WEBVTT - Ep 15 MRSA: Make Resistance Susceptible Again 0:00:06.320 --> 0:00:10.280 Warning for the squeamish, this is about to get graphic. 0:00:12.360 --> 0:00:16.119 Inside Tony Love's fingers they found pockets of puss the 0:00:16.160 --> 0:00:19.000 size of nickels. There was one in the center of 0:00:19.040 --> 0:00:21.520 his hand. It was the size of a golf ball. 0:00:22.720 --> 0:00:26.600 Orthopedic surgeons probed Tony's hips and shoulders with a long, 0:00:26.720 --> 0:00:30.480 wide boarn needle, looking for infection trapped behind the joints 0:00:30.560 --> 0:00:35.280 cartilaginous sheaths. His left knee, the one he couldn't bend, 0:00:35.560 --> 0:00:38.720 was rigid and swollen. When they slid the needle in, 0:00:39.360 --> 0:00:43.280 puss pushed out under pressure, forcing back the base of 0:00:43.320 --> 0:00:47.240 the syringe. They got out enough to fill a baseball. 0:00:48.320 --> 0:00:51.560 One of the orthopedic surgeons sliced into Tony's left thigh 0:00:52.000 --> 0:00:55.920 and eased a part the muscles. There was puss underneath them, 0:00:56.200 --> 0:00:59.760 creamy and dull. There was too much to evacuate through 0:00:59.760 --> 0:01:02.640 the small incision they had cut, so they kept cutting, 0:01:03.280 --> 0:01:06.520 looking for the end of the pocket. They laid his 0:01:06.600 --> 0:01:09.679 thigh open from his knee almost to his hip joint. 0:01:10.120 --> 0:01:13.360 Wherever they cut they found a dense deposit of puss 0:01:13.480 --> 0:01:17.080 wrapped around the bone. They used a tool like a 0:01:17.160 --> 0:01:20.640 dentist jet to work it free, rinsing the cavity between 0:01:20.720 --> 0:01:23.720 bone and muscle with high pressure water and sucking the 0:01:23.760 --> 0:01:27.800 slurry away. The abscess was so deep that they could 0:01:27.840 --> 0:01:30.920 not trust they had cleaned out all the infection, and 0:01:30.959 --> 0:01:33.720 so they left the gash open. They wrapped it in 0:01:33.800 --> 0:01:36.840 dressings that would let the mess drain, and rolled him 0:01:36.840 --> 0:01:37.800 back to the ICU. 0:02:03.080 --> 0:02:06.480 I'm erin Welsh and i'm erin almond updyke. 0:02:06.680 --> 0:02:09.520 And you're listening to this podcast will kill you? 0:02:10.160 --> 0:02:10.760 Yep. 0:02:15.800 --> 0:02:17.040 Yeah, yikes. 0:02:17.280 --> 0:02:20.200 That's like pretty gnarly even for our standards. 0:02:20.200 --> 0:02:25.320 Oh absolutely wow. So that was a little excerpt adapted 0:02:25.360 --> 0:02:27.600 from Superbug by Maren McKenna. 0:02:27.960 --> 0:02:30.640 Shout out Marey McKenna making it grud. 0:02:30.520 --> 0:02:34.600 Oh my gosh. So it's it's part of Tony Love's story, 0:02:34.639 --> 0:02:37.519 who was a thirteen year old boy from Chicago who 0:02:37.560 --> 0:02:40.160 in two thousand and seven became infected with a deadly 0:02:40.240 --> 0:02:45.400 strain of Staphylococcus aureus, the star of our show today. Yeah, 0:02:45.440 --> 0:02:48.560 and this strain was not only methicine resistant, but also 0:02:48.680 --> 0:02:53.000 slightly resistant to vankamisin, which is the last resort antibiotic. 0:02:53.160 --> 0:02:56.840 But we're going to get all into that, so just wait. So, 0:02:56.880 --> 0:02:59.320 as you may have guessed, this week we are covering 0:02:59.520 --> 0:03:03.359 Staphla caucus oreus, specifically MERSA mersa. 0:03:03.800 --> 0:03:10.360 What is mersa so mersa is mephicillin resistant Staphylococcus aureus. Okay, 0:03:10.639 --> 0:03:13.119 we'll get into all of that, but first there's really 0:03:13.160 --> 0:03:16.600 important business we need to take care of that. It's 0:03:16.600 --> 0:03:17.919 what we're drinking. 