Last week, more than 200 physicians, microbiologists, nurses and scientists came to the Hilton Hawaiian Village to hear more than 30 speakers who came from five continents to share information about the global epidemic of Methicillin-resistant Staphylococcus aureus (MRSA). The three-day conference was organized by the Staphylococcus Institute because of the problems we face with this formidable organism, which appears to affect the people of Hawaii more than any other state and is a particular problem among Pacific Islanders and the homeless in Hawaii, according to national studies and the posters displayed.

The updates and information shared by the international leaders and clinicians and scientists brought some ideas and hope about how to deal with this global epidemic, including the following:

» MRSA is a serious epidemic around the world as well as in the United States, where it kills more people than AIDS.

» The epidemic strains of staphylococci are evolving and increasing in resistance to antibiotics as well as virulence. They also have learned ways to spread more easily among people.

» MRSA is a community problem that is now finding its way into hospitals.

» Antibiotics might not always be needed for infections, even when caused by MRSA. Incision and drainage of an abscess might be enough in many cases - the body then takes over and heals itself. Overuse of antibiotics can impair the immune system and kill off protective bacteria.

» The reservoir for MRSA is people, one-third of whom carry the organism in and around their noses. A few animals can carry it as well but most appear to be a different strain that does not cause an infection in people.

» The environment is not a usual source of staphylococci as they do not survive long outside people. There is, however, new information about how to reduce the spread when material is contaminated - such as with a copper coating.

» Rapid testing for MRSA is now available and studies are under way in Honolulu. The time for identification of MRSA has been shortened from two to three days down to an hour. This methodology is being tested in a local emergency room and is in use to test people before they are admitted in many hospitals

What the future has in store for this epidemic is unclear but the Staphylococcus Symposium has brought a better understanding and some hope - with messages to be taken from Hawaii to the rest of the world.

If you have questions or would like to help support the Staphylococcus Institute, a nonprofit organization, please let us know - at www.IDLinks.com or 808-373-3488 or 544-2852.

Alan Tice, M.D., is an infectious-disease specialist in Honolulu. He is the founder of Infections Limited Hawaii, whose Web site coordinates information and resources available on infectious diseases and clinical microbiology.