Antibiotic resistant bugs at the beach

Most people know that a good place to pick up an antibiotic resistant infection is in a hospital. Lots of pathogenic bugs there living (often) happily in a sea of antimicrobial agents. Better to stay away from hospitals, somewhere nice. But apparently, not at the beach:

A drug-resistant germ linked to surgical wound and urinary tract infections was found on five U.S. West Coast beaches, according to scientists who said the bacteria isn't usually seen outside of hospitals.

Samples of sand and water were taken from seven public beaches and a fishing pier in the state of Washington and southern California, according to a study reported today at a meeting of infectious diseases doctors in the nation's capitol. While the level of public risk is unknown, the beaches may help transmit the germ called enterococci, study authors said. (Elizabeth Lopatto, Bloomberg)

The enterococci are not the feared methicillin resistant Staph aureus (MRSA), but like Staph , the enterococci are also common colonizers of the human intestinal tract and female genital tract. Still, they sometimes cause infections, and when they do Vancomycin is the drug of choice. Like MRSA, too, these vancomycin resistant enterococci (VRE) have been almost entirely confined to the hospital environment (about one in 8 hospital acquired infections are from enterococci and 30% of these are VRE). This report suggests that VRE are following MRSA in moving into the community environment. While the most at risk are those with impaired immune systems or chronic medical conditions, we can expect cases of otherwise healthy people to be infected with VRE in the community.

There are other drugs that can be used to treat enterococcal infections but the existence of VRE means that treatment may be delayed because a course of Vancomycin is tried first. So this isn't a looming catastrophe, in and of itself. What it is, is a red flag about the spread of antibiotic resistant organisms into the general environment. How these bugs got to the beaches is something that needs examination, but sewage is a likely suspect.

Meanwhile, have fun at the beach. Try not to think about it.

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San Diego has always had the sewage from Tijuana come into "its" waters. I believe the City of San Diego built and paid for a sewage treatment plant for Tijuana many moons ago.
Haven't been to Tijuana in ages but would hold to the idea that improvement in Mexican living standards hasn't changed that much if at all.

What's very troubling about this is that VRE can pass the vancomycin resistance plasmid to MRSA, and then, for sepsis infections, the only thing we have left is colistin which can cause renal damage. Also, inappropriate initial treatment (i.e., treating VRE with vancomycin) has a significant effect on mortality and morbidity.

This is not good news.

Being a non scientist - I would have hoped the UV radiation from the sun and the salt from the water would have killed this type of bacteria..... how does this bacteria survive in such a harsh environment?

From a plumber's point of view:

Every year, the EPA hands out fines to cities that dump raw sewage into the ocean. The fine is greater if sewage gets into a bay or confined water source, so greater care is taken in treatment. How does it happen?

During rainy season, ground water infiltrates broken sewer pipes in both city mains and residential/commercial laterals.

This causes Sanitary Sewage Overflows overwhelming the capacity at sewage treatment plants. You may have seen sewage backing up manholes, flooding the streets during a storm. That's when the dumping takes place.

Doesn't surprise me that resistant bacteria are found along with the usual bacteria counts that render our beaches closed for a day or two...

Fortunately, cities have been proactively dealing with annual EPA fines by redirecting the fines toward paying up to half the cost of sewer replacements, thus helping the homeowner, the qualified plumber (the local economy) and the environment. Not enough cities are proactive, and who knows, it's always up to the EPA to agree to funding. Hopefully more will be available with a new administration.

As for San Diego, once they take care of their own SSO's why couldn't the respective governments work together to fix such an easily repaired problem?

Instead of wasting billions overseas, why not spend comparatively minute amounts where needed at home, infrastructure in dire need of repair? Only the ill informed would call that Socialism. I'd call it a "Country First" kind of prudent investment. That's why Obama must overwhelm with votes to prevent another stolen election.

That's what this plumber (who works with all the licensing, workmen's comp, various and sundry increasing insurance, etc) thinks. Joe, I am a plumber, I know plumbers, and you're no plumber!!

By Smelly Mel (not verified) on 01 Nov 2008 #permalink

SM: In my part of the country it isn't infiltration from groundwater but storm runoff that causes the Combined Sewer Overflows. The old combined systems handle about 40 times the volume in rain as they do with just domestic sewage so the treatment plants can't handle it and the raw sewage (but no very diluted) gets diverted vis the CSOs.

Every day I become more enamored of composting toilets. What is the logic of using clean water to move poop, anyway? Yes, I know, we "flush it and forget it!" Until we go to the beach, I guess.

Susan: I agree with you, although there are some hurdles to using them. They take up a fair amount of room in the floor below and in many places you are required to also have a flush toilet. I know the person who owns the Clivus multrum company and that's a good place to start if you want to try one.