Killer Hospital-Bred Infection Enters Broader Community
by
findingDulcinea Staff
An antibiotic-resistant variant of staph bacterium responsible for the deaths of children in three U.S. states appears in schools in Connecticut, Maryland and New York.
30-Second Summary
Methicillin-resistant Staphylococcus aureus, or MRSA, is untreatable with the most commonly used antibiotics.
The first cases of MRSA infection occurred in hospitals. But increasingly these potentially deadly germs are making their way into the community at large. The so-called “super-bug” recently claimed the lives of children in Virginia, Mississippi and New Hampshire.
A study by doctors from the Centers for Disease Control and Prevention has found that MRSA killed more than 18,650 Americans in 2005—more than were killed by AIDS that year.
The most vulnerable group is people with weakened immune systems, a class of person common to the hospital environments where the bug developed. But MRSA infections are increasingly afflicting young healthy individuals.
Indeed, 28 professional athletes, including NBA star Grant Hill, have been stricken with this bacterium, and many have suffered severe consequences.
MRSA moves quickly. It can multiply from one bug to 17 million within 24 hours.
It has traveled so quickly through community settings that doctors now speak of “Community Acquired” MRSA, to differentiate these cases from those believed to have commenced in a healthcare environments.
The first cases of MRSA infection occurred in hospitals. But increasingly these potentially deadly germs are making their way into the community at large. The so-called “super-bug” recently claimed the lives of children in Virginia, Mississippi and New Hampshire.
A study by doctors from the Centers for Disease Control and Prevention has found that MRSA killed more than 18,650 Americans in 2005—more than were killed by AIDS that year.
The most vulnerable group is people with weakened immune systems, a class of person common to the hospital environments where the bug developed. But MRSA infections are increasingly afflicting young healthy individuals.
Indeed, 28 professional athletes, including NBA star Grant Hill, have been stricken with this bacterium, and many have suffered severe consequences.
MRSA moves quickly. It can multiply from one bug to 17 million within 24 hours.
It has traveled so quickly through community settings that doctors now speak of “Community Acquired” MRSA, to differentiate these cases from those believed to have commenced in a healthcare environments.
Headline Links: Student Deaths, MRSA Kills More Than AIDS
MRSA has appeared in a significant number of U.S. newspaper headlines in recent weeks. A previously healthy 17-year-old high school student died on Oct. 15, 2007 after a week-long battle with MRSA. His classmates successfully demanded that the school be closed and sterilized.
Source: CNN
In early October, two children, an 11-year-old in New Hampshire and a 4-year-old in Mississippi, in addition to Ashton Bonds of Virgina, died from MRSA infections. Doctors are baffled: “We don't know why this organism began to mutate in this way in the community ... This community onset is by far the concern for us," stated Dr. Jaime Fergie, director of the pediatric infectious diseases unit at Driscoll Children's Hospital.
Source: ABC News
School officials in Delaware County, PA cancelled all after-school activities and disinfected the school after a high school student was infected with MRSA.
Source: NBC10
The recent deaths from and infections of MRSA, coincided with the release of a study from The Journal of American Medical Association, which has found that more Americans are killed each year by MRSA related infections than A.I.D.S.
Source: Dallas News
"Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States" was published on Oct. 17, in The Journal of American Medical Association. The abstract is free, however, the full text of the article requires subscription.
Source: The Journal of American Medical Association
Background: What is Staph?
“Staph” or Staphylococcus aureus is a form of bacteria carried on the skin and the most common type of skin infection. Between 25-30 percent of Americans are colonized (when bacteria are present, but not causing an infection) in the nose with staph bacteria. MRSA is a type of “staph” bacteria that is resistant to methicillin, oxacillin, penicillin and amoxicillin.
Source: Centers for Disease Control and Prevention
According to the CDC, it is estimated 94,360 persons developed a serious MRSA infection in 2005. Of those infected, 18,650 persons died from MRSA-related infections during a hospital stay. Approximately 85 percent of all invasive MRSA infections were associated with healthcare treatment, and 14 percent occurred in persons without obvious exposure to healthcare.
Source: Centers for Disease Control and Prevention
In 2005, through the Freedom of Information Act, Great Ormond Street hospital, an esteemed children’s hospital in London, reported 357 children under the age of three had been found with MRSA in the past five years. The hospital had originally stated that only seven children under the age of three had been infected with MRSA in the past three years.
Source: The Times of London
Historical Perspective: Prevalence of Antibiotics
Since the 1940s, when penicillin was first invented, over 150 different types of antibiotics have been created. Yet the prevalence of antibiotics has also meant the creation of “super-bugs,” which appear when an antibiotic fails to kill every bacteria it is formed to kill. Mayo Clinic explains that these superbugs can even exchange survival information with other bacteria—even different species—allowing additional drug-resistant organisms to emerge.
