Post by Watchman on Oct 30, 2007 10:30:14 GMT -5
STAPH | Drug-resistant strain -- which kills more in U.S. than HIV -- moving outside health care centers
October 28, 2007
BY JIM RITTER Health Reporter/jritter@suntimes.com
Drug-resistant staph infections are killing more Americans than HIV, government researchers say.
But perhaps even more disturbing was their finding last week that the "superbug" known as MRSA no longer is confined to hospitals, nursing homes, dialysis centers, etc.
About 15 percent of the serious MRSA infections now arise outside health care settings, U.S. Centers for Disease Control and Prevention researchers reported.
"Old diseases have learned new tricks," Dr. Elizabeth Bancroft of the Los Angeles County health department wrote in the Journal of the American Medical Association.
Shelby Hoff, 21, of southwest suburban Darien, is among the victims. Like many who get "community associated" MRSA infections, Hoff is young and healthy. She hadn't been to the hospital in more than four years when she got sick.
It began as a lump on her wrist. The lump went away but came back. Her doctor said it was probably gout.
At its peak, the infection was spreading as fast as an inch per hour. Hoff's arm was red and swollen, and she developed a fever.
Tests confirmed Hoff had MRSA -- methicillin-resistant staphylococcus aureus.
Staphylococcus aureus, often called staph, are bacteria. "Methicillin resistant" means they do not respond to common antibiotics such as penicillin and methicillin.
Hoff thinks she got it from her health club, "which wasn't the cleanest." MRSA can live for long periods on surfaces. But it's also possible Hoff got MRSA from skin contact such as shaking hands.
Hoff was put on vancomycin, one of the few antibiotics that still work against MRSA. The drug caused hives and itching, and has left her with some hearing damage. But it saved her life.
"They said that if I had waited one more day, I would have died," she said.
Hoff spent six days in the hospital and continued to take vancomycin intravenously at home. It took a month before she could grip a pencil and several more weeks of physical therapy before she could write legibly.
More than 2½ years later, the effects still linger -- Hoff's right arm is sensitive to temperature extremes.
Community-associated MRSA has been spreading in such settings as housing projects, prisons and schools. In recent weeks, students in Virginia, New Hampshire and Mississippi have died from MRSA.
Schools in Evergreen Park, Aurora and Naperville and a high school in southwest Chicago reported several new confirmed cases of MRSA last week.
Staph bacteria normally aren't a problem. About 25 percent to 30 percent of the general population have staph bacteria in their noses, and about 1 percent are colonized with MRSA.
And, most MRSA infections aren't serious. They typically cause pimples or skin boils. But serious MRSA infections can lead to pneumonia, bloodstream infections or surgical wound infections.
Dayle Stirm of southwest suburban Crest Hill developed a MRSA infection after surgery for a broken leg.
It took three surgeries to clean out the infection, and Stirm was hospitalized nine days. "At one point, they told my husband I could lose my leg below the knee," she said.
The infection left permanent damage. Stirm, 60, can walk only six or seven minutes with a cane before her leg gets so tired and weak she needs a wheelchair.
MRSA also can be fatal.
A few days after preemie Madeline Reimer came home from the hospital, she developed what appeared to be a cold.
Thirty-six hours later, Beth Reimer found her daughter limp in the crib of her Plainfield home. Madeline was airlifted to the hospital, where she died, 11 days later, from MRSA.
Jeanine Thomas, president of MRSA Survivors Network, said MRSA is "a horrific, recurring infection that occurs at all ages."
Illinois recently became the first state to require hospitals to screen high-risk patients for MRSA. The Illinois Hospital Association, which supports the law, says the tests cost $5 to $21 per patient.
Evanston Northwestern Healthcare goes further. Since 2005, it has been screening every patient at its three North Shore hospitals.
Those who test positive are given an antibiotic ointment for their nose and asked to shower or bathe with an antiseptic soap. This usually gets rid of the bug, thereby reducing the risk of subsequent MRSA infections.