0:03:19.120 --> 0:03:22.280 This week is a real doozy. I must say. Yeah, 0:03:23.280 --> 0:03:25.120 we've outdone ourselves even as. 0:03:25.040 --> 0:03:28.160 Far as quarantine needs go for us, Like we've we've 0:03:28.440 --> 0:03:31.600 tried some things. Yeah, and this time is. 0:03:32.200 --> 0:03:36.400 The visual is striking. We encourage you to make this 0:03:36.520 --> 0:03:40.360 please do, and then please post pictures of it, please 0:03:40.440 --> 0:03:48.520 do so. We are calling it hard to say without. 0:03:48.280 --> 0:03:53.160 Laughing, Fruit of the wound, Fruit. 0:03:53.000 --> 0:03:58.440 Of the wound, ladies and gentlemen. So it is a 0:03:58.480 --> 0:03:59.880 gorgeous looking cocktail. 0:04:00.080 --> 0:04:02.080 It's truly something spectacular. 0:04:02.320 --> 0:04:04.600 Basically a gin fizz with. 0:04:05.040 --> 0:04:07.600 A nice big old scoop of vanilla ice cream on top. 0:04:07.680 --> 0:04:13.680 Yeah, so that it slowly oozes down into the blood cavity. 0:04:13.360 --> 0:04:16.080 And make sure you top it with a cluster of grapes. 0:04:17.320 --> 0:04:20.360 Okay, I guess we should move past what we're drinking. Yeah, 0:04:20.400 --> 0:04:23.960 and I want to know what is STEPH forrius. 0:04:24.040 --> 0:04:45.760 Yeah, let's talk about it. Okay. 0:04:45.839 --> 0:04:50.479 So the first thing to know about MRSA, which is 0:04:50.520 --> 0:04:54.359 its colloquial name, I suppose, is it's it's kind of 0:04:54.400 --> 0:04:56.560 a weird one for us because most of the time 0:04:56.600 --> 0:04:59.680 when we cover a disease on this show, we're covering 0:04:59.720 --> 0:05:05.680 something pretty specific. Right, Tuberculosis is transmitted in a certain way, 0:05:05.880 --> 0:05:09.320 it causes a certain set of symptoms, blah blah blah. 0:05:09.040 --> 0:05:11.960 Right, and this is the epidemic and this is though 0:05:12.200 --> 0:05:13.200 exactly right. 0:05:13.640 --> 0:05:16.680 So MRSA is a little bit different because it's kind 0:05:16.680 --> 0:05:22.960 of a specific form of a specific pathogen that can 0:05:23.040 --> 0:05:30.400 cause so many different diseases, as we'll see. So MRSA, 0:05:31.600 --> 0:05:37.000 we already said it stands for methicillin resistant Staphyococcus oreus. 0:05:37.520 --> 0:05:40.120 So what is staph oreus? That's the first question that 0:05:40.200 --> 0:05:43.400 we have to answer, am I right, You're totally right, 0:05:43.440 --> 0:05:47.760 I know. So staph aureus is a gram positive coxi, 0:05:48.080 --> 0:05:51.080 which means it's a bacteria that's shaped like a ball. 0:05:51.480 --> 0:05:54.040 Okay, Weirdly, usually. 0:05:54.560 --> 0:05:58.800 I can say, you know, this bacteria is transmitted in 0:05:58.880 --> 0:06:03.920 this way like fecal, oral or respiratory droplets. 0:06:04.000 --> 0:06:04.160 Right. 0:06:04.240 --> 0:06:06.440 These are things that people who have been listening you 0:06:06.600 --> 0:06:09.359 know these terms, and you're familiar with them, right, But 0:06:09.520 --> 0:06:11.600 I'm not going to say any of those things right 0:06:11.640 --> 0:06:17.480 now because the thing about staff is it's absolutely everywhere. 0:06:18.560 --> 0:06:20.800 It just exists. 0:06:21.720 --> 0:06:25.720 So it's probably on your skin, it's in your nose, 0:06:26.160 --> 0:06:27.920 it's on your food, it's in your butt. 0:06:28.560 --> 0:06:33.000 We're talking staff oreas, not necessarily MRSA. 0:06:32.720 --> 0:06:35.680 Right, staff orious. So I'm going to focus on staff 0:06:35.680 --> 0:06:37.960 Orias for the whole first part of this biology section 0:06:38.160 --> 0:06:40.599 just so we can get a feeling for what bug 0:06:40.640 --> 0:06:41.760 we're talking about. 0:06:41.680 --> 0:06:46.000 And that would include both strains that are resistant like MRSA, 0:06:46.120 --> 0:06:49.800 but also ones that are completely susceptible to all antibiotics. 