UK May Be Unprepared For CA-MRSA Say Researchers

Featured Article
Main Category: MRSA / Drug Resistance
Also Included In: Infectious Diseases / Bacteria / Viruses
Article Date: 28 Nov 2007 - 16:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

Researchers speaking at a conference in Cardiff, UK, earlier today, 28th November, said that while doctors don't know if CA-MRSA (community associated methicillin resistant Staphylococcus aureus) is likely to spread as fast in the UK as it has in the US, they are worried about it.

The new strains of CA-MRSA appear to stick to damaged skin and airways more easily than the hospital based MRSA strains prevalent in the UK, and they reproduce more quickly.

The researchers, led by Dr Marina Morgan from the Royal Devon & Exeter Foundation NHS Trust, told delegates at the Federation of Infection Societies Conference 2007 at the University of Cardiff, that if CA-MRSA spreads in the UK as fast as it did in the US, then many patients will be admitted to hospital with a wrong diagnosis and given the wrong antibiotics, and by the time doctors realise what is happening it could be too late.

CA-MRSA is mainly spreading in the US and is a major cause of infection among American children.

As Morgan explained:

"The new community associated MRSA strains appear to be more virulent and more easily spread between people."

"These community associated versions have been found in people with few, if any, reasons to have MRSA. Typically they haven't recently been in hospital, or / and are not looking after or living with people with MRSA," she added.

Compared with hospital MRSA the CA-MRSA strains respond to a wider range of antibiotics, but they are more virulent. The majority of them also produce a toxin called Panton-Valentine leucocidin (PVL) that kills white blood cells, the immune system's first line of defence against pathogens like staph.

Morgan said that:

"Although the resistant strain is not yet widespread in the UK, we have seen increasing numbers of PVL-toxin producing Staphylococcus aureus infections, mainly presenting with recurrent boils and abscesses."

The body responds by producing even more white blood cells to compenstate for those killed off by the first onslaught of PVL, and this produces the severe boils and abscesses, explained Morgan.

CA-MRSA is spread from human to human through close contact, so it spreads among family members, staff and children in nurseries, and also in athlectic teams, said Morgan.

Infection by the PVL form of MRSA can in a small proportion of cases lead to very severe infections like septicaemia and a deadly form of pneumonia called necrotizing pneumonia where the toxin eats away at lung tissue.

"With this type of necrotising PVL pneumonia, even with the strongest antibiotics, more than 60 per cent of otherwise healthy young and fit people will die," said Morgan.

Morgan went on to explain that these infections are easy to miss, and can be dismissed as recurrent boils. It is not until the infection becomes serious that doctors then realize it could something more serious.

"Then, with severe invasive infections like pneumonia, early diagnosis is vital as treatment with the correct antibiotics and massive doses of immunoglobulin can save children's lives," she explained.

According to the US Centers for Disease Control and Prevention (CDC), as a result of investigating CA-MRSA outbreaks among children, athletes, military recruits, Pacific Islanders, Native Americans, Alaskan Natives, men who have sex with men, and prisoners, there are certain factors that increase the risk of infection and spread. These factors include: close contact (skin to skin), open wounds or cuts or grazes, unclean surfaces and frequently touched items, crowded living conditions and poor hygiene.

To reduce risk of CA-MRSA infection, the CDC advises:

• Keep hands clean by washing thoroughly with soap and water, or an alcohol-based sanitizer.
• Clean and cover cuts and scrapes with a bandage until they are healed.
• Do not touch other people's wounds or bandages.
• Do not share personal items such as towels and razors.

Patients: click here for information on CA-MRSA (CDC).

Doctors: click here for information on CA-MRSA (CDC).

Written by: Catharine Paddock
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today