Thursday, November 01, 2007
Staph infections remain common and treatable

By Anthony Policastro, M.D

It has been just about three months since I published this article. However, in the light of the current news and the questions that I am receiving in the office, I decided to publish it again this soon. There are many bacteria that cause infections. Some of them are common. Some are not. One of the more common bacteria goes by the name of Staph aureus (short for staphylococcus aureus). Infections with staph aureus are seen frequently. When I was doing my residency, we had a family of antibiotics to treat it. The name of that family was methicillin. If we saw an infection that looked like staph aureus, we had several antibiotics to choose from. Most of the infections we saw were skin infections. Staph aureus is the most common cause of skin infections with pus in them. It is also one of the common causes of impetigo. It can cause serious infections in other parts of the body. Fortunately, those infections are less common. It was easy to see a skin infection and know that it was staph aureus. All that needed to be done was order methicillin and treat the infection. Over the years two things happened. The first was that we began to see some staph aureus that were no longer sensitive to methicillin. It was a few bacteria at first. However, the frequency became more and more. The result is that now most staph aureus is resistant to methicillin. The name we give to these new strains is Methicillin Resistant Staph Aureus (MRSA). MRSA is now so common that many people have heard the term. The second thing that happened is that the skin infections became more severe. At one time, you could treat a patient with methicillin. If the infection did not get better quickly, you could change the antibiotic. It was not a problem to delay using the right antibiotic. However, within the last 2 - 3 years MRSA infections have become much more aggressive. They grow faster. They grow deeper into the body tissue. They spread faster. It is important to treat them early. It is important to treat them quickly. It is important to treat them aggressively. If someone gets a skin infection, there are four things they should look for. One is redness. If it stays at the site of the infection, that is not very worrisome. If the redness begins to enlarge, that is more of a problem. The second thing to look for is tenderness. The more tender an infection is, the more it is likely to be under pressure. Treating it to relieve that pressure is important. The third thing is to see if the area is hot. The fourth is to look for swelling. If someone has an infection that is red, hot, swollen and tender, they should be seen for it. Other signs suggest that the infection is starting to spread. Individuals with those signs need to be seen urgently. Fever means that the entire body is reacting to a local infection. A red line extending from the infection suggests that the infection is spreading along the lymph tracks in the body. Swollen glands near the infection means that the infection has already spread to those glands. These three things warrant a visit to the physician or emergency room very quickly. Once the infection is diagnosed, it will need to be treated with an antibiotic. That antibiotic will need to be something other than methicillin. We used to use Keflex for these infections, but MRSA is usually resistant to that as well. The drugs that we commonly use are called Clindamycin or Bactrim. Staph aureus is still common. However, the way it behaves has changed. The way we treat it has also changed. It is a bacteria that deserves some respect.

NMH uses prayer bears for care

Nanticoke Pastoral Care Services are on a mission to turn tears into smiles for pediatric patients at Nanticoke Memorial Hospital. The My Prayer Bears ยจ are just one way the Pastoral Care team helps brighten a patient's stay at the hospital. The Pastoral Care Team provides chaplin services to Nanticoke in a variety of spiritual ways including pastoral crisis intervention, offering a prayer or blessing, administration of religious rites and ongoing pastoral support for long term cases. Funding for the prayer bears was provided by "The Pegeen and Samantha Brown Pediatric Fund" at Nanticoke Hospital. The fund was established in memory of Mrs. Brown and her daughter for pediatric programs and services at Nanticoke. A new pediatric friendly unit is under construction in the Emergency Department.

Lymphedema sufferers often go untreated
Millions of Americans suffer from lymphedema or edema of the arms, legs, trunk or reproductive organs and have not received treatment. The term "edema" refers to an excessive amount of fluid in tissues or organs of the body resulting in swelling. Lymphedema is the swelling of subcutaneous tissue and skin as a result of the malfunction of the lymphatic system. There are two types of lymphedema:
  • primary develops when lymphatic vessels are missing or impaired (a rare inherited condition that can present itself at any point in the patient's life); and
  • secondary develops when lymphatic vessels are damaged or lymph nodes are removed (result of physical damage or interruption of the lymph system). Lymphedema isn't just a physical deficit and being diagnosed is a life-altering event.
  • Suddenly your body doesn't function like it did before. It doesn't look or feel the same. Your self-image and interactions with others may change. Activities you took for granted may now be difficult or even dangerous. If you, someone you know, or a patient suffers from the symptoms of swelling and/or has been diagnosed with this disease, contact Nanticoke Health Services at Herring Run at 629-6224 for help.

    Depression support group in Laurel
    The Mental health Association in Delaware will be sponsoring a Depression Support Group in Laurel on the second and fourth Thursdays of each month. The meetings begin at 7 p.m. In November, the meetings are the second and fifth Thursdays due to the Thanksgiving Holiday. The purpose of the Laurel Depression Support Group is to share experiences related to living and coping with depression. The group is confidential and offered at no charge. The MHA encourages anyone dealing with a depressive disorder to attend. Register in advance by calling 1-800-287-6423.
  • Peer support groups sponsored by Mental Health Association of Delaware are not intended to replace professional mental health treatment.
  • To maintain the privacy of our members, MHA does not publish support group locations; locations are provided with registration.