CINDY ELLEN RUSSELL / CRUSSELL@STARBULLETIN.COM A recent study by the University of Hawaii found that bacterial samples for the methicillin-resistant Staphylococcus aureus were lower than expected off Waikiki and Ala Moana beaches. Here, Chadie Shiraishi, 7 (middle), took a break from digging in the sand yesterday while surrounded by her siblings Chazie, 2, and Chad, 9, at Ala Moana Beach Park.

Superbug swims Waikiki

The bacterium is found in low levels when water samples are taken at town beaches

"They were not as high as maybe I thought they would be," said Steven Seifried, associate professor of cell and molecular biology.

"There wasn't a lot of staph there, but still we have twice the nation's rate of staph aureus on the island," said UH associate professor Matt Bankowski, vice president and director for clinical microbial infectious disease at Diagnostic Laboratory Services.

"We are looking for more virulent strains, trying to make sense out of what they mean," Bankowski said. "Do they really contribute in a big way to disease, or is it a synergistic effect?"

Seifried and Bankowski are partners with Dr. Alan Tice, a UH infectious disease specialist, in the Summer Staph Institute at the UH John A. Burns School of Medicine.

Hawaii is experiencing "globalization of staph aureus," partly because of tourism but also because the bacterium might live longer in a moist tropical environment, Seifried said.

"We don't know whether the high prevalence is due to the fact that we have so many different strains or whether it's due to something unique about our population."

Tice said, "Globally, staphylococci is making a resurgence. It is invading, and it is almost as bad as al-Qaida in many respects. It kills more people than Iraq and Afghanistan in combat.

"It is worse in Hawaii than any other place, and it is getting worse," Tice said, noting Hawaiians and Pacific Islanders are disproportionately affected.

Methicillin-resistant Staphylococcus aureus, or MRSA, includes strains resistant to amoxicillin, penicillin and oxacillin.

Once prevalent mostly in hospitals and other health care facilities, community-associated infections are growing, spread by contact with people or objects with the bacteria.

About one-third of people carry the organism in their nose but have no symptoms, Tice said. Most people with the bacterium do not get infected, but it is a common cause of skin infections and it can be life-threatening.

Staph Institute scientists are sampling the sea to study the derivation of the organisms, to what extent they are bred in the ocean and where concentrations are, he said.

They are developing rapid diagnostic techniques, doing molecular biology research and looking for funding for environmental studies, Tice said.

They are also trying to help people understand what staph is and how to avoid and treat infections, he said. "We want to reduce fear because we have to live with the organisms. There are ways to be careful," he added, such as frequently washing hands and controlling infections with topical antibiotics.

Seifried said the researchers have developed "a pretty sensitive technique" that allows them to detect low amounts of staph A in the water.

They did a series of water collections last summer off Waikiki and Ala Moana and an intensive study over Christmas, he said. They also obtain samples collected at surf breaks by the state Department of Health.

"The bottom line is, we can see these things, but the concentrations of them are so low that it's difficult to imagine that it's actually a risk," Seifried said. "The bathers are shedding staph A into the water, but the ocean is big. ... Dilution happens so quickly."

The focus has been on the drug-resistant organisms because they are harder to treat, Bankowski said, "but other strains contribute to death or virulent forms."

Concerns are being raised about regular staph aureus strains that are not methicillin resistant, he said. "We do have evidence that MSSA (methicillin-sensitive Staphylococcus aureus) does have virulent strains. Some might lose resistance but still maintain virulence.

"The bottom line is, we should be concerned about Staphylococcus aureus in general," Bankowski said. "We see much more variety of types here in Hawaii than on the mainland, where maybe one type is circulating. We're a global magnet here."

Surveillance for staph in hospitals is a major concern, added Bankowski, who just returned from an American Society for Microbiology conference in Boston. Researchers are looking into molecular methods as a means of controlling infections in hospitals more effectively, he said.