MRSA ‘superbug’: Everyone at risk!

By Dr. Ananya Mandal, MDSep 2 2011

Methicillin-resistant Staphylococcus aureus (MRSA), a type of staph bacteria that does not respond to commonly used antibiotic treatments, is a type of infection that has been a problem in hospital settings for many years. Back in 2000 it began steadily making its way into the lives of otherwise healthy people, especially children, who are not typically at risk for the fast-moving bacteria.

“Everyone is at risk,” said Dr. Patrick Romano, author of a new report that found the number of children hospitalized with MRSA infections, mostly acquired from within the community, has more than doubled since 2000. “MRSA really started as a bacterium that was seen in hospitals among high-risk patients. But during the last decade, we saw it spread to the general population.” The study was published online in the Aug. 30 issue of the journal Clinical Infectious Diseases.

“The problem is that MRSA began to affect people who were perfectly healthy,” adds Dr. Jaime Fergie, author of a 2005 study that concluded that infections in children had reached “epidemic proportions.” Mutations in the organism made it more virulent and easy to transmit, he says. “We continue to see more severe, life-threatening infections affecting the blood, lungs, muscles and even bones of previously healthy children.”

In 2009, 71,900 children were hospitalized because of infections under the skin, according to the Agency for Healthcare Research and Quality, and the CDC estimates there are approximately 10,800 deaths in the U.S. each year caused by staph, of which 5,500 are linked to MRSA. The problem became so widespread that in January, the Infectious Diseases Society of America called the condition a “huge public health problem” and published its first-ever guidelines for the treatment of MRSA in pediatric patients.

“We have to live with the fact that it's out there, all around us in the community. At this point, we expect a certain level of these infections,” Romano says. “Now, it's a matter of recognizing the early signs and treating it early when we see it.” He said that that the infection site could look like a spider bite or a pimple that is advancing rapidly. Bleach baths and proper cleaning can help prevent spread experts add.

For the study, researchers from Johns Hopkins Children's Center looked at the medical records of 3,140 children admitted to the pediatric intensive care unit between 2007 and 2010.

Records showed that children who carried MRSA before they arrived at the hospital were nearly six times more likely to develop invasive MRSA infections after discharge than non-carriers and eight times more likely to develop them while still in the hospital

Further, 15 children acquired MRSA while in intensive care, though they were MSRA-free when they came to the hospital. And, seven of those 15 developed serious infections, six of them while still in the hospital

Lead investigator Dr. Aaron Milstone, a pediatric infectious disease specialist, said, “Hospitalized children colonized with MRSA have a very real risk for invasive infections, both while in the hospital and once they leave, so mitigating this risk is a serious priority. We need standardized protocols on ways to protect MRSA carriers from developing invasive infections while also minimizing its spread to others. In the meantime, there are certain things healthcare providers can do to protect all patients.”

Thorough hand washing by doctors and physicians as well as isolation of MRSA carriers in private rooms can help prevent the spread of MRSA.