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  • Staphylococcus or, as it’s more widely known, staph, is one of the most common bacteria

  • found on humans around the world. In some cases, it can pose a real threat to your body’s

  • immune system - even proving lethal. So, if it’s so widespread,

  • why aren’t we all getting infected?

  • - Hi, my name is Vance Fowler. I'm an infectious disease doctor in the division of infectious

  • diseases at Duke University Medical Center. For the last twenty years or so, I've focused

  • on the clinical care, and the research around drug-resistant bacteria,

  • and staph aureus in particular.

  • Staphylococcus is a bacteria that lives on our skin. And about 40% of people on the planet

  • carry it on their body but are asymptomatic. So almost half of us are walking around unaware

  • that were carriers of staph.

  • And usually that’s just fine.

  • - There are many different kinds of staph, but the one that causes the greatest amount

  • of problems in human medicine is a bacteria called staphylococcus aureus. This is generally

  • the bacteria that people are referring to when they talk about a staph infection.

  • Staph aureus can be colonized in the nose, armpits, genital areas, and other parts of

  • the skin. And this colonization can go on for years, with the patient being totally

  • asymptomatic throughout much of their lives.

  • - Sometimes, for reasons that we really don't completely understand yet, this staph will

  • change from being a bystander to being trouble.

  • And when it makes that change, that trouble becomes an infection in your skin or soft tissues.

  • How this usually happens is with a break in the skin, allowing the infection

  • to enter the body and the bloodstream.

  • - And once you get staph in your blood, or staph aureus bacteremia, then things get a

  • lot more serious. The reason it gets serious is because now it has access to infect and

  • cause an infection in virtually any site in the body.

  • For example, it can cause pneumonia and involve the lungs. It can cause infections

  • in your bone, called osteomyelitis, and it can cause joint infections, cause arthritis,

  • and it can cause infections of your heart, cause endocarditis.

  • And this is what makes it unique in the bacterial world - its ability to cause a wide range

  • of medical concerns. This is because staph aureus has what are called virulence factors,

  • or things that allow it to cause infection.

  • - Basically, though, all of its virulence factors fall into one of two categories.

  • They're either adhesions,

  • which are proteins that allow the bacteria to stick to things that it doesn't need to

  • stick to, like heart valves, spines, bone... or toxins, which, generally speaking, are

  • involved in causing local damage to cells and tissue. So it will cause cell rupture,

  • cause tissue to break down and die.

  • With the help of these virulence factors, the bacteria can turn lethal

  • once it gets into the bloodstream.

  • - So wow, I know that sounds scary, and it is pretty serious. How do you know you have

  • a staph infection? The key thing about a staph infection is you're going to have

  • symptoms in the site that's involved.

  • Because staph mostly impacts the soft tissue, infections can look like a boil or abscess

  • that’s red, hot, swollen or seeping. Fortunately, these can mostly be treated with antibiotics.

  • - Some of the other forms of infection may be a little more subtle, and they may require

  • diagnosis in the hospital or in the emergency room. If you get staph in your bloodstream,

  • really the hallmark finding is fever and chills.

  • There’s another type of staph that is even more alarming: MRSA, or Methicillin-Resistant

  • Staphylococcus Aureus. It’s a concern not just because of its resistance to antibiotics,

  • but also because it’s showing signs of spreading into new territory.

  • - The epidemiology of MRSA has also changed over the years. Traditionally it was associated

  • almost exclusively with patients who had been in the hospital, or patients who had ongoing

  • contact with the medical system, for example, long-term care facilities, hemodialysis patients,

  • things like that.

  • But about fifteen years ago, something happened. People with absolutely no contact with the

  • health care system began to develop boils and abscesses due to a MRSA infection.

  • - Not only was this happening in the United States, but throughout other parts of the

  • world, other communities were experiencing basically the same phenomenon

  • of community-acquired MRSA infections.

  • So, why in the world did this happen? Well, that'sa great question and

  • honestly I wish I could tell ya.

  • It's probably like most things, a variety of several factors, but obviously

  • critical amongst that has got to be the overuse of antibiotics.

  • And while there’s no commercially available vaccine for staph aureus, there is

  • some encouraging progress with medical advances.

  • - One of the key elements that we're just beginning to understand

  • is the role of the host in causing and perpetuating staph infections.

  • The interplay between the bacteria and the host immunity is complex.

  • Ultimately, because staph aureus is so common, there are three main takeaways.

  • These are: preventionwashing your hands at home and in medical environments;

  • recognizing the symptoms early: boils, abscesses, and anything red or swollen;

  • and seeing your healthcare provider as soon as you see signs or feel ill.

  • - We understand now that there are things that we can do to help patients in the hospital

  • have a dramatically lower rate of developing staph infections.

  • So for example, daily chlorhexidine baths when they're in the Intensive Care Units.

  • While there have been setbacks in terms of new epidemiology, new outbreaks, the opioid crisis...

  • there's a lot of reason to have a good deal of optimism as well,

  • in terms of new drugs and better understanding.

Staphylococcus or, as it’s more widely known, staph, is one of the most common bacteria

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B1 中級

這種抗藥性細菌現在可能就藏在你的腋窩裡 (This Drug-Resistant Bacteria Could Be Hiding in Your Armpits Right Now)

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    林宜悉 發佈於 2021 年 01 月 14 日
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