Products from Dr. Eugene Guthery, M.D., Medical Director for the CRIWT

Urgent Need:
MRSA as seen by the Infectious Disease Society of America

“Recognized by the World Health Organization and the U.S. Centers for Disease Control and Prevention (CDC) as one of the greatest threats to human health worldwide, antimicrobial resistance takes a staggering toll in the United States and across the globe: 

• Just one organism, methicillin-resistant Staphylococcus aureus (MRSA), kills more
   Americans every year than emphysema, HIV/AIDS, Parkinson’s disease, and homicide
   combined. 
• Nearly 2 million Americans per year develop hospital-acquired infections (HAIs), 
   resulting in nearly 100,000 deaths – the vast majority of which are due to pathogens that
   are at least partially resistant to antibiotics.”

The problem of antimicrobial resistance has been duly noted by President Obama when he announced ‘The Antibiotic Resistance National Action Plan’ on 27 March 2015.  

One of the ‘nightmare’ pathogens is Staphylococcus aureus, specifically Methicillin-resistant Staphylococcus aureus (MRSA).  Staphylococci are the most frequent cause of surgical-site infections and blood-stream infections.  The most frequent site of colonization is the anterior nares.  Bactroban (mupirocin) was developed for MRSA in the early 1990s.  Similar to what occurs with any antibiotic for a resistant pathogen, the organism has become resistant to Bactroban.  Nasal decolonization has been shown to have clinical benefit when performed prior to certain surgical procedures and for all patients admitted to an Intensive Care Unit (ICU).  The ubiquitous use of mupirocin in these clinical settings will only exacerbate the resistance pattern of the pathogen.


Triseptin® Water-Aided Surgical Hand Scrub, Nasal Spray and other products for MRSA

Summary

Eugene Guthery, M. D.  is an internal medicine physician with subspecialty training in Clinical Pharmacology and Gastroenterology and
the inventor of the Triseptin® Water-Aided Surgical Hand Scrub.  He was granted U. S. Patent 6,110,908 on August 29, 2000.   It is currently sold on an non-exclusive basis as a water-aided antiseptic by CareFusion.

HWF (Health and Wellness Formulation, Inc) is interested in antiseptics, especially in products that would help control Methicillin-Resistant Staphylococcus aureus (MRSA).   The product would be sold with our malaria product to aid developing countries in their infectious care needs and on a non-exclusive basis to find markets in the U.S. in order to fight the very serious problem of antibiotic resistance (see the attachment Antibiotic Resistance Fact Sheet 2013 by the Infectious Disease Society of America).

An additional patent directed to controlling MRSA was granted on April  16, 2013 (United States Patent 8420627 entitled "Nasal, wound and skin formulations and methods for control of antibiotic-resistant staphylococci and other gram-positive bacteria").  This product is effective against ALL MRSA, VISA (vancomycin-intermediate Sensitive Staphylococcus aureus)and VRE (vancomycin-resistant enterococcus).  The product will kill > 200 million MRSA in one minute in vitro!!!  The Staph are killed by disintegration of the cytoplasmic membrane (See APMIS attachment).  The Staph can NOT become resistant to the product.

Background of MRSA Control

Currently, the recommendations to control MRSA include decolonization of surgical patients in all cases of open-heart surgery as well as any procedure in which a foreign body is placed (e.g., orthopedic and neurosurgical implant procedures) as especially high-risk operations, which would include any surgical procedure in patients whose immune systems are severely impaired, which would include any patient undergoing chemotherapy, patients that are admitted to the ICU.  The ICU patient standard of practice treatment receives Bactroban in the nose for five consecutive days and topical CHG (chlorhexidine gluconate) for as long as the patient is in the ICU.

Universal use of Bactroban is probably a bad idea as this will increase the number of MRSA strains resistant to this antibiotic (Lee, Andie S., Patrice François, Gesuele Renzi, et al.  Mupirocin resistance in methicillin-resistant Staphylococcus aureus and mupirocin consumption over ten years in a tertiary hospital; Wenzel NEJM Case Closed June 13, 2013).


Markets for the MERSA

Our MRSA antiseptic (without alcohol) against MRSA strains resistant to mupirocin (Bactroban) were tested at the University of Iowa. Only 30 microliters (0.03 ml) were needed to kill every strain of MRSA that is BOTH resistant to commonly used Methicillin and Bactroban brands. 

The Markets are found to include:

1) PreSurgical - Patient and surgical team
2) All ICU Patients, ICU nurses, and staff
3) Chronic Dialysis Clinics patients and staff (the cutaneous sites over
     dialysis catheters, nose and hands).
4) Athletic participants
5) Application in alcohol antiseptic gels for enhanced kill against MRSA.
6) Impetigo
7) Wounds
8) Burns