Staph - Scourge of hospitals, has come to bite us

For years, doctors have been warning about the over-prescription of antibiotics and an alarming increase in drug-resistant diseases. Now, a nasty new strain of bacteria has come back to bite us. Golden Staph has long been a scourge of hospitals, but doctors are now alarmed by a strain that’s been causing dangerous infections in people outside hospitals.

New research described in Thursday morning’s New England Journal of Medicine shows that more and more people are getting drug-resistant staph infections outside of the hospital.

Researchers looked at data on staph infections in Baltimore, Atlanta and Minnesota, and found overall that 17 percent of the cases of drug-resistant staph infections - more than 2,000 cases - could not be traced back to a hospital.

Staphylococcus aureus, the bacterium’s official name, resides on the skin or in the nasal passages of one in three people. It is usually benign but can flare up to cause painful infections. For the past 30 years, hospitals have been battling a mutant form called methicillin-resistant S. aureus (MRSA) that is resistant to penicillin-related antibiotics and is especially lethal. Now this drug-defying strain is showing up in the general population. It can be deadly if it enters the blood stream, heart, or lungs, killing anywhere from 25% to 43% of its victims.

It’s not surprising that drug-resistant strains are common in hospitals. Widespread use of antibiotics gives the microbe more chances to develop resistance. But scientists aren’t sure why these super bugs have spread to the community.

“Staph is uniquely adaptive,” notes Dr. Franklin D. Lowy, professor of medicine at Columbia University. Because it is carried in the nose, the microbe has the opportunity to come in and out of hospitals with every visitor. Staph is also highly promiscuous, able to quickly exchange genes with other strains and even other species of bacteria. That makes the microbe a constantly moving target for antibiotics, which work by blocking production of certain enzymes that the bacteria need to survive. Confronted with a drug, rapidly evolving staph colonies grab genes from some other type of bacterium that codes for a different enzyme.

For years, the best treatment for MRSA was the powerful antibiotic vancomycin. But even this weapon has failed against new strains of staph that have emerged. Some infectious-disease experts predict that by 2010, 40% of staph infections will be vancomycin-resistant. And for the moment, there are few alternatives. Cubist Pharmaceuticals Inc. (CBST ) in Lexington, Mass., won approval in September for a new type of antibiotic, Cubicin, that works as well as vancomycin against staph. But experts figure it’s only a matter of time before the bug learns to evade Cubicin, too.

Two small biotech companies are trying to get around the resistance problem by harnessing the body’s own immune system. Nabi Biopharmaceuticals, in Boca Raton, Fla., is testing a vaccine, and Inhibitex Inc. in Alpharetta, Ga., is developing an engineered protein called a monoclonal antibody.
Microbe experts are intrigued by these approaches but doubt that they will be 100% effective.

People can avoid staph infection by simple preventive measures that includes regular hand washing, cleaning and covering wounds, avoiding shared towels, razors, clothing and athletic equipment, disinfecting public pools and whirlpools, and installing antibacterial soap dispensers.

Also, handwashing is critical especially if you are engaged in a contact sport such as football or in any activities that involve being in close quarters with others. When water is not available, alcoholic gels can be beneficial. Young people more often develop the infection.
Also, avoid sharing any personal items including sports equipment. And, if you do develop an infection, see your doctor pronto.

People should seek medical attention if an infection becomes more painful, or a large boil develops, or the infection seems to spreading from the original site, such as redness spreading over the skin. If fever or chills develop, urgent care should also be sought. If boils or abscesses appear suddenly and grow rapidly, it’s also a sign of a virulent infection.