Drug-resistant staph
infections, once mostly confined to hospitals, have
spread to the nation's schools and gyms.
In October, a
12-year-old boy's death from this dreaded infection
caused alarm in a Bedford-Stuyvesant elementary school
in New York. In California, an elementary school student
in Yuba City has the infection, while 31 Chico State
University students tested positive for the bug since
January. In San Diego County, a drug-resistant staph
infection, called MRSA or the "super bug," took the life
last February of Carlos Don IV, a sixth-grader.
Striking more than
90,000 Americans, the nearly 19,000 deaths from staph
infections surpassed AIDS deaths in 2005, a study in The
Journal of the American Medical Association (JAMA)
estimated in October.
Here are some
answers to common questions about an increasingly common
killer:
WHAT IS STAPH?
Staph is shorthand
for Staphylococcus aureus, bacteria that healthy people
often have on their skin or in their noses. Usually
these bacteria cause either no problem or minor skin
infections. But if the germ invades the bloodstream,
urinary tract, lungs or heart through an infected wound,
staph infections can be life-threatening.
WHAT DO THE TERMS
MRSA AND CA-MRSA MEAN?
MRSA stands for
Methicillin-Resistant Staphylococcus Aureus. Methicillin,
an antibiotic that includes several types of penicillin,
can no longer be counted on to fight these staph
bacteria.
The "CA" in CA-MRSA
indicates "Community-Associated" MRSA infections, as
opposed to those acquired in hospitals. MRSA can be
pronounced as a single word (mersa) or as the four
individual letters.
WHY HAS THIS
SUDDENLY BECOME A BIG DEAL?
While for years most
MRSA infections were acquired in hospitals, an
increasing number of people in the general population
are getting sick from MRSA. No nationwide agency keeps
consistent statistics on these kinds of infections, so
October's JAMA study, which extrapolated data from
states and counties that do keep those figures, was in
effect a wake-up call that MRSA infections are rising
nationwide.
WHAT ARE THE
SYMPTOMS?
While symptoms vary
widely, the first signs are often minor skin wounds,
pimples, sties, insect bites and rashes that have become
infected. These contain pus and feel itchy or warm. They
can be swollen and reddish in color. If the infection
goes deeper and is not correctly treated, it can result
in pneumonia, blood poisoning, septic arthritis and
other severe conditions, which all have different
symptoms.
HOW DO YOU GET
IT?
You can get a staph
infection or MRSA by direct skin-to-skin contact with
someone who has the condition. You can also get it by
sharing infected towels or athletic equipment. Having an
open wound increases risk, as can visiting or staying in
a hospital.
HOW CAN YOU PREVENT
GETTING A STAPH INFECTION AND/OR SPREADING IT?
Following the simple
instructions in the accompanying box will help keep you
safe from staph or MRSA infections. Frequent
hand-washing is paramount and is mentioned in medical
sources of all kinds as the No. 1 way to keep from
getting staph infections.
Hospitals, of
course, battle the bacteria constantly. It's perfectly
reasonable before a hospital stay - especially if
surgery is involved - to ask about the institution's
program to prevent transmission of MRSA and other
infections and how its program is enforced.
Medicare and
Medicaid are considering not paying hospitals for
treatment of "conditions that could have been
prevented," which include hospital-acquired infections.
If that goes into effect, hospitals that have been lax
would probably clean up their act.
ARE SOME PEOPLE
MORE SUSCEPTIBLE TO STAPH INFECTIONS THAN OTHERS?
Young children are
among the higher-risk populations, as are the elderly
and people with HIV/AIDS. People taking
immunosuppressive drugs for diseases such as lupus and
rheumatoid arthritis are also more susceptible.
IS A STAPH
INFECTION EASY TO DIAGNOSE?
Yes, labs can detect
ordinary staph infections from tissue samples or nasal
secretions. But under a microscope, MRSA germs look like
those of any staph infection, so a second test is
needed. Newer tests that quickly detect MRSA are
expensive and may not be covered by insurance.
WHAT'S THE
TREATMENT?
If you keep a staph
skin infection clean and dry, it probably will heal on
its own.
If infection
persists, a health professional may decide to drain or
clean the problem area. If that doesn't do the trick,
methicillin and other antibiotics can get rid of an
ordinary staph infection.
But antibiotics
usually do not work for MRSA. Newer antibiotics like
vancomycin have proved effective against some strains of
the bacteria, but some are already becoming resistant to
those. That is one reason many health professionals are
judicious in prescribing antibiotics.
IS THERE REASON
FOR PANIC?
No, but caution is
advised, especially if you or a loved one falls into a
high-risk group. You can probably avoid staph infections
by following the preventive measures and avoiding
antibiotics for colds or flu. And, above all, keep
washing those hands!
PROTECTION AND
PREVENTION
Staph infections are
preventable. Here are the steps, all rooted in common
sense:
- Wash your hands
frequently with warm soap and water or an alcohol-based
hand sanitizer.
- Wash your hands
even more frequently and thoroughly when in a hospital
or when in contact with a person who has a staph
infection.
- Bandage any wounds
and don't touch those of other people.
- Avoid sharing
personal items like razors, towels, washcloths and
toothbrushes that may have come in contact with an
infected wound.
- Keep your skin
healthy and try to prevent it from becoming dry and
cracked.
- Take care when
using shared athletic equipment. Wipe it clean and wash
your hands after using it (some are advocating that
equipment be regularly sterilized, especially in school
gyms).
- If you think you
may have a staph infection, see a health professional.
SIDEBAR
Staph is short for
staphylococcal, a type of bacteria, and MRSA stands for
Methicillin-Resistant Staphylococcus Aureus. No matter
how you say it, here are resources to help you learn
more about staph infections:
WEB SITES
- nlm.nih.gov/medlineplus/staphylococcalinfections.html
This Web site, a
service of the U.S. National Library of Medicine and the
National Institutes of Health, has links to journal
articles, clinical trials and specific conditions.
- cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.htmlA
question-and-answer format makes this site easy to read
while providing important staph information.
- mayoclinic.com/health/staph-infections/DS00973
The Mayo Clinic is a
great source for basic information, risk factors,
screening and diagnosis information.
- consumersunion.org
Type in "MRSA" in
the search box of this nonprofit organization, and you
will find several current articles on the topic. Be sure
to sort by date.
- mrsaresources.com
Pulled together by
people with loved ones affected by MRSA, this site
provides information and, perhaps more importantly, is a
starting point for networking and support.
BOOKS
"MRSA and
Staphylococcal Infections," R. Chang Hernan, M.D. (2006)
Written for laymen,
this large-print book gives a basic understanding of
staph and has photos of these types of infections.
"Help! What's Eating
My Flesh? Runaway Staph and Strep Infections!" Thomasine
E. Lewis Tilden (2007)
This 64-page book,
geared for ages 9-12, is part of the 24/7 Science Behind
the Scenes series.
- Denise Davidson
Visit Copley News
Service at
www.copleynews.com.