Source: Mayo Clinic
Reactions: Few Hospitals Reduce Rates of MRSA, Committee to Reduce Infection Deaths
"The real doomsday scenario now is that you have an increasing number of young fit people with Community MRSA, you have a flu epidemic that makes the lungs more susceptible to infection and then the MRSA will actually kill people very quickly,” stated Professor Richard James of Nottingham's Centre for Biomolecular Sciences.
Source: BBC News
Recent studies have indicated that MRSA rates are seven to eight times higher than the rates found in a 1999-2000 CDC study. "This is a real wake-up call, particularly for administrative and clinical leaders," states Assn. for Professionals in Infection Control & Epidemiology CEO Kathy L. Warye. "This study shows that infection control is really important, and MRSA prevention is at the top of the list."
Source: American Medical News
According to Dr. Morgan who has treated Methicillin-resistant Staphylococcus aureus (MRSA) cases at the Royal Devon and Exeter Hospital in Britain, “[MRSA] is the worst bug I have ever seen and people really need to know about it … It is untreatable. It multiplies very quickly. One bug will multiply into 17 million within 24 hours.” Doctors have found that a strain of MRSA, Community-Associated MRSA, is looming on playgrounds and in gyms rather than just hospitals.
Source: The Guardian
Betsy McCaughey, a former lieutenant governor of New York, is founder of the Committee to Reduce Infection Deaths. She criticizes the Centers for Disease Control and Prevention for not recommending the test of MRSA for all patients to stop the spread of the bacteria; this is despite the fact that ‘MRSA hospital related infections increased 32-fold from 1976 to 2003.
Source: The New York Times
Betsy McCaughey's site contains luminous information including 15 steps you can take to reduce your risk of a hospital infection.
Source: Committee to Reduce Infection Deaths
Through screening and strict hygiene measures, a few hospitals, including the Veteran’s Affairs Hospital in Pittsburgh, PA, have drastically cut the numbers of MRSA infections—in some cases by 78 percent. Yet, only a quarter of American hospitals use a methodological approach to screening for bacterial colonization. Terri Gerigk Wolf, the Director of director of VA Pittsburgh Healthcare Systems, explains: “People don’t believe it’s in their institution, and, if it is, that it’s too big to do anything about, that you just have to accept it.”
Source: The New York Times
In 1985, the University of Virginia Hospital adopted a program of identification, isolation and treatment of patients colonized with MRSA. In 1999, the hospital's number of reported cases of MRSA infections was 60 to 80 percent lower than comparable hospitals.
Source: Infection Control & Hospital Epidemiology
Related Links: CDC, The Association for Professionals in Infection Control and Epidemiology
The Minesota Department of Health offers MRSA information for healthcare professionals including clinical labs, information for labs and guidelines for healthcare facilities.
Source: Minesota Department of Health
Consumer Health Ratings provides reports that have been reviewed and selected by editors of the site about infections in hospitals as well as CA-MRSA.
Source: Consumer Health Ratings
Clinical trials including treatment for and studies on MRSA are available from the health aggregator Helia.
Source: Helia
The Association for Professionals in Infection Control and Epidemiology produced a study concerning the recent increasing rates of MRSA. The MRSA Prevalence Study recently found that 46 patients per 1,000 were colonized or infected with MRSA, which is eight to 11 times greater than previous estimates.
Source: Association for Professionals in Infection Control and Epidemiology
The American Academy of American Family Physicians has an online video about MRSA covering definition, epidemiology, clinical syndromes, abscesses and management.
Source: American Academy of American Family Physicians
The Center for Diseases Control and Prevention acts as an umbrella organization for MRSA research, prevention and surveillance through several networks including Dialysis Surveillance Network (DSN), which follows MRSA bloodstream infections and Healthcare Infection Control Practices Advisory Committee (HICPAC), which works to reduce the transmission of MRSA.
Source: Centers for Disease Control and Prevention
Reference: Prevention With Simple Solution, Treatment
“This disease is spread by close skin-to-skin contact, crowding, sharing contaminated items,” Nicole Coffin, a spokesperson at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, stated, "At this point, everybody in the community can be at risk for MRSA.”
Source: National Geographic
The Mayo Clinic recommends that people avoid sharing personal items such as towels and razors; keep wounds covered; sanitize linens; wash hands thoroughly and if one has a skin infection that requires treatment, request a test for MRSA. To avoid MRSA while in the hospital, ask all hospital staff to wash their hands before touching the patient, wash your own hands often, and make sure that all intravenous tubes are inserted and removed in sterile conditions.
Source: Mayo Clinic
Staph bacteria can live on the skin and not cause any health problems for its host. However, if the bacteria enters the bloodstream or the skin an infection can appear. Bacteria can also be transmitted from hand to mouth, which is why proper hand-washing is critical.