0:06:49.920 --> 0:06:54.039 Yes, exactly, staff orioas staff Orius. Yeah, the bigger, big 0:06:54.080 --> 0:06:59.440 old essay. Okay, So yeah, it's just it's everywhere. It's 0:06:59.760 --> 0:07:05.320 you know, it's probably statistically on at least one person 0:07:05.400 --> 0:07:08.239 in this house right now, just living on us. 0:07:08.600 --> 0:07:09.880 Yeah, thirty three percent. 0:07:10.000 --> 0:07:10.560 Yeah, there you. 0:07:10.520 --> 0:07:15.160 Go, boom, way to go. But most of the time 0:07:15.320 --> 0:07:18.640 it doesn't matter that it's everywhere. It just hangs out. 0:07:18.720 --> 0:07:21.400 It's like a mutual not even a mutualistic It's just 0:07:21.440 --> 0:07:24.400 like an organism that lives on you. It doesn't cause 0:07:24.440 --> 0:07:27.240 you harm. It probably doesn't do much that we know of. 0:07:27.360 --> 0:07:30.480 It just hangs out and it's fine. It exists as 0:07:30.520 --> 0:07:33.760 a part of you. But every once in a while 0:07:34.160 --> 0:07:38.480 it can cause disease. And honestly, because we try and 0:07:38.560 --> 0:07:41.280 keep these episodes in an hour, I can't even talk 0:07:41.320 --> 0:07:44.040 about all of the different diseases that it can cause, 0:07:44.480 --> 0:07:49.120 because that's just how many diseases staphylococcusorius can cause. 0:07:49.280 --> 0:07:50.080 It's so crazy. 0:07:50.200 --> 0:07:53.400 It causes these diseases like these, so many different diseases 0:07:53.560 --> 0:07:59.160 because it where it infects or how it infects or yeah. 0:07:59.280 --> 0:07:59.600 Both. 0:07:59.800 --> 0:08:03.760 So I'll go through some of the different things that 0:08:03.800 --> 0:08:06.600 you can get from staff, and then we'll talk more 0:08:06.640 --> 0:08:10.840 specifically about both MRSA and probably what most people think 0:08:10.920 --> 0:08:14.880 of when they think about a staff infection. Okay, okay, 0:08:15.240 --> 0:08:19.720 So first of all, there's a range of different diseases 0:08:19.800 --> 0:08:23.600 you can get from staff. You can get pneumonia if, 0:08:23.880 --> 0:08:28.000 for example, you get a viral infection in your respiratory 0:08:28.040 --> 0:08:32.600 tract that then maybe causes some damage and leaves you susceptible, 0:08:32.679 --> 0:08:36.319 like your immune system becomes compromised. Staph oureus that lives 0:08:36.320 --> 0:08:38.920 in your nose can sort of travel down into your 0:08:38.920 --> 0:08:44.200 respiratory tract, infect your lungs and cause pneumonia. Boom number one, 0:08:45.200 --> 0:08:49.880 number two. It can cause pretty long. It can cause 0:08:49.920 --> 0:08:54.120 what's called acute endocarditis, which acute just means rapid onset, 0:08:54.160 --> 0:08:57.520 which in this case also means more serious. Doesn't always. 0:08:58.559 --> 0:09:01.560 It can cause like a rapid onset that endocarditis, ENDO 0:09:01.720 --> 0:09:06.640 means inside card means your heart, like cardio itis is inflammation, 0:09:06.880 --> 0:09:11.440 So we're talking inflammation on the inside of your heart. 0:09:11.559 --> 0:09:13.960 Okay, that sounds pretty pretty dangerous. 0:09:14.000 --> 0:09:15.600 It's pretty bad. 0:09:16.240 --> 0:09:18.400 And we're not even talking about whether or not it's 0:09:18.440 --> 0:09:23.400 susceptible to antibiotics. This is just stapf orous grabbing on 0:09:23.679 --> 0:09:26.600 to your heart valves. No big deal, No big deal, 0:09:26.880 --> 0:09:27.600 Well big deal. 0:09:27.600 --> 0:09:32.040 Actually it's a huge deal. It's quite a big deal. Uh. Yeah, 0:09:32.080 --> 0:09:33.120 So that can happen. 0:09:33.360 --> 0:09:37.600 Uh. It's especially common in IVY drug users because staff 0:09:37.600 --> 0:09:41.080 can live on your skin. So if you inject into 0:09:41.120 --> 0:09:45.400 your veins through your skin, that bacteria can travel straight 0:09:45.480 --> 0:09:50.520 to your tri cuspid valve and grab hold fun. 0:09:50.120 --> 0:09:53.520 Try cuspid valve is in your heart, in your heart. 