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Superbug Rates on the Rise

Hard-to-Treat C. diff, MRSA Infections Simultaneously Increasing in Many States
By
WebMD Health News
Reviewed by Louise Chang, MD

Oct. 30, 2008 (Washington D.C.) -- Hospitalizations for two nasty superbugs are simultaneously rising in many states, researchers say.

One is the potentially dangerous diarrhea bug known as Clostridium difficile, or C. diff. The other is methicillin-resistant Staphylococcus aureus, or MRSA, a bacterium that causes infections in different parts of the body, including the skin, the bloodstream, the lungs, and the urinary tract.

Both pathogens are tough to treat as they are often resistant to commonly used antibiotics.

From 2003 to 2005, hospitalizations rates rose in 23 of 26 states reporting these outcomes, says Andrew Ramsey, MPH, of the University of Massachusetts School of Public Health at Amherst.

Overuse of antibiotics may partly explain the trend, he tells WebMD.

The findings were presented at a joint meeting of the American Society for Microbiology and the Infectious Diseases Society of America.

C. diff vs. MRSA

Spores from C. diff enter our bodies through the mouth, which is the entryway for the gastrointestinal tract. The overgrowth of the C. diff bacteria in the colon or large intestine can cause diarrhea, which is often severe and accompanied by intestinal inflammation known as colitis.

Antibiotics can kill "good" bacteria in the colon that keeps C. diff at bay, explains M. Lindsay Grayson, MD, vice-chairman of the committee that chose which studies to highlight at the meeting and an infectious diseases specialist at Austin Health in Melbourne, Australia.

Infection often runs rampant in hospitals and nursing homes, where patients and health care workers are in close proximity. Typically, the bug can't be wiped out by standard cleaning agents, he tells WebMD.

The symptoms of MRSA depend on where you're infected. Most often, it causes mild infections on the skin, causing pimples or boils. But it can also cause more serious skin infections or infect surgical wounds, the bloodstream, the lungs, or the urinary tract.

It's tougher to treat than most strains of Staphylococcus aureus -- or staph -- because it's resistant to some commonly used antibiotics.

Active hygiene programs typically have more of an impact on MRSA than on C. diff rates, Grayson says. That's because it's spread by contact with people who carry the bug.

No matter which infection you have, experts say you should always make sure that health care providers thoroughly clean their hands with soap and water or an alcohol-based rub before and after caring for you.

Missouri Has Highest Rates, South Carolina the Lowest

For the new study, Ramsey and colleagues used data from the Healthcare Utilization Project of the Agency for Healthcare Research and Quality to examine rates of the two pathogens in U.S. hospitals from 2003 to 2005.

In the 26 states examined, there were 103 cases of MRSA per 100,000 people and 86 cases of C. diff per 100,000 people.

Missouri had the highest rates for both MRSA and C. diff, and South Carolina had the lowest rates of both.

New Jersey, California, and Hawaii were the only states in which rates of one of the infections dropped while the rates of the other increased.

Ramsey says the findings point to the need for prevention programs simultaneously targeting both C. diff and MRSA.

Additionally, close study of the three states in which rates of one infection rose while the other dropped may help to identify "what works and what doesn't," he says.

From the patient's point of view, Ramsey repeats what has become many doctors' mantra: Do not ask for antibiotics unless you have a bacterial infection they can fight. It's well known that overuse of antibiotics leads to the development of drug-resistant superbugs.

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