MEDRS. Yes this stuff is being studied and yes it has promise. But no it is not yet a recognized treatment for MRSA. Doc James (talk · contribs · email) 23:19, 22 September 2018 (UTC)

Just my $0.02, but I don't see any evidence that this has been successfully used as in vivo treatment. See https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0160242 for recent study of this. ^Bongo_matic 07:06, 23 September 2018 (UTC)

Thanks. The question here is to focus on Wikipedia guidelines. It seems : the fact that Phage Therapy is used as a treatment in other countries is non-medical information (it is not a medical claim) and as such does not depend on WP:MEDRS. Anyway, what about this ref from the American Society of Microbiologie ? Riffstilde (talk) 14:34, 24 September 2018 (UTC)

The biggest issue is making sure to separate the fact that it is being used vs. whether it actually work. The article on phage therapy has serious issues with undue weight and lack of reliable information - large sections on its use and implementation with a very small section called "potential benefits". We could argue about any other unproven therapy in the same manner. MartinezMD (talk) 15:06, 24 September 2018 (UTC)

Though, personnally, I wonder if it is 100% unproven given the amount of evidence in medical litterature of people in very extreme condition being cured while they were on the point of dying or being amputated, with all other treatments having failed, I agree with you that it needs prudent wording similar to what is found in the article cannabis: "A 2017 review found only limited evidence for the effectiveness of cannabis in relieving chronic pain in several conditions.[23] Another review found tentative evidence for use of cannabis in treating peripheral neuropathy, but little evidence of benefit for other types of long term pain.[24]". I guess there has been some fight on the subject of cannabis too. Riffstilde (talk) 16:04, 24 September 2018 (UTC)

Responding to Riffstilde's comment at 14:34; this ref from the American Society of Microbiologie is a blog and not MEDRS. Content about medical use is biomedical information. Jytdog (talk) 19:06, 24 September 2018 (UTC)

Riffstilde please note the sourcing at Cannabis - "a 2017 review"... "another review" - these are MEDRS refs. What MEDRS calls for is not hard to understand. Please engage with it. Jytdog (talk) 19:06, 24 September 2018 (UTC)

Dear Jytdog, this ref from the American Society of Microbiologie was a reply to ^Bongo_matic. I take this opportunity to quote MDRS: "Sourcing for all other types of content – including non-medical information in medicine-articles – is covered by the general guideline on identifying reliable sources." The fact that Phage Therapy is widely used in Russia, Georgia, Ukraine, Poland and is being introduced in Belgium and France, and that it is being used in the US under FDA emergency exemption [21 CFR 56.104(c)] is not biomedical information according to What is not biomedical information: it is regulatory status and societal information.

I will follow your guidance and try an edit similar to "a 2017 review" ... "another review" - supported by MEDRS refs. Thanks. Riffstilde (talk) 08:17, 25 September 2018 (UTC)

You need a review article that includes valid statistics - e.g. adding phage therapy had x% improvement in outcome, or days to cure, or reduced mortality, etc. Too much out there is case reports, anecdotes, stories, etc. It is a good theory; the issue is does it actually work. Look for that type of information. MartinezMD (talk) 09:55, 25 September 2018 (UTC)

Thanks MartinezMD. At this stage we have 2 topics of discussion:

1. Can we open a Phage Therapy section within 'Treatment', on the sole factual basis that Phage Therapy is being used in eastern countries to treat patients on a broad scale and more recently in a limited way in a few other western countries under the shield of the Helsinki Convention and of the FDA emergency exemption ?
2. What sources are acceptable to support the claim that Phage Therapy can be considered as a treatment under American standards ?