0:09:53.600 --> 0:09:55.959 Yeah, yeah, that's in your heart right side. 0:09:56.640 --> 0:09:58.640 Pretty cool, all right? 0:09:58.840 --> 0:10:05.120 Number three disease. It can also cause osteo myelitis. 0:10:05.640 --> 0:10:06.600 Break that down for me. 0:10:06.720 --> 0:10:12.000 Osteo bone Okay, Mile, I guess you don't know about 0:10:12.000 --> 0:10:14.920 that one. Ignore it itis inflammation. 0:10:14.640 --> 0:10:15.600 Bone inflammation. 0:10:17.559 --> 0:10:19.440 I really wanted to on Mile too. 0:10:19.720 --> 0:10:22.120 I mean, like Mile, like mayle In is sheath, so 0:10:22.160 --> 0:10:24.720 it must be sheath, I think, because I do think it. 0:10:24.720 --> 0:10:27.280 It affects like the very first layer of your bone. 0:10:27.800 --> 0:10:30.559 But it is like a bone infection that it can cause, 0:10:30.720 --> 0:10:34.800 super common in children. Probably what uh, your friend Tony 0:10:35.000 --> 0:10:38.439 Tony Tony Love not actually friends, but you know what 0:10:38.520 --> 0:10:41.520 I mean, our first hand account, our first Tony Love 0:10:41.840 --> 0:10:44.880 most likely had some form of osteomyelitis based on his symptoms. 0:10:44.920 --> 0:10:48.160 God sounds terrifying. It is. 0:10:48.320 --> 0:10:51.400 It's super scary, especially because in like super young kids, 0:10:51.440 --> 0:10:55.080 you'll just have this like crazy joint pain. And you know, 0:10:55.720 --> 0:10:58.120 if you're a parent or whatever, you're like, what could 0:10:58.160 --> 0:11:01.760 possibly be wrong? Like you might not have any visible 0:11:01.960 --> 0:11:05.360 outer issues, Like you had a scrape a couple of 0:11:05.400 --> 0:11:07.719 weeks ago that completely healed, and now all of a 0:11:07.760 --> 0:11:10.880 sudden you can barely walk because your knees infected with 0:11:10.960 --> 0:11:12.080 staff oreas. 0:11:12.360 --> 0:11:16.040 Kids are scraped all the time, they're rough and tumbled 0:11:16.120 --> 0:11:19.240 like you, I can't. I still have gravel embedded in 0:11:19.280 --> 0:11:23.600 my knees. I have some in my head, and so 0:11:23.760 --> 0:11:26.120 to think like, oh, well that must be the cause 0:11:26.160 --> 0:11:26.320 of it. 0:11:26.559 --> 0:11:27.640 Oh it's crazy. 0:11:27.920 --> 0:11:32.440 Yeah. It can also cause various forms of arthritis. So 0:11:32.480 --> 0:11:36.120 if it infects your joint rather than your bone directly, yeah, 0:11:36.200 --> 0:11:37.040 it's everywhere. 0:11:37.280 --> 0:11:38.679 Also not done. 0:11:40.320 --> 0:11:45.920 Staff Orias produces several toxins, right, so each of those 0:11:45.960 --> 0:11:48.080 could probably like we could have a whole episode on 0:11:48.120 --> 0:11:52.679 all the various toxins that staff Orias produces. But some 0:11:52.760 --> 0:11:55.360 of them you've probably heard about. So one of them 0:11:56.080 --> 0:12:01.120 is an exfoliative toxin. Doesn't that sound nice? It's foliant, 0:12:01.600 --> 0:12:04.559 great for your skin. Sure, Nope, it causes like your 0:12:04.600 --> 0:12:06.720 skin to just sluff off. 0:12:06.800 --> 0:12:08.680 I don't like the word sluff sluf. 0:12:09.360 --> 0:12:11.800 That's the word I'm gonna use. Yeah, it can also 0:12:11.920 --> 0:12:15.120 cause have you heard of it? Toxic shock syndrome? Oh yeah, 0:12:15.160 --> 0:12:17.599 oh yeah, that's staph orious bip. We're not going to 0:12:17.640 --> 0:12:20.120 get into soups detail about it because like, again, it 0:12:20.160 --> 0:12:23.480 could be a whole episode, but it's basically a toxin 0:12:23.600 --> 0:12:27.360 called it's called a super anigen because it basically makes 0:12:27.679 --> 0:12:30.959 your it's an anigen, which is something that that your 0:12:31.000 --> 0:12:34.640 body reacts to and makes antibodies against, and it makes 0:12:34.640 --> 0:12:39.160 your body make so many antibodies, like it is like all. 0:12:39.040 --> 0:12:40.520 The antibodies come to me. 0:12:41.160 --> 0:12:43.719 And so then your body goes crazy and it goes 0:12:43.720 --> 0:12:47.160 into shock because you just have so much immune system 0:12:47.400 --> 0:12:51.480 action that your body is like, can't just your immune 0:12:51.520 --> 0:12:56.640 system goes crazy kind of And that is from staph orious. 