Here in Virginia, a 17 year old high school senior at Staunton River High School was recently hospitalized with a strain of antibiotic resistant Staphylococcus bacteria. Known as MRSA (methicillin resistant staphylococcus aureus) this is a very dangerous disease. Sadly, Ashton Bonds died while on a ventilator when doctors discovered that a clot had formed in his heart.
MRSA can be spread by skin to skin contact or especially through an open wound. Hospitals are increaingly bedeviled by it, as it can be spread by invasive machinery. How about a gym or locker room in which an infected person has cuts or abrasions? Yup. School officials in the area of Bedford Virginia responded to the death of Bonds by closing 21 schools in order to throughly clean them. According to school officials, there have been six confirmed cases in the Bedford Vriginia area, but all of them except for Bonds recovered and are back in school.
The CDC commented on MRSA today. The overall annual infection rate from resistant Staph is an astounding 32 in every 100,000 Americans. Well, that is less surprising if you realize that Staphylococcus is a common bascterium that can be found on the skin or inthe nasal cavity of 25 to 30 percent of the population without causing illness. The good news is that even when infection occurs, most cases are relatively mild skin infections that do respond to treatment by a few remaining antibiotics (it is quite resistant now to Penicillin, sadly). Only about one quarter of the victims were infected in a hospital- but that is a confusing statistic, since the number also represents roughly five percent of all hospital patients. Around half of the total victims got their infection from some source within the health system. Kidney dialysis is a problem area. Schools and prisons are problematic as they bring large numbers of people into contact with each other.
One problem with MRSA is that it has yet to be heavily studied, and we really do not even know how many Americans die from it each year. A CDC study extrapolated from a sample of 988 deaths from MRSA to guess that nationwide total per year could be as high as 18,000- more people than died from AIDS in 2005!! But who knows if it is accurate to extrapolate from a sample in this way. Like most communicable diseases, it gives the most trouble to people who for watever reason have weakened immune systems.
In any event, this is a serious problem with limited solutions. Hospitals and health care providers are likely to redouble their efforts at disinfection- but the organism is hard to kill. Public education efforts are likely to vastly expand. One key element of the effort to stay ahead of this deadly threat- only use antibiotics when you need to use them, and follow the directions to the letter. The antibiotic resistance that makes MRSA such a threat to us is the result of our sloppy and inappropriate use of antibiotics, which has through the process of natural selection made many of them ineffective. Never never never go and beg for an antibiotic from your doctor because your kid has a cold, then stop giving it to her after a couple days when she starts to get better. For one thing, the Cold organism is a virus and antibiotics do not attack viruses. For another, it is a textbook approach to building a superbug- expose a bacterium to something that stresses it, but then remove the stress before all the colony has been killed. The survivors will be the ones who have partial resistance to the antibiotic, and if you repeat this process the bug gets stronger. If the remaining antibiotics become ineffective, good luck to us all.