As Gulf coast residents try to recover, the Centers for Disease Control (CDC) reports that they have found cases of difficult-to-treat infections in a relief center housing evacuees from Hurricane Katrina.
At least 30 adults and children in a Texas evacuation center show boils on their skin, according to the CDC. Preliminary tests suggest that some of the infections may be caused by methicillin-resistant Staphylococcus aureus (MRSA), a drug-resistant bacteria.
Fortunately, it seems that these cases were caught in time. "These patients are receiving clinical care and infection control measures are ongoing," reports the CDC in a statement.
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But since these "superbugs" can survive traditional antibiotic treatments, they can be tougher to treat. Left unchecked, MRSA infections cause a variety of problems, including fever, low blood pressure and, eventually, organ failure.
What can you can do to protect yourself from these infections? Dr. Martin Blaser, chair of the Department of Medicine at NYU School of Medicine and president-elect of the Infectious Diseases Society of America, explains.
What are MRSAs?
Staph aureus is bacteria that normally lives in the human body: on the nose and in certain moist areas such as the armpits. Virtually everyone carries Staph aureus, but usually it doesn't affect your health. But sometimes it may be resistant to antibiotics, like MRSA, which stands for methicillin-resistant Staphylococcus aureus. Often, infections start in the skin or the upper respiratory tract, but can involve any part of the body.
With the advent of antibiotics, there was tremendous improvement in the treatment of infections. Unfortunately, as antibiotics were developed and widely used, staph became resistant to them. The resistance started with penicillin, and then with a second group of antibiotics, like ampicillin. Then, a third group of antibiotics were found, called methicillin, which are very good at fighting Staph aureus, but now more and more of the bacteria have become resistant to this antibiotic.
So, if you had a wound that became contaminated with one of the resistant Staph aureus, then, it wouldn't be a different infection than a non-resistant infection, but it would be much harder to treat.
How do people get MRSA?
Initially, MRSA infections were first seen in people who were in the hospital for long periods of time. Since these people were typically subjected to many different antibiotic treatments, it wasn't surprising that the infections they had might be methicillin-resistant. And if, for example, a patient is receiving a certain antibiotic and the antibiotics are killing off their normal bacteria, then it's taking away a layer of defense, so they are more susceptible to picking up an antibiotic-resistant organism.
Also one patient might have a MRSA infection and it may spread to another person who might be susceptible because they have an open wound or a suppressed immune system.
So how does the bacteria get to people outside the hospital?
What's really surprising are new reports indicating the finding of MRSAs in people in the community who haven't had any obvious exposure to the hospital. This finding reflects the fact that the reservoir of resistant bacteria in hospitals has gotten so great—and most people who are in hospitals eventually go home—so they're spreading it into the community. This is basically a phenomenon that began in hospitals and is spilling out into the community.
How are MRSA infections treated?
If somebody has a serious staph infection, they would be treated with methicillin, or some oral antibiotic that is similar. But, if they have a MRSA, then they need intravenous therapy and have to be hospitalized to get a more toxic antibiotic; typically vancomycin is used. Unfortunately, sometimes staphylococcus is resistant to vancomycin, too. So methicillin-resistant staph is a problem by itself, but it's also a harbinger that further resistances are on the way.
Are most MRSA infections cured?
Most people are cured, but some people have serious infections and die. Occasionally, people die because they're treated for what the doctor thinks is an ordinary infection when it turns out that it's a resistant infection.
What advice do you have for people with infections?
If a doctor prescribes an antibiotic for an infection, usually, the doctor will tell you, "If you're not seeing a good recovery, if your fever doesn't go down, if the wound or sore looks worse, it's more red, it hurts more, then you should come back and seek medical attention," and those rules are still the same. You just have to keep an eye on your symptoms and, if your symptoms are not responding to the treatment, then you have to go back and see your doctor.
Are there any precautions to take to prevent an MRSA infection?
At this point, there is no specific precaution that you can take other than avoid infections: keep your wounds clean. If you have a wound, and it looks infected, seek medical attention. If you find that you have an infection and you have a fever, then you should seek medical attention right away.
Is any work being done to develop new antibiotics that will fight resistant bacteria?
Well, it's an active area of research, but one big concerns is that manufacturers are barely turning out any new antibiotics because the economics are not very favorable. This is a real problem in social policy, because, if the bacteria are getting more resistant and antibiotic production is slowed, then the battle is being lost, and future generations will pay.
What advice do you have for preventing the development of new resistant bacteria?
"Since the discovery of antibiotics, we have had antibiotic resistance," says Blaser, "and the more antibiotics we use as a society, the more resistant bacteria were going to get. So we have to do two things as a society: cut down on unnecessary uses of antibiotics in both humans and farm animals and we have to develop new antibiotics so that we can keep ahead."