0:12:56.800 --> 0:12:58.160 Can I ask a stupid question? 0:12:58.280 --> 0:12:58.760 Of course? 0:12:59.640 --> 0:13:03.560 What is going on biologically with shock? 0:13:05.160 --> 0:13:07.880 I feel like that's a whole. That's a whole, but like, 0:13:07.920 --> 0:13:11.840 give me the So there's a lot of different forms 0:13:11.880 --> 0:13:16.040 of shock. There's septic shock, which usually is from some 0:13:16.160 --> 0:13:19.040 kind of bacterial infection, and then there's also things like 0:13:19.200 --> 0:13:24.600 cardiogenic shock, hypovolemic shop shock. All of these basically involve 0:13:24.679 --> 0:13:28.640 a drastic drop in blood pressure. So that's the underlying 0:13:28.679 --> 0:13:31.000 mechanism that's going to make you end up dying, is 0:13:31.000 --> 0:13:34.040 that your blood pressure essentially plummets, and then your organs 0:13:34.040 --> 0:13:37.240 start to fail because they're not getting blood perfusion to 0:13:37.320 --> 0:13:39.240 your organs, and then you die. 0:13:39.400 --> 0:13:40.800 Okay, yeah, cool, right. 0:13:40.679 --> 0:13:44.120 So toxic shocks and toxic shocks in wonderful. 0:13:44.120 --> 0:13:47.840 So shock induced by a toxin not done, by the way. 0:13:48.240 --> 0:13:49.880 Oh god, there's more. 0:13:51.000 --> 0:13:55.000 There's another toxin that it can produce that causes very 0:13:55.320 --> 0:13:59.120 rapid onset food poisoning. Drink that drink, air, and drink 0:13:59.160 --> 0:14:01.120 that drink. You're probably fine. 0:14:01.200 --> 0:14:04.600 Oh god, as the as the ice cream curdles. 0:14:04.320 --> 0:14:05.560 It does, it is curdling. 0:14:06.240 --> 0:14:09.200 But yeah, this food poisoning is like super super rad 0:14:09.760 --> 0:14:14.080 rapid onset, like within one to eight hours. Because what's 0:14:14.080 --> 0:14:17.040 basically happening is if you leave out a plate of 0:14:18.000 --> 0:14:21.000 let's say, spam and eggs, because that's a really good example, 0:14:21.240 --> 0:14:28.320 or for you Midwesterners, potato salad, okay, potato salad, mac salad, 0:14:28.360 --> 0:14:31.400 anything mayonnaise, meat. 0:14:31.160 --> 0:14:34.800 Anything that's called salad only because it has mayonnaise added 0:14:34.840 --> 0:14:35.080 to it. 0:14:35.280 --> 0:14:43.080 Yeah, yeah, truth, yeah yeah, salad, tuna salad. Yeah, you 0:14:43.160 --> 0:14:46.080 leave that out on the counter. It's covered in staff oreos. 0:14:46.120 --> 0:14:49.800 It's everywhere that staff aureus starts producing a toxin and 0:14:49.840 --> 0:14:51.880 then it just sits there. So then you're like, oh, 0:14:51.920 --> 0:14:53.920 I forgot, I'll put this back in the fridge. It 0:14:53.960 --> 0:14:57.440 doesn't matter. The toxin's already there. And then you're gonna 0:14:57.440 --> 0:15:01.000 eat that mac salad because it was so good yesterday. 0:15:01.360 --> 0:15:04.040 And then eight hours later you're barfing all over the 0:15:04.040 --> 0:15:07.240 place and it is preferentially barfing and not diarrheating. 0:15:07.480 --> 0:15:10.600 So interesting. Okay, yeah, okay, So if you ever have 0:15:10.720 --> 0:15:12.360 food poisoning, barf. 0:15:12.200 --> 0:15:14.760 Yeah, like super right after you ate something where you 0:15:14.800 --> 0:15:17.400 were like, I probably shouldn't have eaten that. Oh god, 0:15:17.440 --> 0:15:19.160 probably it was my wrap. 0:15:19.680 --> 0:15:21.600 Today you're not barfing. 