- WASHINGTON (Reuters) -- A
drug-resistant "superbug" found in hospitals has a close cousin
that is affecting athletes, prisoners and small children in growing numbers
across the United States, disease experts said on Wednesday.
-
- Methicillin-resistant Staphylococcus aureus or MRSA can
become fatal if not treated with the right antibiotics, said Dr. Daniel
Jernigan of the U.S. Centers for Disease Control and Prevention.
-
- "MRSA is showing up in places it had never been
seen before -- as a predominant cause of skin disease among children in
some regions of the country, as clusters of abscesses among sports participants,
as the most common cause of skin infections among inmates in some jails
and among military recruits and rarely, as a severe and sometimes fatal
lung or bloodstream infection in previously healthy people," Jernigan
told reporters.
-
- Most commonly it takes the form of an abscess or boil,
and doctors routinely try to treat it with penicillin-based antibiotics,
Jernigan said. These will not work against MRSA.
-
- In hospitals, MRSA resists almost everything but an intravenous
antibiotic called vancomycin. But so-called community-acquired MRSA can
be treated with a range of antibiotics including doxycycline and cotrimoxazole,
sold under the brand name Bactrim.
-
- However, 70 percent of the time doctors use ineffective
drugs to treat it, Jernigan said. And the community-acquired strain has
some of its own nasty tricks.
-
- "Unlike the hospital strains, the community strains
were capable of producing a toxin called Panton-Valentine Leukocidin or
PVL," he said.
-
- "PVL is a necrotizing cytotoxin, which means it
can cause destruction of cells in the skin leading to pus formation but
also can cause a serious and often fatal form of pneumonia."
-
- LARGE ABSCESSES
-
- This may be why MRSA infections cause large abscesses
and are often first mistaken as spider bites, he said.
-
- It is also easily passed around. "There is something
about the community strain of MRSA that, when given the right circumstances
and group characteristics, makes for very efficient transmission of the
bacteria," Jernigan said.
-
- He said the CDC is trying to persuade doctors to grow
cultures from skin infections before treating patients, so they know which
drugs to use. Improper use of antibiotics may be helping drive the evolution
of drug-resistant bacteria, health experts say.
-
- Jernigan said studies have shown MRSA makes up a significant
number of all diagnosed staph infections, ranging from 9 percent in Maryland,
to 20 percent in Georgia and 30 percent in Hawaii.
-
- The numbers are rising, Jernigan said. "We also
found that rates of community-associated MRSA infections were disproportionately
higher among children," he said.
-
- In 2003, the Colorado Department of Public Health and
Environment investigated an outbreak at a fencing club. Outbreaks were
reported among high school and college football players and wrestlers in
Pennsylvania, Indiana and California.
-
- And between 1997 and 1999 four small children in North
Dakota and Minnesota died from MRSA.
-
- Jernigan said five factors were associated with outbreaks
of the infection -- crowding, skin contact, abrasions or cuts in the skin,
sharing contaminated equipment or towels and a lack of hygiene.
-
- "From investigations of outbreaks at boot camp and
in jails, it is clear that MRSA is being first brought into these settings
by individuals that are carrying the bacteria in their nose without having
any disease," Jernigan said.
-
- "Once introduced, the bacteria can efficiently spread
to others, and is then amplified in that setting."
-
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