Staph germs harder than ever to treat, studies say: picked up in ordinary community settings ... USA TODAY Oct 27, 2008

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http://www.usatoday.com/news/health/2008-10-27-staph-infections_N.htm Staph germs harder

than ever to treat, studies say

By Marilynn Marchione, Associated Press

USA TODAY Oct 27, 2008 WASHINGTON — Drug-resistant staph bacteria picked up in ordinary

community settings are increasingly acquiring "superbug" powers and

causing far more serious illnesses than they have in the past, doctors reported

Monday. These widespread germs used to be easier to treat than the dangerous

forms of staph found in hospitals and nursing homes. "Until recently we

rarely thought of it as a problem among healthy people in the community,"

said Dr. Gorwitz of the federal Centers for Disease Control and

Prevention. Now, the germs causing

outbreaks in schools, on sports teams and in other social situations are posing

a growing threat. A CDC study found that at least 10% of cases involving the

most common community strain were able to evade the antibiotics typically used

to treat them. "They're becoming

more resistant and they're coming into the hospitals," where they swap

gene components with other bacteria and grow even more dangerous, said Dr.

Klugman, an infectious disease expert at

Emory University .

"It's really a major epidemic." The germ is

methicillin-resistant Staphylococcus aureus, or MRSA. People can carry it on

their skin or in their noses with no symptoms and still infect others —

the reason many hospitals isolate and test new patients to see if they harbor

the bug. MRSA mostly causes skin

infections. Cleveland Browns tight end Kellen Winslow was just hospitalized for

a staph infection, his second in recent years, and the team reportedly has had

at least six cases in the past three years. But the germ can be

life-threatening if it gets into the bloodstream, lungs or organs. Pneumonia,

sinus infections and even "flesh-eating" wounds due to MRSA are on

the rise, doctors reported Monday at an infectious diseases conference in

Washington . About 95,000 serious

infections and 20,000 deaths due to drug-resistant staph bacteria occur in the

United States each year. To treat them,

"we've had to dust off antibiotics so old that they've lost their

patent," said Dr. Daum, a pediatrician at the

University of Chicago . The CDC used a network

of hospitals in nine cities and states to test samples of the most common

community MRSA strain, USA300, over the last few years. MRSA usually is

resistant only to penicillin-type drugs. But 10% of the 824 samples checked

also could evade clindamycin, tetracycline, Bactrim or other antibiotics. "The drugs that

doctors have typically used to treat staph infections are not effective against

MRSA," and family doctors increasingly are seeing a problem only hospital

infection specialists once did, Gorwitz said. Even more worrisome:

many of these community strains had features allowing them to easily swap genes

and become even hardier. Also at the conference: •Doctors from

Spain reported the first hospital outbreak of

MRSA resistant to linezolid, a last-resort drug sold by Pfizer Inc. as Zyvox in

the United States and

Zyvoxid in Europe . A dozen intensive care

patients got pneumonia and bloodstream infections last spring and the outbreak

was controlled after use of the antibiotic was severely curbed, said Dr.

of Hospital Clinico San in

Madrid . •

town University saw a spike in sinus infections due to MRSA. The germ accounted for 69% of the

staph-caused cases in the hospital between 2004 and 2006 compared with 30% from

2001 to 2003. •

Henry Ford

Hospital in Detroit found that more than half of staph-caused pneumonia cases from 2005 through

2007 were due to MRSA. •Doctors from

Case Western Reserve University and the VA Medical Center

in Cleveland found that by the time hospitals isolated and tested new patients to see if

they harbored MRSA, many had already contaminated their skin and surroundings.

Within about a day of being admitted, roughly a third had already started to

spread the germ. Hospital screening is

controversial, and has had mixed success, said Dr. M. Grayson, an infectious

diseases expert at the University of

Melbourne in

Australia . The nation's Veterans

Affairs hospitals began universal MRSA testing in 2007.

Illinois and some other states have adopted

or are considering laws requiring hospitals to test high-risk and

intensive-care patients for MRSA. The conference is a

joint meeting of the American Society for Microbiology and the Infectious

Diseases Society of America.