So maybe it is better to close this discussion and open 2 different discussions? Any objections ? Riffstilde (talk) 13:37, 25 September 2018 (UTC)

I don't think we need two discussions. They are both the same. This is an article on MRSA, not phage therapy. So the issue of inclusion is one of undue weight versus general notability with medical assertions requiring proper references. It is perfectly acceptable to state that phage therapy is being used in some parts of the world, but as a treatment it has not been proven reliable. The article on phage therapy itself does not show proven benefit, and that's an entire article. It would seem to be promising, but it has not been demonstrated as yet. Unless there is stronger evidence, one or two sentences is all I think appropriate, not a section. MartinezMD (talk) 17:35, 25 September 2018 (UTC)

It does not appear to me that the claim that it is being used in some parts of the world is adequately sourced to avoid undue weight even for such a muted claim. There is lots of quackery in the world and "treatments" used for a variety of conditions. Without reliable sources in medical journals as to the prevalence of such treatments (i.e., approved therapy or widely-recognized off-label use), this would be hard to distinguish. Not to suggest that phage therapy is actually quackery (which is not my view—rather, it's that it has not (yet?) proven therapeutically valuable). I would think the reference to its use as treatment should be eliminated based on current sourcing. ^Bongo_matic 05:30, 26 September 2018 (UTC)

Thanks; I will try to supply here sourcing supporting the fact that PT is used as an MRSA official treatment in a number of countries, including 2 in the EU, such as Poland, Cszech Republic, Ukraine, Georgia, Russia. That's a population about the size of the US.

1. Primary sources that PT is used , with phagics targeting MRSA :

Poland: Hirzfeld Institute and phage department with a list of their publications on bacteriophages ;

Cszech Rep.: Bohemia Pharm and Stafal ;

Slovakia: Stafal ;

Ukraine: Farmex Group LLC for NeoProbioKear Inc., Canada and Piofag ;

Georgia: George Eliava Institute, its collection of S. aureus, and its Staphylococcal bacteriophage ;

Georgia: Biochimpharm and its Phagestaph

Russia: Microgen - the only major drug company in the business and its Staph phage.

All these products are registered in their countries and the registration info is available from the pages I listed for most products. They are available in pharmacies for instance here in Russia or here and here in Ukraine.

A few Russian publications are available on Microgen website here and (thanks Google Translate) can also be read in english.

Now a very intersesting piece of news from Science First Hand. It mentions that: "Bacteriophages are currently produced in Russia on an unprecedented scale, like nowhere else in the world. Bacteriophages are manufactured as high-grade drugs, and the consumption of these antibacterial agents in Russia is more than 1 billion packs per year". Doesn't Phage Therapy deserve a section "Treatments not available in the US"? — Preceding unsigned comment added by Riffstilde (talk • contribs) 13:23, 26 September 2018 (UTC) Riffstilde (talk) 14:15, 26 September 2018 (UTC)

In my opinion no. For it to be a section it needs to be proven effective. There is a lot of use but that doesn't mean it works. I'll give you an example; look at Acute bronchitis. Treatments such as ibuprofen, cough syrups, etc. are widely used, maybe more than any other remedy, but they do not get their own section. They got a sentence each. MartinezMD (talk) 15:02, 26 September 2018 (UTC)

This is not even trying to engage with MEDRS. Please see your talk page. Jytdog (talk) 23:06, 26 September 2018 (UTC)

Phage therapy is about bacteriophages, virus that kill bacteria, so it is not about treating symptoms but about treating the bacterial infection itself. The fact that it is used in many countries to treat people is a social fact, not a medical claim. I hope that according to wikipedia guidelines we can work toward a consensus. This means finding a way to express that (1) PT is used as a treatment in some part of the world and (2) you can add also what you feel needed to express that you feel PT has no proven medical value and state why with appropriate references. Riffstilde (talk) 09:46, 2 October 2018 (UTC)

Nope. The burden of proof is to establish effectiveness if you want a section. You can't place the burden to prove a negative. Using your logic every single bacterial infection article would warrant a phage therapy section. You can set up an RFC, but I don't think you'll get any different answers from the reviewing editors. MartinezMD (talk)

When it comes, will FDA approval be enough to qualify Phage Therapy as a treatment that can be included in the "Treatment" section? Riffstilde (talk) 18:17, 9 October 2018 (UTC)

I would think so, as long as we are discussing FDA-approval and not FDA-cleared which is a totally different issue. We don't even need FDA approval if enough reliable sources support it, as the FDA is only in the US. FDA approval typically requires a level of proof similar to what we are discussing. The issue remains as to reliable proof of benefit if you want a section, otherwise it is an issue of undue weight as well. MartinezMD (talk) 20:57, 9 October 2018 (UTC)

Thanks. Just to quote Wikipedia here : 'Approved drug. An approved drug is a preparation that has been validated for a therapeutic use by a ruling authority of a government. In the United States, the FDA approves drugs. Before a drug can be prescribed, it must undergo the FDA's approval process.' Riffstilde (talk) 08:10, 10 October 2018 (UTC)

RfC on Handling of FDA-unapproved medical treatments within a disease article.

