Perilous Bug Is Creeping Onto the Streets. Once confined to hospitals,
drug-resistant and potentially deadly staph infections are rising
among general population, study finds
By Charles Piller, Times Staff Writer,
April 7, 2005, Los Angeles Times
Drug-resistant staph infections, once largely confined to hospitals,
are far more common in the general population than previously thought,
according to a study published today in the New England Journal of
Medicine. The study examined more than 1,600 cases of the infection
caused by a strain of Staphylococcus aureus in Baltimore, Atlanta and
Minnesota. Nearly one-fourth of those patients required
hospitalization. men and professional athletes. The latest study,
conducted by researchers from the Centers for Disease Control and
Prevention and several other institutions, confirmed that the organism
was now circulating widely in the general population. The CDC research
found that children younger than 2 were at higher risk, which could be
because children get more cuts and scrapes. Blacks in Atlanta were
found to be at higher risk than whites, the researchers found. "There
was a remarkable association of a large number of cases, all caused by
this drug- resistant strain," said Dr. Henry F. Chambers, a staph
expert at San Francisco General Hospital who wrote an editorial
accompanying the study. Common staph is present on the skin or in the
nostrils of about one in three people, typically without causing
illness. In previous research, the drug-resistant strain was found to
cause painful skin lesions that resembled infected spider bites, a
deadly lung disease known as necrotizing pneumonia, and toxic-shock
syndrome - a type of blood poisoning that can be fatal. But doctors
outside of hospitals typically don't look for drug-resistant staph,
and therefore don't order lab tests to verify the strain. Instead,
they routinely prescribe ineffective antibiotics, sometimes leading to
more severe illnesses and even deaths. In a separate article in the
journal, researchers reported that they have linked drug- resistant
staph infections to a rare, often-deadly disease known as necrotizing
fasciitis, or more commonly, ìflesh eatingî syndrome. ìNecrotizing
fasciitis is a terrible disease, but before now, Staph aureus was
never the cause," said Dr. Robert Daum, a pediatrics professor at the
University of Chicago and one of the first physicians to notice wider
circulation of drug-resistant staph. ìAntibiotic resistance and
virulence are converging," he said. "It's really disturbing."
Researchers reported 14 Los Angeles cases of necrotizing fasciitis - a
fast-spreading infection that kills skin, connective tissue and
muscle. The 14 patients were treated at Harbor-UCLA Medical Center in
2003 and 2004, but had contracted the disease before being admitted to
the hospital. All survived, though several required reconstructive
surgery. The disease typically kills one-third of its victims. Most of
the patients had risk factors for necrotizing fasciitis, including a
history of injected drug use or hepatitis C. But in an unsettling
finding, four victims had no apparent vulnerability. The few
antibiotics that kill the resistant staph strain are costly, and
likely to wane in potency over time, said Dr. Loren G. Miller, a
researcher at the Los Angeles Biomedical Research Institute, and lead
author of the study. "The problem is we are not developing new
antibiotics as fast as we used to because there are very few monetary
incentives for pharmaceutical companies to do that," Miller said. "The
bugs are about two."
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