Staph risk runs higher in Pacific, CDC says
POSTED: Monday, March 16, 2009
Pacific Islanders and certain other ethnic groups appear to be at increased risk for drug-resistant staph infections in the community, infectious disease specialists say.
TO PREVENT A STAPH INFECTION
» Wash hands often.
TO TREAT A STAPH INFECTION
» Wash with water or saline two or three times a day.
For more information, contact the Staphylococcus Institute, Suite 400, 550 S. Beretania St.; call 373-3488 or 538-2881; or see www.IDLinks.com.
"Clearly, there's a problem in Hawaii," Dr. Rachel Gorwitz, U.S. Centers for Disease Control and Prevention official. "It seems Pacific Islanders are disproportionately affected."
Hawaii's hospital rates for methicillin-resistant Staphylococcus aureus (MRSA) are twice the national average, the Staphylococcus Institute in Honolulu has reported.
American Indians and Alaska natives are among other groups investigated by CDC for clusters of community-associated MRSA skin infections.
Gorwitz, medical epidemiologist in the CDC's Division of Healthcare Quality Promotion, was among more than 200 scientists and researchers attending a three-day Staphylococcus Symposium at the Hilton Hawaiian Village last week. The Staphylococcus Institute sponsored the event with funding from laboratories and pharmaceutical companies to address "the evolving MRSA epidemic and response."
Staphylococcus aureus, called "staph," are common bacteria on the skin and in the nose of healthy people that can cause infections. But about one-third of people carry it without any symptoms.
Gorwitz, in an interview, said higher rates of staph in some ethnic groups might have to do with socioeconomic factors, crowding, lack of ready access to health care and possibly cultural factors "in the way people perceive skin care."
Dr. Alan Tice, an infectious disease specialist who is one of the leaders of the Staphylococcus Institute, said Staph aureus is a difficult challenge because "it's an intelligent organism as intent on survival as we are. It's a remarkably creative bacteria." And it is unpredictable, with hundreds of strains, all with different virulence and other components researchers are trying to understand, he said.
One of the earliest descriptions of a resistant strain is in Exodus 9:10 about boils as the "sixth plague," noted Dr. Joseph John Jr., associate chief of staff at the Veterans Medical Center in Charleston, S.C.
"For four or five millennia, if not more, it has caused human problems," said Dr. Robert Moellering, Harvard Medical School professor and researcher who has studied antibiotic resistance more than 35 years.
"It is the perfect bacterial storm," he said, because of incredible genetic diversity, the ability to cause a broad variety of serious infections, to adapt to changing environmental conditions and to develop resistance.
Nothing on the body is immune to the organism except hair, teeth and fingernails, he said. It is spread from person to person, and pets and other animals can carry the bacteria, he said.
The CDC recently launched a public information campaign to alert people to symptoms of infection, how to avoid spreading it and when to see a doctor, Gorwitz said. "We're also educating doctors on what to do," she said, noting patients often confuse a staph skin infection with a spider bite, and doctors "kind of accept that."
"Basic hygiene can go a long way to prevent spread of the disease and infection," she said, stressing the importance of hand-washing and showering after contact with weight equipment, towels or other surfaces in gyms or sports.
She said a variety of antibiotics are effective against MRSA strains, but resistance to drugs doctors typically used to treat staph infections began in the mid- to late 1990s.
"Prior to the '90s, we really didn't see MRSA as a cause of staph infection in the community. Now we're seeing it in a majority of community staph infections, and more are caused by MRSA."
Data suggests the strains are spreading more easily and potentially causing worse disease, she said. "It is not just an issue of resistance and what that means for treatment, but also an issue of seeing more and potentially serious disease."
Skin infections such as pimples and boils caused by the bacteria are not life-threatening, but can be serious and require hospitalization, Gorwitz said. More serious surgical wound and bloodstream infections, pneumonia and bone and joint infections also can occur, she said.
"Again, we're starting to see some of these caused by the more drug-resistant form, and it seems we may be seeing more invasive infections than we saw in the past."