Today's reports on MRSA are quite misleading. it's mostly showing up in health-care related facilities, NOT schools although the profile MAY be changing ..
The researchers attributed the emergence of the strain to a combination of the overuse of antibiotics and the introduction of a vaccine that protects against the infection.
“The use of the vaccine created an ecological vacuum, and that combined with excessive use of antibiotics to create this new superbug,” said Pichichero.
Drug-Resistant Staph Germ's Toll Is Higher Than Thought
Wednesday, October 17, 2007; Page A01
A dangerous germ that has been spreading around the country causes more life-threatening infections than public health authorities had thought and is killing more people in the United States each year than the AIDS virus, federal health officials reported yesterday.
The microbe, a strain of a once innocuous staph bacterium that has become invulnerable to first-line antibiotics, is responsible for more than 94,000 serious infections and nearly 19,000 deaths each year, the Centers for Disease Control and Prevention calculated.
Although mounting evidence shows that the infection is becoming more common, the estimate published today in the Journal of the American Medical Association is the first national assessment of the toll from the insidious pathogen, officials said.
"This is a significant public health problem. We should be very worried," said Scott K. Fridkin, a medical epidemiologist at the CDC.
Other researchers noted that the estimate includes only the most serious infections caused by the germ, known as methicillin-resistant S taphylococcus au reus (MRSA).
"It's really just the tip of the iceberg," said Elizabeth A. Bancroft, a medical epidemiologist at the Los Angeles County Department of Public Health who wrote an editorial in JAMA accompanying the new studies. "It is astounding."
MRSA is a strain of the ubiquitous bacterium that usually causes staph infections that are easily treated with common, or first-line, antibiotics in the penicillin family, such as methicillin and amoxicillin. Resistant strains of the organism, however, have been increasingly turning up in hospitals and in small outbreaks outside of heath-care settings, such as among athletes, prison inmates and children.
On Monday, Ashton Bonds, 17, of Lynch Station, Va., succumbed to MRSA, prompting officials to shut down 21 Bedford County schools today for cleaning to prevent further infections. The infection had spread to Bonds's kidneys, liver, lungs and the muscle around his heart.
The MRSA estimate is being published with a report that a strain of another bacterium, which causes ear infections in children, has become impervious to every approved antibiotic for youngsters.
"Taken together, what these two papers show is that we're increasingly facing antibiotic-resistant forms of these very common organisms," Bancroft said.
The reports underscore the need to develop new antibiotics and curb the unnecessary use of those already available, experts said. They should also alert doctors to be on the lookout for antibiotic-resistant infections so patients can be treated with the few remaining effective drugs before they develop serious complications, experts said.
MRSA, which is spread by casual contact, rapidly turns minor abscesses and other skin infections into serious health problems, including painful, disfiguring "necrotizing" abscesses that eat away tissue. The infections can often still be treated by lancing and draining sores and quickly administering other antibiotics, such as bactrim. But in some cases the microbe gets into the lungs, causing unusually serious pneumonia, or spreads into bone, vital organs and the bloodstream, triggering life-threatening complications. Those patients must be hospitalized and given intensive care, including intravenous antibiotics such as vancomycin.
In the new study, Fridkin and his colleagues analyzed data collected in California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New York, Oregon and Tennessee, identifying 5,287 cases of invasive MRSA infection and 988 deaths in 2005. The researchers calculated that MRSA was striking 31.8 out of every 100,000 Americans, which translates to 94,360 cases and 18,650 deaths nationwide. In comparison, complications from the AIDS virus killed about 12,500 Americans in 2005.
"This indicates these life-threatening MRSA infections are much more common than we had thought," Fridkin said.
In fact, the estimate makes MRSA much more common than flesh-eating strep infections, bacterial pneumonia and meningitis combined, Bancroft noted.
"These are some of the most dreaded invasive bacterial diseases out there," she said. "This is clearly a very big deal."