There is no consensus for any changes.

Cunard (talk) 05:27, 2 December 2018 (UTC)

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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In a disease article, how can we include treatments such as those in the following list of examples:

1. treatment not available in the US, not FDA approved ,
2. treatment available on an expanded access / compassionate use only basis according to the FDA?
3. treatment approved for therapeutic use by a foreign ruling authority of a government
4. treatment not proven effective (with a statement that it has not been proven effective)

This RfC is about building a consensus on a way to present such treatments in the present article. Wikipedians are invited to join in, including those from non-medical fields. This RfC is the logical follow up of the discussion that appears just before on Talk:Methicillin-resistant_Staphylococcus_aureus. Riffstilde (talk) 10:56, 19 October 2018 (UTC)

Here are a few thoughts as a start.

Definition of "medical treatment"

Wikipedia search on “medical treatment” redirects to “therapy”, which is defined as : Therapy (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem

On the other hand, WP:biomedical_information indicates the following : Treatment or Management : Look for guidelines from major organizations about what ought to be done; look for systematic reviews to find out which of these recommendations have been proven to work.

This discrepancy shows that the word “treatment” can be understood in two ways:

1. a set of medical procedures that aim to improve a patient’s health (“attempted remediation”), or
2. a set of medical procedures that are recognized and proved to improve a patient’s health (“guidelines about what ought to be done” & “recommendations that have been proven to work”)

Use of the word “Treatment” and medical claim

Assuming (2), would make using the word “treatment” a medical claim, since it would mean the procedure is recognized and proved. This would pose serious issues about the possibility of addressing treatments listed above. For instance using the word “treatment” in a statement such as “In China acupuncture is used as a treatment for infertility” would be considered a medical claim / biomedical information, since this statement would be considered as supporting the claim that acupuncture is recognized and proven to work. It would therefore need WP/MEDRS sources to support it. If no such sources were found, the statement would be banned, which seems ridiculous, as it is a matter of fact statement.

Is merely calling something a “treatment” already a medical claim? Can the word “treatment” be used for anything which is not supported by WP:MEDRS sources? In which case, how can we speak of foreign treatments not supported by WP:MEDRS?

Risk of medical professional bias

Medical professionals may tend to see the ‘Treatment’ section as a description of medical recommendations aligned on FDA guidelines (i.e. a description of treatments that can be legally used in the USA), and not as an encyclopedic presentation of existing medical practices (both US and foreign, effective or not effective, etc…).

Do medical practitioners own medical articles in their field ? Do they qualify to decide what is and what is not a treatment, even when the treatment is a foreign allowed treatment? Can they ban foreign allowed treatments from Wikipedia? For instance on the basis that presenting them and calling them a “treatment” would be a medical claim that needs WP:MEDRS sources support?

Wikipedia medical articles scope

Is Wikipedia a worldwide encyclopedia or a manual of American medical good practices ?

Should all approved treatments (FDA and foreign) have the same weight?

Should all approved treatments from English speaking countries have the same weight in the English Wikipedia?

Policy

According to Wikipedia policy, medical claims are subject to WP:MEDRS, but non-medical claims are not. The information that a treatment is allowed only in foreign countries, is an encyclopedic fact, not a biomedical information subject to WP:MEDRS, and according to Biomedical information should not be construed as a subdued medical claim. Otherwise societal facts on foreign medical treatments could no longer appear in Wikipedia medical articles.

Treatments available in other English speaking countries but not in the US

en.wikipedia.org is not limited to America. It is the English Wikipedia. Medical practices in English speaking countries and in other parts of the world cannot be ignored solely because these medical practices are not approved by the US FDA. One example: English is the official language in Britain and India. How could treatments government-approved in these 2 countries and not in the US be prohibited from being exposed in en.wikipedia.org or be given less weight than US approved treatments?

