MRSA, MRSA, MRSA!



MRSA colonies



There always seems to be one topic that sticks with you and haunts you after attending an informative continuing education meeting. After the fall Iowa Veterinary Medical Association meeting last week in Ames, MRSA was the bug that really had me bugged after the meeting. MRSA stands for Methicillin Resistant Staphylococcus aureus. This nasty bacteria has acquired a gene that reduces the ability of our most common antibiotics, penicillins and cephalosporins, to attach to it. This bacteria can roam around and reproduce quite happily and most antibiotics have little or no effect on it! Not only that, but as many as 1 in 3 people are what are referred to as colonized. This means folks with no clinical signs or evidence of disease what-so-ever are carrying this bacteria and can spread it to others. Those people who have active MRSA infections have fever, wounds, high white blood cell counts and a whole host of other severe problems that stem from a bacterial infection gone wild.

Drug resistant bacterial infections seem to come from two main sources or situations.
1.) Bacteria found in the environment, either in a hospital or in the community.
2.) Bacteria that stems from a patient’s own normal flora ( the normal good bacteria that all people and pets have which normally helps to fight off the bad kinds of bacteria) that over populates because of increased and/or inappropriate antibiotic use.
Risk factors for community acquired MRSA, or drug-related resistant infections, are young age, kids participating in contact sports, sharing towels or athletic equipment, having a weakened immune system, living in crowded or unsanitary conditions, and association with healthcare workers. Risk factors for hospital acquired infections are current or recent hospitalization, living in a long term care facility, invasive devices such as catheters, and recent antibiotic use.
What’s the human - animal connection? The most important multi-drug resistant organisms are MRSA as we described earlier, enterococcus species, enterobacter species, and pseudomonas species bacteria. Colonized animals are a concern due to their potential for future development of infection ( especially if they are scheduled for surgery) and the potential for transmission of these drug resistant bacteria to humans. If an animal or human in a household develops illness, it may be very difficult to tell which way the infection was transmitted because it could pass from human to animal or from animal to human. There has been no evidence to show that giving antibiotics to a colonized individual is a good idea. This would just likely make the resistant bacteria smarter and even more resistant to the next antibiotic chosen.
To quote Dr. Jo Ann Morrison, Senior Clinician and Internal Medicine Service Chief at Iowa State University College of Veterinary Medicine, broad, non-targeted antibiotic therapy has caused the following:

• Increased pathogen exposure to antibiotics
• Enhanced the resistance mechanisms of bacteria
• Increased levels and rates of resistance in pathogen populations
• Decreased the effectiveness of medications
• Limited future therapy options
• Favored emergence of resistance by eliminating competing normal flora ( the good bacteria that fights off the bad bacteria)



Ruptured MRSA infection



All that being said, what are we to do. Do what your mother always has told you. Wash your hands. Wash your hands. Wash your hands. Students should never share water bottles or towels in the locker room. Parents need to make their teenagers aware of MRSA and the population of colonized individuals that they are very likely in contact with every day. Disinfecting locker rooms and bathrooms on a regular basis as well as door knobs, locker handles and water fountains is very important. Households should clean bathroom counter and sink surfaces well too. Store toothbrushes upright and away from other toothbrushes and send them through the sanitize cycle in the dishwasher often.

For more information on good disinfecting protocols go to Disinfection protocol.
MRSA Manual I included this just as an example of a management protocol for MRSA because we have used Techni-care at the veterinary hospital for several years with excellent results, but there are many other examples of disinfecting protocol online.
Dr. Elizabeth Bixby

Hermit Crabs

Fall is here and it is back to school time. One of the fun things about going to school is the class pet. Students are enjoying learning about the care and responsibility of all sorts of pets in the classroom. One pet who is becoming a big hit is the land hermit crab. These little crabs are very entertaining for kids and adults alike and are relatively easy to care for with a few instructions.
Hermit crabs need a home, which can be simply an inexpensive ten-gallon aquarium. The aquarium must have a substrate covering the floor. This can be clean sand or coconut fiber or better yet something called Calci-sand which has calcium carbonate to strengthen the exoskeleton. The substrate needs to be deep enough to cover the crab because they enjoy digging and burrowing.  The hermit crab needs a shallow water dish;  if the water is too deep the crab will drown.  It needs to be wide enough to fit the whole crab, as he will drag his whole shell into the dish.  Hermit crabs enjoy their toys.  Put toys for climbing inside the aquarium.  Another item for the aquarium is a large sponge.  The sponge adds humidity to the air and keeps the crabs gills moist.  (Hermit crabs use gills to breath, not lungs like humans do.)

Hermit crabs can be fed a commercial hermit crab food.  If it is in pellet form it must be crushed for them to be able to pick it up.  Crabs also like a large variety of foods for treats such as fruits, vegetables, nuts, raisins, applesauce and peanut butter.  Do not feed hermit crabs dairy products because their systems cannot tolerate dairy at all. 

Hermit crabs need water to drink.  It is important to give crabs non-chlorinated water and keep food and water dishes very clean and remove any uneaten portions daily.  One thing to remember about hermit crabs is that they will molt or shed their exoskeleton as they grow.  They outgrow one skeleton and have to grow a new one.  The crab will need you to provide a new shell about one -third bigger than the old one.  Molting takes about two weeks and during this time you must make an effort to keep the crab extra moist by misting with a squirt bottle and feeding a diet higher in calcium to help make a new skeleton. 

One final note to remember is that hermit crabs do pinch.  When they first come home they may pinch a lot because they are hungry and mishandled.  Children may need to handle them with gloves at first.  Kids should handle the crabs over a soft surface like a bed so that if the child drops the crab, it won't be injured.  Generally it is recommended to pick up the hermit crab by the shell, but use caution because they can still reach around to pinch.  Once the hermit crab is acccustomed to being hand fed and handled the incidence of being pinched does become less and less.  They are interesting to watch and a great way to teach kids about crustaceans.

Elizabeth Bixby, DVM

Pet of the Month - September 2010 - Wrigley Hess

Wrigley Hess (named, of course, because of the Cubs) is a 4 year old German Shorthaired Pointer. His proud parents are Derrick and Lindsay Hess who adopted him when he was a puppy. Wrigley was a bit shy at first, but now he is a dog who loves people and being with his owners. Wrigley can sit, shake hands, lay down, and if you put a treat on his nose, he can flick it off and catch it in his mouth. He is learning how to give high fives as well. Wrigley loves cheese, carrots and any other dog treat. He has found his place to sleep in Derrick and Lindsay's bed and is truly a part of their family. He even tries to join in conversation, when someone talks to him, he will make weird dog noises in response. Wrigley is thrilled that his parents got married in August and has loved "helping" pack the boxes as they move into a new home. He is a very lovable, well-behaved, and smart dog that makes the Hess family complete.