Staph Superbug Most Common Cause Of US Skin Infections

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Main Category: MRSA / Drug Resistance
Also Included In: Infectious Diseases / Bacteria / Viruses;  Dermatology;  Public Health
Article Date: 17 Aug 2006 - 9:00 PDT

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It is known as Methicillin-resistant Staphylococcus aureus (MRSA), or the Superbug. It is resistant to most standard antibiotics and is becoming more resistant to newer ones. MRSA is now the most common cause of skin infections in the majority of American cities, says Dr. G Moran, University of California, Los Angeles, David Geffen School of Medicine. He believes doctors should be giving patients who need antibiotics only those known to effectively combat MRSA. He says things have changed over the last ten years - a different type of bacteria is now the most common cause of infections.

You can read about this in the New England Journal of Medicine (NEJM), August 17 issue.

MRSA used to be known as just the 'Hospital Superbug'. It was found just in hospitals, nursing homes and some other health care facilities. It was very rarely found in the community - what is known as 'community associated infection' with MRSA used to be extremely rare. This is not the case any more. There are more and more cases of MRSA acquired in the community - outside hospitals.

MRSA is not an uncommon bacteria. Apparently about one third of us, and maybe more, carry it around with us in our nose, on our skin and in our throat. Most of the time it is harmless. However, it can occasionally lead to serious and potentially fatal infections. Something as insignificant as a paper-cut can lead to MRSA infection.

The most common sign of Community-Associated MRSA infection is a boil or pimple on the skin. It is often swollen, red, has a discharge, and is painful.

Researchers cultured soft-tissue infections from 422 patients at emergency rooms in 11 US cities. The first time any such study had been done of so many US cities.

59% of all those patients had MRSA infection. Infection rates in those 11 cities varied from 15% to 74%. 97% of the MRSAs were of one strain, called USA-300.

The researchers had expected MRSA to be the most common infection among the 422 patients. However, they were surprised that the USA-300 strain was so common throughout the country.

The following percentages of MRSA samples could be treated with the antibiotics listed below:

-- 100% trimethoprim-sulfamethoxazole
-- 100% rifampin
-- 95% clindamycin
-- 92% tetracycline
-- 60% fluoroquinolones
-- 6% erythromycin

However, 57% of the patients had been prescribed antibiotics which were useless against the MRSA - in other words, the MRSA was resistant to 57% of the antibiotics doctors had prescribed for the 422 people. Hence, doctors should prescribe antibiotics which are known to be effective against MRSA, because MRSA infection is now the most common skin infection in the USA.

There are many steps we can take to reduce the incidence of MRSA infection in the community. It all comes down to a question of basic hygiene. Wash your hands regularly with soap. You can go even further by not sharing towels and some other toiletries.

What is MRSA?

Staphylococcus aureus, a type of bacteria, is present in many people and generally causes no problems. If it gets inside the body, however, such as under the skin it can cause serious infections. If it gets into the lungs it can cause severe pneumonia. People who carry Staphylococcus aureus are generally healthy, and are just 'carriers'.

When Staphylococcus aureus becomes resistant to commonly used antibiotics it is called Methicillin-resistant Staphylococcus aureus (MRSA). Many years ago the most common antibiotic used to treat Staphylococcus aureus was Methicillin. Methicillin is no longer used as an antibiotic, except in identifying drug resistant Staphylococcus aureus.

Most healthy people will never get seriously ill from this bacteria. However, some people can, including children, seniors (the elderly) and people with weakened immune systems, such as people with diabetes or HIV.

Methicillin-Resistant S. aureus Infections among Patients in the Emergency Department
Gregory J. Moran, M.D., Anusha Krishnadasan, Ph.D., Rachel J. Gorwitz, M.D., M.P.H., Gregory E. Fosheim, M.P.H., Linda K. McDougal, M.S., Roberta B. Carey, Ph.D., David A. Talan, M.D., for the EMERGEncy ID Net Study Group
NEJMVolume 355:666-674 - August 17, 2006 - Number 7
Abstract

Written by: Christian Nordqvist
Editor: Medical News Today
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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