Treatments only available in non English speaking countries

WP:MEDRS has inherent limits for foreign treatments when :

• literature is not available in English,
• reviews, secondary and tertiary sources are from foreign journals and publications,
• and are not available in Medline or other essentially English language databases.

Interestingly, all recommended sources of medical information mentioned in WP:MEDRS are in English. What about treatments approved in China with good Chinese medical literature support?

Presentation of FDA unapproved treatments in an article

Any recommendations on the presentation of such content? Should non FDA approved treatments appear within the ‘Treatment’ section, i.e. as a subsection, or within an additional section at the same level as the ‘Treatment’ section?

What about the wording: ‘FDA non approved treatments’, or ‘treatments not available in the US’, or ‘controversial treatments’, ‘alternative medicine treatment’, etc... (depending on the treatment) ?

Another example: Pain Management

Pain management article offers a glimpse at what can be done in order to present various kinds of approved/unapproved/unproven treatments.

Writing for the opponent

In the effort to build a consensus, please consider WP:OPPONENT , the process of explaining another person's point of view as clearly and fairly as you can. Thank you.

Riffstilde (talk) 11:36, 19 October 2018 (UTC)

• Confused. I was summoned here by a bot. I don't know what I'm asked to !vote about (nor where I'm meant to do it). It's offputting to see the US and the FDA mentioned in the list at the top of the RfC. As a reader I'm interested in what treatments are used for MRSA infection, and in whether they work. Sure, the FDA is a reliable source of information, but it's not the only one, and shouldn't be given special status in the question. Maproom (talk) 08:46, 23 October 2018 (UTC)

This RfC is about how the article on MRSA can present treatments that are not officially admitted in the US but are widely used and officially approved in many other developped countries. This issue is raised because all attempts to list Phage Therapy as a treatment are blocked by a couple wikipedians, despite the evidence that Phage Therapy is very widely used by physicians in eastern countries: "Bacteriophages are currently produced in Russia on an unprecedented scale, like nowhere else in the world. Bacteriophages are manufactured as high-grade drugs, and the consumption of these antibacterial agents in Russia is more than 1 billion packs per year". Riffstilde (talk) 11:35, 31 October 2018 (UTC)

• Comment - the issue is that we have opposed a section due to the therapy having no proven benefit therefore having undue weight. One or two sentences with a link to the article was not objected. MartinezMD (talk) 12:32, 31 October 2018 (UTC)

Thanks for making this clear. Russian/Cszech/Moldavian/Georgian/Slovak/Polish/Ukraine doctors and governmental medical authorities in these countries appear to think diffrently as far as indications and proven benefits. Same for the FDA who allows the compassionate use of Phage Therapy. Anyway is Wikipedia an encyclopedia, or a guide of good or bad medical practices ? Why do you let such exotic treatments as TENS, acupuncture and light therapy appear as sections in Pain Management article? You cannot censure information about the bare EXISTENCE of medical practice in foreign countries on the basis that you as an individual do not believe in its efficiency. I don't even want to argue about proven benefit (though there is abundant literature supporting it - how can you deny this? have you researched the subject?) because that's not the point here.

By the way why don't you just suppress Phage Therapy wiki article? I cite the article: "Phages tend to be more successful than antibiotics where there is a biofilm covered by a polysaccharide layer, which antibiotics typically cannot penetrate. In the West, no therapies are currently authorized for use on humans. Phages are currently being used therapeutically to treat bacterial infections that do not respond to conventional antibiotics, particularly in Russia and Georgia. There is also a phage therapy unit in Wrocław, Poland, established 2005, the only such centre in a European Union country."

As well, why do you accept a "Treatment" section in Phage Therapy Wikipedia article and refuse a "Treatment" section in MRSA? Riffstilde (talk) 14:51, 31 October 2018 (UTC)

Because there no reliable sources that can be cited to support your position. Ruslik_Zero 20:07, 31 October 2018 (UTC)

Please find here a list of sources that bacteriophagics are approved drugs in many countries (scroll down a little to find a list of references by countries) and here about FDA compassionate use. You may want to reread the RfC: it is about presenting treatments that are not officially admitted in the US but are widely used and officially approved in many other developped countries. You are invited to make your choice in the survey below. For instance you may choose to Adopt Proposal 5 and explain that you feel "a therapy should not be listed as treatment if it hasn't been approved in the US, even though it is approved elsewhere", or you may choose Adopt Proposal 1 and suggest a prudent wording such as "a 2017 review found that"... "another review", or you may state that you feel needed to balance favorable/unfavorable statements, etc. Let's just try to find a consensual solution. Thanks. Riffstilde (talk) 18:37, 2 November 2018 (UTC)

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----- Proposals -----

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These are proposed presentations of sections and subsections. Feel free to add your own proposal. Comments/preference/choice of proposal should be put in the survey section that follows the list of proposals.

