In recent weeks, drug-resistant staph infections have been making the headlines. Top US doctors are now calling staphylococcus aureus bacteria as “the cockroach of bacteria” due to its ability to lurk in various places and spread easily clinging on unwashed hands.
The culprit is MRSA, or methicillin-resistant staphylococcus aureus, which is a form of the most common staph family of germs. Statistics reveal that about one in every three people carries staph aureus bacteria in their noses, and about one million people carry the MRSA type.
Over time, germs evolve to withstand treatment. Most staph is no longer treatable by the granddaddy of antibiotics, penicillin. By the 1960s, staph also began developing resistance to a narrow-spectrum antibiotic, methicillin.
While MRSA is not a new problem, public anxiety about bacterial infection is. But the recent turn of events should not trigger any panic as “this isn’t something just floating around in the air,” said Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention.
Staph infections occur only during close contact like sharing towels and razors, or rolling on the wrestling mat or football field with open wounds that are not protected with bandages. And according to Gerberding, MRSA is preventable largely by common-sense hygiene.
“Soap and water is the cheapest intervention we have, and it’s one of the most effective,” Gerberding told a hearing of the House Committee on Oversight and Government Reform.
Diseases caused by MRSA are mostly skin infections, such as boils and abscesses. But it can sometimes spread to cause life-threatening blood infections. Last October, it’s been reported that the first national estimate of serious MRSA infections reached 94,000 a year. It’s not clear how many people die, but one estimate put the MRSA death toll at more than 18,000, slightly higher than U.S. deaths from AIDS.
MRSA have two distinct strains: a type spread in hospitals and other health facilities, and a genetically different type spread in communities. Most MRSA victims are hospital patients; only 14 percent of serious MRSA infections are the kind spread in the community.
But the death of a 17-year-old Virginia high school student triggered a wave of reports of MRSA infections in different schools which prompted lawmakers to pepper Gerberding with the following questions:
Should schools close for cleaning if a student gets MRSA? Gerberding said that it’s not necessary. Bleach and a list of other germicides can be used in routine cleaning of areas and equipment where bacteria cluster and thrive.
“There’s no need to go in and disinfect a whole school, because that isn’t how this organism is transmitted,” she said.
How worried should parents be? According to Gerberding, some 200 children a year will get serious MRSA, and the vast majority will be treated successfully. Community-spread MRSA is still easily treated by many other routine antibiotics. So wash and bandage cuts, and seek prompt medical care if they show signs of infection.
Most outbreaks of community-spread MRSA occur not in schools but in prisons, where inmates share toiletries and don’t use soap, or the lack of it.
Should every patient entering a hospital be tested for MRSA, and isolated if they harbor it? Some hospitals have begun that, but current guidelines call for that step only if hospitals fail to reduce MRSA infections by less drastic means, Gerberding said.
Gerberding’s concern is that patients in isolation get less care. Doctors and nurses check on them less. They get more bed sores which makes the body prone to other life-threatening germs.
The biological conundrum is that hospital-based MRSA is more common, vulnerable to fewer antibiotics than the strain spread in communities, and those already-ill patients are more likely to die from it. Yet, the community strain of MRSA may be somewhat stronger, possibly explaining why otherwise healthy people sometimes succumb.
It’s a strain called USA300 that penetrates the skin and cause key immune cells like the white blood cells to explode, setting off a chain inflammation reaction, Gerberding explained. Unlike most hospital MRSA, USA300 also produces a toxin known as PVL, and scientists are furiously investigating its role.
Invention of new antibiotics may help fight MRSA, but the fact that germs will always evolve make doctors believe that going back to the basics of washing our hands clean and keeping our wounds covered remain to be our best defense against bacterial infections.