0:15:21.400 --> 0:15:24.040 Yet, not yet. It's almost eight hours. 0:15:24.120 --> 0:15:28.320 Yeah, So that's a lot. That is a lot, and 0:15:28.360 --> 0:15:32.640 there's one more. This is crazy, isn't it crazy that 0:15:32.760 --> 0:15:34.960 all of these different things can be caused by the 0:15:35.000 --> 0:15:35.960 same bacterium. 0:15:36.920 --> 0:15:38.480 It's bizarre, is what it is. 0:15:38.520 --> 0:15:42.720 It's so it is so so interesting to me. But 0:15:42.880 --> 0:15:47.120 probably the most common thing that people associate with staph infections. 0:15:47.120 --> 0:15:50.080 I know what I used to associate with staff infections 0:15:50.600 --> 0:15:53.400 goes a little something like this. I saw a bump. 0:15:54.320 --> 0:15:56.280 Maybe it was on my butt, maybe it was on 0:15:56.360 --> 0:15:56.840 my arm. 0:15:57.200 --> 0:15:58.840 I don't know. I just had a bump. 0:15:59.160 --> 0:16:01.040 I thought it was a pimp, so I tried to 0:16:01.040 --> 0:16:03.800 pop it, or maybe I thought it was a bug bite, 0:16:03.800 --> 0:16:05.640 but it didn't itch. So I was like, that's kind 0:16:05.640 --> 0:16:08.200 of weird, huh. But it's just like a bug bite, 0:16:08.200 --> 0:16:09.440 it's fine, it's gonna go away. 0:16:09.520 --> 0:16:10.680 Maybe a spider bite. 0:16:10.720 --> 0:16:15.680 Maybe definitely a spider bite, but it wasn't. And then 0:16:16.040 --> 0:16:18.920 it just didn't go away. And then the next day 0:16:19.240 --> 0:16:21.280 it was kind of bigger and it was kind of 0:16:21.320 --> 0:16:26.080 like leaking and oozing. And then the next day my 0:16:26.400 --> 0:16:30.280 entire butt was covered in a giant, bloody pussy absss. 0:16:31.360 --> 0:16:35.240 It was just oozing and it was bleeding. Oh God, 0:16:35.600 --> 0:16:37.400 this did not happen to me, by the way I'm 0:16:37.440 --> 0:16:40.080 saying me, but I'm just saying the royal me. 0:16:40.320 --> 0:16:40.960 It could have. 0:16:41.240 --> 0:16:41.720 It could have. 0:16:42.720 --> 0:16:46.920 Luckily it hasn't as much as I'm willing to say 0:16:46.960 --> 0:16:52.800 at least. But that's sort of the classic staph infection, 0:16:52.880 --> 0:16:55.480 and that would be a staff skin infection. Okay, Right, 0:16:55.560 --> 0:16:59.080 So staff gets into any kind of open wound, super 0:16:59.120 --> 0:17:01.920 common to happen after shaving, where you get like infected 0:17:01.960 --> 0:17:02.800 hair follicles. 0:17:03.240 --> 0:17:06.000 Stop shaving your puobes peopes. 0:17:06.240 --> 0:17:11.240 Seriously, seriously seriously. And yeah, and so that's kind of 0:17:10.960 --> 0:17:13.720 the prototypical staph infection. 0:17:14.080 --> 0:17:15.560 YEA, that is skin infection. 0:17:16.040 --> 0:17:19.360 You end up with this open, absessing wound that kind 0:17:19.359 --> 0:17:22.880 of just doesn't heal and maybe keeps growing or maybe 0:17:22.960 --> 0:17:25.880 kind of stays the same size but just doesn't heal. 0:17:25.960 --> 0:17:29.040 Like you put neosporin on it and it just doesn't 0:17:29.040 --> 0:17:35.360 go away. So that's super common, and that's staff areous. 0:17:36.160 --> 0:17:39.680 How crazy it is that staff can infect so much 0:17:39.680 --> 0:17:42.480 of your body? Yeah, right, like so many different parts. 0:17:43.480 --> 0:17:47.000 So one of the questions is how on earth can 0:17:47.040 --> 0:17:47.720 it actually do that? 0:17:48.119 --> 0:17:48.320 Right? 0:17:48.440 --> 0:17:51.520 Like, how can it infect your lungs and give you 0:17:51.520 --> 0:17:54.480 pneumonia but also give you a skin infection? Like that's weird. 0:17:54.520 --> 0:17:56.919 It's like the jack of all trades bacteria. 