Proposal 1

• 6 Treatment

• 6.1 Antibiotics
• 6.2 Phage Therapy

Phage therapy has been used for years in MRSA in eastern countries ...

Proposal 2

• 6 Treatment

• 6.1 Antibiotics
• 6.2 Phage Therapy (requires FDA emergency exemption)

Phage therapy has been used for years in MRSA in eastern countries ...

Proposal 3

• 6 Treatment

• 6.1 Antibiotics
• 6.2 Treatments used outside the US

• 6.2.1 Phage Therapy

Phage therapy has been used for years in MRSA in eastern countries ...

Proposal 4

• 6 Treatment

• 6.1 Antibiotics

.....

• 7 Phage Therapy

Phage therapy has been used for years in MRSA in eastern countries ...

Proposal 5

• 6 Treatment

• 6.1 Antibiotics

.....

• 10 Research

Phage therapy has been used for years in MRSA in eastern countries and studies are ongoing in western countries.

Proposal 0

Phage Therapy should not be mentioned in MRSA article.

SURVEY

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Please post your preferred proposal and comments here:

Keep Proposal 1. Clear and simple presentation. Riffstilde (talk) 14:33, 31 October 2018 (UTC)

If the sources meet WP:MEDRS then include as in Proposal 1 otherwise, as in Proposal 5 The issue should be clear, if there are sources which qualify as WP:MEDRS, then it should be included in treatment, otherwise it should be included as valuable, but separate information. This RfC is not about whether the FDA is the only source of WP:MEDRS, it is about whether there are WP:MEDRS sources supporting Phage Therapy. Dryfee (talk) 20:17, 5 November 2018 (UTC)

Not really: The rfc is about finding a consensus on how to present treatments such as those in the following list of examples:

1. treatment not available in the US, not FDA approved ,
2. treatment available on an expanded access / compassionate use only basis according to the FDA?
3. treatment approved for therapeutic use by a foreign ruling authority of a government
4. treatment not proven effective (with a statement that it has not been proven effective) Riffstilde (talk) 14:33, 20 November 2018 (UTC)

• This is an incoherent mess. Not a good use of the RfC process per WP:RFC and should be withdrawn. It is also just a continuation of the WP:BLUDGEONing advocacy for phage by this person. And no - we will not use "other" sections to COATRACK medical claims about phage into the page, sourced to the same bad sources that have been presented here all along. Transparently tendentious. Jytdog (talk) 19:31, 9 November 2018 (UTC)

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The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Deaths?

Staphylococcus aureus has a relevant chance to kill a patient (see e.g. CDC). Is that different for MRSA? That would be worth a comment in the article. Is it not different and this virus has a notable death rate? That would also be worth mentioning. From the article ("signs and symptoms") it sounds like this would be a relatively harmless disease: No long-term consequences are mentioned. --mfb (talk) 07:34, 12 July 2019 (UTC)

Mortality rates are already discussed in the article. What do you think needs adding? Also, as with the majority of bacterial infections (it's not a virus btw), if you are successfully treated there are no long-term consequences. MartinezMD (talk) 23:52, 12 July 2019 (UTC)

MRSA hoax?!

This article doesn't even mention Chris Malyszewicz and the MRSA hoax though news about them is one of the "three all-time classic bogus science stories" in the British media (according to a source in Lancet_MMR_autism_fraud). --Espoo (talk) 20:43, 21 July 2020 (UTC)

Doesn't seem to be notable enough to include, but do you have the specific link? See WP:NOTEVERYTHING MartinezMD (talk) 20:57, 21 July 2020 (UTC)