Drug-resistant germs on the rise, doctors warn.
More Americans acquiring hard-to treat staph infections. Dangerous
drug-resistant staph infections are showing up at an alarming rate
outside hospitals and nursing homes in the United States.
April 8, 2005, The Associated Press
New research found that in one part of the
country, as many as one in five infections were picked up out in the
community. Until recently, these hard-to-treat cases were seen only in
hospitals and other health-care settings where they can spread to
patients with open wounds or tubes and cause serious complications.
Now doctors are seeing resistant strains among inmates, children and
athletes. Researchers at the Centers for Disease Control and
Prevention suspected that those outside infections might just be
leaking out of hospitals rather than emerging from the general
population. But their study in Baltimore, the Atlanta area and
Minnesota proved that theory wrong. Germs ënow a community problem'
Overall, they found 17 percent of drug-resistant staph infections were
caught in the community and did not have any apparent links to
health-care settings. "Close to one-fifth of what used to be a
hospital-specific problem is now a community problem. And that's a
large number," said the CDC's Dr. Scott K. Fridkin. "We didn't think
it would be anywhere near that high when we started the study." Their
findings are published in Thursday's New England Journal of Medicine.
In a second study in the journal, researchers reported that
drug-resistant staph has acquired "flesh-eating" capabilities and
caused 14 cases of rare necrotizing fasciitis in the Los Angeles area.
All needed surgery and 10 were in intensive care. The condition is
usually caused by strep bacteria, and there has been only one other
confirmed case caused by staph. "The bugs are winning, unfortunately,
and we need to catch up," said Dr. Loren G. Miller, one of the
researchers at Harbor-UCLA Medical Center. "We really need to rapidly
develop antibiotics to catch up with the bugs and start using
antibiotics more appropriately." Staph bacteria are a common cause of
skin infections. Healthy people may carry the bacteria on their skin
and in their noses. When infections occur, they are mostly pimples and
boils, but the germ can cause serious surgical wound infections,
bloodstream infections and pneumonia. Three-quarters of the
community-acquired cases in the CDC study were skin infections, but 23
percent of the cases were serious enough to require hospitalization.
Staph bacteria resistant to the penicillin drug family are called
methicillin-resistant Staphylococcus aureus, or MRSA. The CDC
researchers checked up to two years of lab reports for drug-resistant
staph. More than 80 percent of the 12,553 cases were excluded because
the patients had been hospitalized, had a history of surgery or
dialysis or had another risk factor. Children at highest risk About 17
percent overall, or 2,107 cases, were determined to be
community-acquired staph. The rate was 20 percent in Atlanta, 12
percent in Minnesota and 8 percent in Baltimore. "When they got out in
the community, it was felt these strains weren't strong enough to make
it on their own. That no longer appears to be the case," said Dr.
Henry F. Chambers of the University of California at San Francisco,
who wrote an accompanying editorial. The CDC research found that
children under 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. In cases confirmed through interviews, half
were in people who shared a bedroom, and only about one in 10 were in
day care. Fridkin said the study may have underestimated
drug-resistant staph out in the community because not all cases are
sent to labs for analysis. Philip Tierno, director of clinical
microbiology at NYU Medical Center, said people can help prevent staph
infections by washing their hands, using an antiseptic and a bandage
on all cuts and scrapes, and avoiding the sharing of towels, razors,
clothing and athletic equipment. "People should be aware that
something that looks like an innocent infection might have a serious
consequence," said Tierno, who wrote "The Secret Life of Germs."
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