The infection is most common among African Americans and the elderly, but also commonly strikes very young children.
"We see these cases all the time," said Robert S. Daum, a pediatric infectious-disease specialist at the University of Chicago. "In the last five weeks, I've taken care of five children who were sick enough to be hospitalized and require intensive care."
Studies have shown that hospitals could do more to improve standard hygiene to reduce the spread of the infection. Individuals can reduce their risk through common-sense measures, such as frequent hand-washing.
In the second paper, Michael E. Pichichero and Janet R. Casey of the University of Rochester in New York documented the emergence of an antibiotic-resistant strain of another bacterium known as Streptococcus pneumoniae, which causes common ear infections. Although all 11 children identified in the Rochester area with the microbe so far were successfully treated, five required an antibiotic approved only for adults, and one child was left with permanent hearing loss.
The researchers attributed the emergence of the strain to a combination of the overuse of antibiotics and the introduction of a vaccine that protects against the infection.
"The use of the vaccine created an ecological vacuum, and that combined with excessive use of antibiotics to create this new superbug," Pichichero said.
What the medical community actually reads on this is found HERE:
http://www.medpagetoday.com/search-results.cfm
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Recommendations for the Prevention of Staphylococcal Infections for Schools*
GENERAL CLEANING STRATEGIES
- Establish and maintain routine schedules for environmental cleaning.
- Clean environmental surfaces with an all-purpose cleaner and use the product in accordance with the manufacturer’s instructions.
- Ensure that high-touch surfaces (e.g., doorknobs, light switches, drinking fountains, faucet handles, and surfaces in and around toilets) are cleaned daily.
- Promptly clean and decontaminate body fluid contamination of surfaces using either a 1:10 dilution of household chlorine bleach (1 part bleach in 9 parts water, prepared daily) or a germicidal product with specific label claims for HIV or hepatitis B virus.
- Maintain cleaning schedule for school cafeteria and dining area as directed by the environmental health division of the local health department.
STRATEGIES FOR CLEANING SPORT/ATHLETIC-RELATED EQUIPMENT AND ITEMS
- Clean items used in sporting and/or athletic-related activities after each use with an all-purpose cleaner and use the product in accordance with the manufacturer’s instructions.
- Promptly clean and decontaminate items that have visible soiling with blood or other body fluids using either a 1:10 dilution of household chlorine bleach (1 part bleach in 9 parts water, prepared daily) or a germicidal product with specific label claims for HIV or hepatitis B virus.
MEASURES FOR PREVENTING STAPHYLOCOCCAL SKIN INFECTIONS AMONG ATHLETES
- Advise students, faculty and staff regarding the importance of hand hygiene to minimize the spread of infectious disease.
- Encourage good hygiene, including showering and washing with soap, after all practices and competitions.
- Ensure availability of adequate soap and running water for hand washing in all bathrooms.
- Provide individual-use towels during all practices and competitions.
- Discourage sharing personal items.
- Do not allow athletes with draining wounds or infections to participate in practices or games until the wound has stopped draining. Because some staph infections may be difficult to treat, this may be a few weeks or longer. Permit the athlete participant to participate in non-contact activities if wounds are covered and the infected person observes good hygienic practices – washing hands, showering and laundering clothes.
- Train athletes and coaches to recognize wounds that are potentially infected (e.g., purulent drainage, redness, or tenderness around the wound).
- Encourage athletes to report wounds and skin lesions to coaches and encourage coaches to assess participants regularly for wounds and skin lesions.
- Discourage sharing water bottles.
- Give consideration to having athletes shower before participating in a competition or public activity.
- Ensure that practice uniforms and physical education uniforms are laundered on a weekly basis, or if feasible, more frequently.
- Encourage athletes who have non-healing, draining skin lesions and wounds that persist for more than one week to seek medical attention.
*The local health department may need to implement more stringent requirements during an outbreak.
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