0:17:57.200 --> 0:17:58.280 Yeah, it really is. 0:17:58.880 --> 0:18:01.280 So there's a few different and it manages to do 0:18:01.320 --> 0:18:05.240 this and it mostly just centers around evading your immune 0:18:05.240 --> 0:18:08.640 system full stop. Okay, it's just kind of really good 0:18:08.640 --> 0:18:10.919 at that. So one of the things it does is 0:18:11.000 --> 0:18:13.639 produce exotoxins, which we already talked about, right, some of 0:18:13.680 --> 0:18:18.880 the toxin mediated diseases like toxic shock syndrome and barfing 0:18:18.880 --> 0:18:24.520 food poisoning for example. Okay, but it also has another 0:18:24.600 --> 0:18:27.960 way that it is able to cause disease, and that's 0:18:28.000 --> 0:18:31.200 by this particular surface protein that it has. It's called 0:18:31.320 --> 0:18:34.879 protein A, which is not creative, but it basically is 0:18:35.000 --> 0:18:39.120 just a protein that is really good at both evading 0:18:39.160 --> 0:18:42.239 our immune system, So it's good at hiding from our 0:18:42.240 --> 0:18:47.360 immune system and it's really good at invading our epithelial cells. 0:18:47.880 --> 0:18:53.240 And epithelium are the cells that line basically everything in 0:18:53.280 --> 0:18:57.160 your body. So your skin is epithelium, but also the 0:18:57.200 --> 0:19:00.520 inside of your lungs that's epithelium, The inside of your 0:19:00.520 --> 0:19:06.239 heart also epithelium. Your entire GI tract also epithelium. So 0:19:07.119 --> 0:19:11.640 this protein allows it to invade those cells very very easily. 0:19:11.840 --> 0:19:16.399 Okay, So this bacterium lives on the surface of a 0:19:16.520 --> 0:19:20.359 lot of our body, Yes, but it also possesses the 0:19:20.480 --> 0:19:23.679 key to invade the surface of our body. 0:19:23.880 --> 0:19:24.240 Yes. 0:19:24.280 --> 0:19:27.640 That seems highly sus right. 0:19:29.880 --> 0:19:31.720 It is. It's a highly sub. 0:19:31.560 --> 0:19:36.560 I think I use that perfectly correctly, perfectly correctly. So 0:19:36.800 --> 0:19:38.920 can we talk for a second about resistance. 0:19:39.200 --> 0:19:43.000 Yeah, that's I think what we need to talk about now. Okay, So, yeah, 0:19:43.000 --> 0:19:48.639 so Mursa is a resistant form of this horrible staff 0:19:48.680 --> 0:19:50.040 bacteria that we've. 0:19:49.880 --> 0:19:50.680 Been talking about. 0:19:51.400 --> 0:19:57.040 So antibiotic resistance in general just for people who might 0:19:57.040 --> 0:20:00.439 not be aware. Just means that when you try and 0:20:00.520 --> 0:20:05.080 give somebody an antibiotic, which normally would help cure an 0:20:05.119 --> 0:20:08.240 infection of bacteria, it doesn't work. 0:20:09.000 --> 0:20:09.480 Okay. 0:20:09.760 --> 0:20:13.080 MRSA happens to be a strain of staff aureus that 0:20:13.200 --> 0:20:16.760 is resistant to what are called beta lactam antibiotics, which 0:20:16.840 --> 0:20:22.480 means like methicillin, penicillin, a bunch of the sillins, silins, ellins, chillins. 0:20:25.280 --> 0:20:27.879 And the way that it does that, it's basically just 0:20:28.119 --> 0:20:33.160 changes a protein so that the antibiotic can't bind. 0:20:32.960 --> 0:20:34.960 To it anymore. Okay, it was pretty much it. 0:20:35.640 --> 0:20:37.320 But I know the question that you want to know 0:20:37.640 --> 0:20:42.760 is how on earth can it become resistant? 0:20:42.920 --> 0:20:43.200 Yeah? 0:20:43.280 --> 0:20:46.720 Right, like, how how does that happen? I want to 0:20:46.760 --> 0:20:48.680 talk for like an hour about this. 0:20:48.840 --> 0:20:52.320 Oh that sounds like a great idea. Should we maybe 0:20:52.320 --> 0:20:55.160 do a future antibiotic? 