April 20, 2004 -- A dangerous antibiotic-resistant infection once primarily confined to hospitals appears to be spreading in communities, affecting children and otherwise healthy people.
In years past, methicillin-resistant staphylococcus aureus (MRSA) was seen almost exclusively among very sick hospital patients. However, in recent years, an increasing number of reports of MRSA in the community have surfaced. And this week new research detailing alarming outbreaks of MRSA infection on opposite ends of the U.S. was presented in Philadelphia at the annual meeting of the Society from Healthcare Epidemiology of America.
MRSA has already been dubbed "the Superbug" in England, where an 11-fold increase among children has occurred during the past decade, according to a study in last month's Archives of Disease in Childhood.
Staph aureus is a group of bacteria commonly found on the skin. When skin is cut or scraped, the bacteria can enter the body and cause a relatively common skin infection. But when these bacteria become resistant to antibiotics, as is the case with MRSA, they can spread to cause pneumonia, bone infections, or life-threatening infections of the bloodstream.
One place that MRSA has been seen more recently is among athletes in contact sports. In fact, Drew Gooden of the Orlando Magic basketball team was hospitalized last month for MRSA infection resulting from infected hair follicles on his leg. The infection was repeatedly drained and he needed three days of intravenous drug treatment.
"But now we're seeing it in people outside a hospital setting," says Nancy Church, RN, manager of infection control at Providence St. Vincent Medical Center in Portland, Ore. "We're seeing it in people being brought to our hospital for treatment for it."
Last summer, she says, 10 patients were brought to her hospital's emergency room with MRSA infection that also proved to be resistant to powerful antibiotics.
"Most were young adults," she tells WebMD. "First, we were seeing it among those who played contact sports and were IV drug users or had HIV. Then we started to see it outside the realm of contact sports and drug use, in those with no known risk factors." As with Gooden, their infections needed to be drained and treated with intravenous medications to prevent further complications.
On the other end of the country, another researcher says the number of kids brought to Children's Hospital of Philadelphia for treatment of antibiotic-resistant staph infections doubled between 2001 and 2003. About half of the 79 children had no known risk factors that would have increased their risk for MRSA infection.
What is alarming is that many of these infections developed in cuts, scrapes, insect bites, and other minor injuries that occur everyday in active young children, says Susan Coffin, MD, the facility's medical director of infection prevention and control. "It's unclear why, but these resistant bacteria now occur in children who are otherwise healthy," she tells WebMD.
Church says that it's believed that the rash of outbreaks detailed in both hospitals likely results from the overuse of antibiotics. "But it's clearly not the same genetic strains as we've seen in hospitalized patients."
Both experts say their studies should serve as a warning to prevent potential problems. Their advice:
- Thoroughly wash any open wound with soap and water, no matter how minor it appears, and continue to keep it clean.
- Wash hands frequently -- especially before touching any wound.
- Avoid sharing towels, combs, soap, and other items that touch skin.
- Get prompt medical attention for any skin wound that leads to a fever or develops a blister, boil, redness, or swelling -- symptoms of possible staph infection.
"These infections can easily be controlled if they are diagnosed early and treated with antibiotics to which they are not resistant," says Coffin. "Any serious-looking skin infection should be promptly seen by a doctor."