Stubborn infection worst in Hawaii


POSTED: Wednesday, March 11, 2009

Studies of Hawaii's homeless people show more than 70 percent of those with wounds have staph infections — and 80 percent of the strains are drug-resistant, says Dr. Alan Tice, Honolulu infectious-disease specialist.

The high rate of methicillin-resistant Staphylococcus aureus in the homeless compares with 2 percent to 5 percent in the average population and they appear to have an epidemic strain of the “;superbug”; known as USA300, he said.

Hawaii hospitals also have twice the national average of patients with MRSA, he said.

“;They have learned resistance to common antibiotics we've been throwing at them for years,”; he said. “;We're No. 1 in the country.”;

These will be among growing problems posed by antibiotic-resistant bugs explored by more than 200 authorities in the field at a three-day conference tomorrow through Saturday at the Hilton Hawaiian Village.

An opening ceremony for “;The Evolving MRSA Epidemic — and Response”; was scheduled tonight at the hotel. State Sen. Joshua Green (D, North Kohala/Kona), a Big Island emergency room doctor, will discuss a plan to deal with the superbugs.

The meetings, starting at 6:30 a.m. tomorrow, are open to anyone interested in MRSA; the kamaaina price is $25 a day. The low price is offered because of special needs in isle communities, Tice said.

The Hawaii-based Staphylococcus Institute organized the conference to discuss the epidemic and address it as an international issue, Tice said.

The sessions will focus on epidemiology, therapy, microbiology and basic research. Posters will be presented from around the world, including from Iran, “;which has a particular problem with antibiotic resistance that may be a precursor to what is coming,”; conference planners said.

“;We're trying to figure out what to do to contain it (the superbug),”; said Tice, a University of Hawaii-Manoa professor and private-practice infectious-disease specialist. His institute partners are Dr. Matt Bankowski of Diagnostic Laboratory Services and Dr. Steven Seifried, UH associate professor of cell and molecular biology.

Staphylococcus aureus is a common bacteria that lives on the surface of the skin of healthy people. It is a major cause of skin and soft-tissue infections and can be deadly.

Tice said an estimated 19,000 Americans die each year because of MRSA infections — “;more than the number of people who die of AIDS,”; he said. “;Yet it's almost ignored and considered part of life.”;

He said the USA300 strain is relatively new. “;We didn't know how big a problem it is in the homeless population.”;

In Denmark, pigs were found colonized with the bacteria, he said.

“;In our attempts to look at it, animals don't appear to have it, with a few exceptions.”; Some outbreaks have occurred with horses and pigs, but not in Hawaii, he said.

The Netherlands found ways to contain the superbug, but “;these organisms are not dumb,”; Tice said. “;They have abilities to spread that they didn't have before. It goes from one person to another.

“;We need to understand: What's spreading this in our homeless community and is it a threat to others? Is it a reservoir? Do we have to do more with safety kits? If a person has to be hospitalized, should they be held in quarantine?”;

U.S. veterans hospitals put people with S. aureus in quarantine when they're admitted, but other hospitals don't, he said, noting heavy debate on this question.