0:20:55.520 --> 0:20:59.160 I think, yeah, We're going for antibiotics, antibiotics and antibiotic 0:20:59.240 --> 0:21:01.879 resistance because it is really fascinating the way, like the 0:21:01.920 --> 0:21:07.399 evolutionary arms race that happens between a bacteria and what 0:21:07.440 --> 0:21:10.479 you treat it with. Most of the antibiotics that we 0:21:10.680 --> 0:21:15.880 have actually come from other bacteria. Or fungi or plants. 0:21:16.240 --> 0:21:20.000 So these are substances that are produced in nature in 0:21:20.119 --> 0:21:24.520 order to fight off bacterial infections that invade them. So 0:21:24.800 --> 0:21:27.600 whether it's a bacteria fighting off another bacteria, or a 0:21:27.640 --> 0:21:30.120 fungus trying to fight off a bacterial infection. 0:21:29.960 --> 0:21:30.560 Or what have you. 0:21:31.040 --> 0:21:35.200 And so bacteria are constantly evolving ways to fight off 0:21:35.440 --> 0:21:39.760 these defenses, and then other bacteria and funguses and plants 0:21:39.800 --> 0:21:43.560 and people are constantly evolving ways to try and fight 0:21:43.600 --> 0:21:48.800 off those bacteria. But basically what can happen is that 0:21:49.359 --> 0:21:53.880 once you get a mutation, for example, in the case 0:21:53.880 --> 0:22:00.000 of MRSA in this single protein, essentially you can then 0:22:00.160 --> 0:22:03.600 change this protein just enough that this antibiotic can no 0:22:03.680 --> 0:22:10.960 longer bind. Once that single bacteria has that protein, anytime 0:22:11.040 --> 0:22:15.240 you give it penicillin or methicillin, it's gonna survive, which 0:22:15.280 --> 0:22:17.840 means it's gonna still hang out in your body and 0:22:17.960 --> 0:22:22.440 reproduce and reproduce. So now that the new colony that's 0:22:22.480 --> 0:22:25.119 in your body now or in your nose is now 0:22:25.440 --> 0:22:29.240 all of them are resistant. And even if you have 0:22:29.480 --> 0:22:33.520 other bacteria, like let's say you've got like six different 0:22:33.600 --> 0:22:36.280 kinds of staff living on your body, because that's not insane. 0:22:36.320 --> 0:22:39.800 Staff is everywhere, right, Once you start hitting those staff 0:22:39.840 --> 0:22:44.119 with an antibiotic, if there's one that happens to be resistant, 0:22:44.680 --> 0:22:47.879 bacteria can do something called conjugation, which is kind of 0:22:47.920 --> 0:22:52.320 like bacteria sex yep. Basically they can give each other 0:22:52.480 --> 0:22:57.040 the ability to also resist penicillin, and so it can 0:22:57.160 --> 0:23:02.440 spread both by a single bactium replicating, but it can 0:23:02.520 --> 0:23:06.320 also spread from bacterium to bacterium via conjugation. 0:23:06.640 --> 0:23:10.359 And it's really more it becomes a numbers game. Yeah. 0:23:10.400 --> 0:23:11.440 Absolutely, you just have. 0:23:11.640 --> 0:23:21.680 So many bacteria reproducing or replicating that one just by probability, Yeah, 0:23:22.359 --> 0:23:25.920 to evolve that mutation exactly right, or it's going that 0:23:25.920 --> 0:23:28.920 that mutation will emerge and then it will. 0:23:28.920 --> 0:23:34.120 Spread in that population. Yeah, yeah, yeah exactly. So yeah, 0:23:34.440 --> 0:23:37.080 that's pretty much. That's pretty much MERSA in a nutshell. 0:23:37.119 --> 0:23:41.280 It's not an all bad news game because most MRSA 0:23:42.080 --> 0:23:45.399 is still susceptible to another antibiotic called vanko mycin. 0:23:45.920 --> 0:23:47.680 Okay, okay, so we it's not. 0:23:47.600 --> 0:23:51.880 Like we've run out completely of treatment options, but yeah, 0:23:51.960 --> 0:23:54.479 I mean that it's it is really scary because if 0:23:54.520 --> 0:23:57.560 you don't identify an infection as a MERSA infection and 0:23:57.600 --> 0:24:01.639 you start treating it with penicillin or methicillin, it's not 0:24:01.640 --> 0:24:04.760 going to do anything, and in some cases it might 0:24:04.760 --> 0:24:07.400 make it worse because now you're going to have, you know, 0:24:08.000 --> 0:24:14.040