Source: The Wall Street Journal
Keep Kids Healthy suggests that athletes shower and wash with soap after all competitions and practices as MRSA can spread with indirect contact through workout areas and even clothes.
Source: Keep Kids Healthy
Several athletes including NBA star, Grant Hill, NFL player Junior Seau, have become stricken with MRSA after surgery. Yet, more athletes are contracting Community-Acquired MRSA in gyms and during practices. Mike Gansey, a former West Virginia Guard, had expected to be drafted in the NBA until he contracted MRSA; he was bedridden in the hospitals for two weeks. "You can't physically move. It feels like you got hit by a truck and you don't even know it," stated Gansey.
Source: ESPN
Texas A&M Health Science Center Institute of Biosciences and Technology at Houston researchers found an association between CA-MRSA and an aggressive, often fatal, form of pneumonia.
Source: Science
The American College of Emergency Physicians has urged its members to carefully screen all incoming patients for MRSA, and to discourage overusage of antibiotics, which can result in patients developing resistance to antibiotics, rendering them less effective to fight future infections.
Source: Infection Control Today Magazine
Opinions/Analysis: The Lancet, Mayo Clinic
The Lancet, a leading medical journal, criticized the call for a “deep clean” of British hospitals by Prime Minister Gordon Brown exclaiming that this decision was not based on scientific fact. The Journal argues that while the population may want “clean wards and crisp uniforms” the government must stop pandering to populism and instead concentration on the: "Disinfection of high-touch surfaces is what is needed, more so than removing visible dirt.”
Source: The Guardian
Although an Editor for Mayo Clinic, James M. Steckelberg, M.D., asserts that the public should be aware of how to avoid emerging infectious diseases like MRSA, he cautions the public from panicking. Dr. Steckelberg explains: “For people in developed nations, the risk of catching one of these diseases is very low. You're more likely to get food poisoning in your favorite restaurant than you are to contract an exotic illness … The best approach is to stay informed and take reasonable precautions, including—and this is both so simple and so critical—washing your hands thoroughly and often.”
Source: Mayo Clinic
The Health Editor of U.S. News & World Report, Dr. Bernadine Healy, explains that while MRSA can be fatal there are steps we can all take to avoid it: “It has such a simple, simple solution … that is wash your hands. Soap and water will do it. If there is any kind of infection … or wound cover it up.”
Source: U.S. News & World Report
In March of 2006, the Infectious Diseases Society of America released a ‘Hit List’ of the six top-priority drug resistant ‘super bugs’ including MRSA. The IDSA called on Congress to pass legislation that would encourage the pharmaceutical industry to develop drugs to combat these super bugs as pharmaceutical companies have a greater interest in creating life-long drugs, such as a cholesterol drug, as opposed to a week-long antibiotic.
Source: Infectious Diseases Society of America
By manipulating the compounds of the cell walls found in MRSA with a chemical barricade, researchers at Notre Dame University have found three new types of synthetic antibiotics, which seem to force MRSA to respond to medication.
Source: Scientific American
Omar Rivera, a 12-year-old Brooklyn middle school student, died of MRSA on Oct. 14. His middle school, IS 211 in Canarsie, waited until Oct. 25 to send home a letter informing parents that Omar had died of an MRSA infection. Parents interviewed by the Post were concerned by the delay. Among them was Joan Noble, whose son attends the school: "When the kids misbehave, they call us. With a case like this, I don't understand why we didn't get a phone call."
Source: The New York Post
Updates
Researchers from the University of East London have found allicin can treat the strongest strains of MRSA. Allicin is the ingredient that gives garlic its potent smell, yet, it has proved effective even when Vancomycin and Glycopeptides, two anti-biotics considered the last defense against MRSA, do not work. Results of a six-month study will be published in the Journal of Biomedical Science next year.
Source: The BBC
The former Deputy Commissioner of the Food and Drug Administration argues that we need new diagnostic tests and medicines rather than just preventive measures to battle MRSA. Dr. Gottlieb also argues that because antibiotics come with a lot of work, but not a lot of payoff, Pharmacuetical companies are not creating new antibiotics to fight such conditions as MRSA. “Since 1998, just 10 new antibiotics have been approved by the Food and Drug Administration, only two of which work in fundamentally new ways… if public-health policies compel doctors to hold the best new antibiotics in reserve, we need to compensate with incentives for developing those niche drugs,” explains Dr. Gottlieb.
Source: The Wall Street Journal
The New York Times examines the "hype" surrounding MRSA including whether the increase in MRSA is because MRSA is more prevalent than in previous years, or if there are more cases because there is better accounting of the disease.
Source: The New York Times
The Centers for Disease Control and Prevention covers basic questions and answers concerning MRSA. Questions answered include: Should students with MRSA skin infections be excluded from attending school and in what settings do MRSA skin infections occur?








