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2007-8-31 15:12:19 |
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The incidence of community-acquired antibiotic-resistant staph infections increased almost seven-fold in Chicago's Cook County Hospital system between 2000 and 2005, according to a study published in the May 28 issue of Archives of Internal Medicine. Methicillin-resistant Staphylococcus aureus (MRSA) infections-which do not respond to standard antibiotic treatments-have been often associated with hospitals and other health care environments. But begining in 1998, a community-associated form of the bacteria (CA-MRSA) emerged globally, according to the study reprot. Risk factors for CA-MRSA include jail or prison time, exposure while playing certain sports, intravenous drug use, overcrowded housing, tattooing and poor hygiene. "An understanding of factors promoting acquisition and emergence of CA-MRSA may aid in the development of prevention strategies," the authors write. For the study, Bala Hota, M.D., M.P.H., and colleagues at Rush University Medical Center and John H. Stroger Jr. Hospital of Cook County, Chicago, examined tissue, fluid and bone cultures at the 464-bed public hospital and its associated clinics between 2000 and 2005. They restricted their study to patients with infections of community onset, not hospital onset, to understand infection rates in the community; patients studied were those who did not have recent hospitalizations, MRSA infection or other health care exposures. To determine characteristics associated with CA-MRSA, 518 community-onset cases that occurred between 2001 and 2004 were compared with 704 controls who had community-associated methicillin-susceptible Staphylococcus aureus (CA-MSSA), which responds to methicillin-like antibiotics. "The incidence of CA-MRSA skin and soft tissue infections increased from 24 cases per 100,000 people in 2000 to 164.2 cases per 100,000 people in 2005," the authors write. The number of infections susceptible to antibiotics remained stable over this time, indicating that MRSA occurred in addition to and not in place of MSSA. For MRSA, "risk factors were incarceration, African-American race/ethnicity and residence at a group of geographically proximate public housing complexes; older age was inversely related." "Why CA-MRSA has emerged at such a rapid rate remains unclear," the authors write. Hospitals and long-term care facilities have long been thought to be "epicenters" for antimicrobial resistance, promoting cross-transmission of resistant bacteria because individuals with and without the bacteria are housed at the same location. These findings suggest that prisons, public housing and other community settings also may promote cross-transmission because large at-risk populations remain together for long periods of time. "In conclusion, among Cook County Hospital patients, the rate of CA-MRSA skin and soft tissue infections increased rapidly between 2000 and 2005, adding significantly to the overall burden of staphylococcal disease," the authors write. "Epidemiological analysis suggests that control measures could focus initially on core groups that have contributed disproportionately to risk, although CA-MRSA becomes endemic as it disseminates within communities." Contact: Don Rashid 312-864-0070 JAMA and Archives Journals (The release was slightly edited by foodconsumer.org) For more information about CA-MRSA, read the following cited from cdc.gov. Released: February 3, 2005 What is Staphylococcus aureus (staph)? Staphylococcus aureus, often referred to simply as "staph," are bacteria commonly carried on the skin or in the nose of healthy people. Approximately 25% to 30% of the population is colonized (when bacteria are present, but not causing an infection) in the nose with staph bacteria. Sometimes, staph can cause an infection. Staph bacteria are one of the most common causes of skin infections in the United States. Most of these skin infections are minor (such as pimples and boils) and can be treated without antibiotics (also known as antimicrobials or antibacterials). However, staph bacteria also can cause serious infections (such as surgical wound infections, bloodstream infections, and pneumonia). What is MRSA (methicillin-resistant Staphylococcus aureus)? Some staph bacteria are resistant to antibiotics. MRSA is a type of staph that is resistant to antibiotics called beta-lactams. Beta-lactam antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin. While 25% to 30% of the population is colonized with staph, approximately 1% is colonized with MRSA. Who gets staph or MRSA infections? Staph infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems. These healthcare-associated staph infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia. What is community-associated MRSA (CA-MRSA)? Staph and MRSA can also cause illness in persons outside of hospitals and healthcare facilities. MRSA infections that are acquired by persons who have not been recently (within the past year) hospitalized or had a medical procedure (such as dialysis, surgery, catheters) are know as CA-MRSA infections. Staph or MRSA infections in the community are usually manifested as skin infections, such as pimples and boils, and occur in otherwise healthy people. How common are staph and MRSA infections? Staph bacteria are one of the most common causes of skin infection in the United States and are a common cause of pneumonia, surgical wound infections, and bloodstream infections. The majority of MRSA infections occur among patients in hospitals or other healthcare settings; however, it is becoming more common in the community setting. Data from a prospective study in 2003, suggests that 12% of clinical MRSA infections are community-associated, but this varies by geographic region and population. What does a staph or MRSA infection look like? Staph bacteria, including MRSA, can cause skin infections that may look like a pimple or boil and can be red, swollen, painful, or have pus or other drainage. More serious infections may cause pneumonia, bloodstream infections, or surgical wound infections. Are certain people at increased risk for community-associated staph or MRSA infections? CDC has investigated clusters of CA-MRSA skin infections among athletes, military recruits, children, Pacific Islanders, Alaskan Natives, Native Americans, men who have sex with men, and prisoners. Factors that have been associated with the spread of MRSA skin infections include: close skin-to-skin contact, openings in the skin such as cuts or abrasions, contaminated items and surfaces, crowded living conditions, and poor hygiene. How can I prevent staph or MRSA skin infections? Practice good hygiene: Keep your hands clean by washing thoroughly with soap and water or using an alcohol-based hand sanitizer. Keep cuts and scrapes clean and covered with a bandage until healed. Avoid contact with other people’s wounds or bandages. Avoid sharing personal items such as towels or razors. Are people who are positive for the human immune deficiency virus (HIV) at increased risk for MRSA? Should they be taking special precautions? People with weakened immune systems, which include some patients with HIV infection, may be at risk for more severe illness if they get infected with MRSA. People with HIV should follow the same prevention measures as those without HIV to prevent staph infections, including practice good hygiene, cover wounds (e.g., cuts or abrasions) with clean dry bandages, avoid sharing personal items such as towels and razors, and contact their doctor if they think they have an infection. Can I get a staph or MRSA infection at my health club? In the outbreaks of MRSA, the environment has not played a significant role in the transmission of MRSA. MRSA is transmitted most frequently by direct skin-to-skin contact. You can protect yourself from infections by practicing good hygiene (e.g., keeping your hands clean by washing with soap and water or using an alcohol-based hand rub and showering after working out); covering any open skin area such as abrasions or cuts with a clean dry bandage; avoiding sharing personal items such as towels or razors; using a barrier (e.g., clothing or a towel) between your skin and shared equipment; and wiping surfaces of equipment before and after use. What should I do if I think I have a staph or MRSA infection? See your healthcare provider. Are staph and MRSA infections treatable? Yes. Most staph and MRSA infections are treatable with antibiotics. If you are given an antibiotic, take all of the doses, even if the infection is getting better, unless your doctor tells you to stop taking it. Do not share antibiotics with other people or save unfinished antibiotics to use at another time. However, many staph skin infections may be treated by draining the abscess or boil and may not require antibiotics. Drainage of skin boils or abscesses should only be done by a healthcare provider. If after visiting your healthcare provider the infection is not getting better after a few days, contact them again. If other people you know or live with get the same infection tell them to go to their healthcare provider. |
