2 replies to this topic

[esther231]

Staph fatalities may exceed AIDS deaths By LINDSEY TANNER, AP Medical WriterWed Oct 17, 7:48 AM ET

More than 90,000 Americans get potentially deadly infections each year from a drug-resistant staph "superbug," the government reported in its first overall estimate of invasive disease caused by the germ.

Deaths tied to these infections may exceed those caused by AIDS, said one public health expert commenting on the new study. Tuesdays report shows just how far one form of the staph germ has spread beyond its traditional hospital setting.

The overall incidence rate was about 32 invasive infections per 100,000 people. That's an "astounding" figure, said an editorial in Wednesday's Journal of the American Medical Association, which published the study.

Most drug-resistant staph cases are mild skin infections. But this study focused on invasive infections — those that enter the bloodstream or destroy flesh and can turn deadly.

Researchers found that only about one-quarter involved hospitalized patients. However, more than half were in the health care system — people who had recently had surgery or were on kidney dialysis, for example. Open wounds and exposure to medical equipment are major ways the bug spreads.

In recent years, the resistant germ has become more common in hospitals and it has been spreading through prisons, gyms and locker rooms, and in poor urban neighborhoods.

The new study offers the broadest look yet at the pervasiveness of the most severe infections caused by the bug, called methicillin-resistant Staphylococcus aureus, or MRSA. These bacteria can be carried by healthy people, living on their skin or in their noses.

An invasive form of the disease is being blamed for the death Monday of a 17-year-old Virginia high school senior. Doctors said the germ had spread to his kidneys, liver, lungs and muscles around his heart.

The researchers' estimates are extrapolated from 2005 surveillance data from nine mostly urban regions considered representative of the country. There were 5,287 invasive infections reported that year in people living in those regions, which would translate to an estimated 94,360 cases nationally, the researchers said.

Most cases were life-threatening bloodstream infections. However, about 10 percent involved so-called flesh-eating disease, according to the study led by researchers at the federal Centers for Disease Control and Prevention.

There were 988 reported deaths among infected people in the study, for a rate of 6.3 per 100,000. That would translate to 18,650 deaths annually, although the researchers don't know if MRSA was the cause in all cases.

If these deaths all were related to staph infections, the total would exceed other better-known causes of death including AIDS — which killed an estimated 17,011 Americans in 2005 — said Dr. Elizabeth Bancroft of the Los Angeles County Health Department, the editorial author.

The results underscore the need for better prevention measures. That includes curbing the overuse of antibiotics and improving hand-washing and other hygiene procedures among hospital workers, said the CDC's Dr. Scott Fridkin, a study co-author.

Some hospitals have drastically cut infections by first isolating new patients until they are screened for MRSA.

The bacteria don't respond to penicillin-related antibiotics once commonly used to treat them, partly because of overuse. They can be treated with other drugs but health officials worry that their overuse could cause the germ to become resistant to those, too.

A survey earlier this year suggested that MRSA infections, including noninvasive mild forms, affect 46 out of every 1,000 U.S. hospital and nursing home patients — or as many as 5 percent. These patients are vulnerable because of open wounds and invasive medical equipment that can help the germ spread.

Dr. Buddy Creech, an infectious disease specialist at Vanderbilt University, said the JAMA study emphasizes the broad scope of the drug-resistant staph "epidemic," and highlights the need for a vaccine, which he called "the holy grail of staphylococcal research."



The regions studied were: the Atlanta metropolitan area; Baltimore, Connecticut; Davidson County, Tenn.; the Denver metropolitan area; Monroe County, NY; the Portland, Ore. metropolitan area; Ramsey County, Minn.; and the San Francisco metropolitan area.

____

On the Net:

JAMA: http://jama.ama-assn.org CDC: http://www.cdc.gov

[maineman]

Esther, this is truly scary....you're right. When I left NYC 24 years ago it was already a small problem. OVer the years it mushroomed in the big city hospitals, where very sick patients were being treated. It was much less of a problem in suburban and rural hospitals, but even they have succumbed in the past few years. THis is not just a USA problem, by the way. And much work is being done. Good hospitals now routinely swab every patient that gets admitted for whatever reason. Patients who test + for MRSA are isolated and strict procedures are followed. Intense room cleaning is undertaken for all rooms with MRSA patients. Luckily, we still have medications that work to eradicate the infection. In some hospitals that have initiated this MRSA surveillance protocol the issue has nearly been solved. Believe it or not, handwashing remains the biggest problem. Not sure if you recall 2 studies within the past 2 years. One on public handwashing (hidden video in public restrooms) showed MOST people did not wash... ugghh. Second was done on hospital nurses and doctors and the results were terrible. Inexcusable. I used to wear a tie until 8 years ago when after a study of infection in doctor's lab coats it occured to me that my TIE could be a source of infection, going from room to room. Medicine is good at addressing a crisis like this so I wouldn't be too worried... Finally, true, really sad story. A good friend of mine brought his elderly parents to live here, as they were in their 80s and not doing well alone. His mother was a funny, little fat old lady. Not exactly the picture of health, in any way, but had no major medical problems. Soon after they moved she cut her leg unpacking. I was on vacation. The covering doctor sent her to the emergency room. The ER doctor gave her a dose of a penicillin type medicine and admitted her to the hospital overnight. Next day her wound looked okay and they sent her home on antibiotics. A week later I got back from vacation and she was having diarrhea. I immediately stopped her antibiotics (which I didn't think she needed in the first place) and cultured her stool, which tested positive for c. dificile, which, like MRSA, is a hospital acquired "opportunitistic" infection. She got dehyrdrated from the diarrhea. She ended up needing to be readmitted to the hospital for dehyration and IV support. She got MRSA from being in the hospital - so now she has TWO hospital acquired infections. She became very ill, with dehydration and temperatures of 104 degrees. She was placed in the ICU and ultimately died. Unbelievable. This was about a year ago. I blew a gasket with our hospital's infectious disease group and we now have VERY STRICT protocols in place. I still go visit the father of my friend once a week on Wednesdays. WHen I go into ANY hospital or nursing home nowadays I take along antiseptic cream and hand wipes. AND I wash before and after any interaction with the patient or the patient's charts. mm

[esther231]

Oh, that is a sad story. And frightening. I didn't like that it is being spread in not just hospitals but in locker rooms, gyms, jails and poor neighborhoods. Staph, I believe, was one of the main causes of early death before antibotics. It's scary that a form is antibiotic resistant and spreading in uncontrolled environments. And they said more people are dying of it than of AIDS!!!! Yikes!!! Sure seems like it's harder to avoid this than to avoid AIDS.