On MRSA Infections Worldwide

June 20, 2011

Methicillin-resistant Staphylococcus aureus (MRSA) infection has become increasingly common in recent years, due in large part to overuse of antibiotics. According to a 2007 report in Emerging Infectious Diseases, a publication of the Centers for Disease Control and Prevention (CDC), the average number of MRSA infections doubled nationwide between 1999 and 2005 – from 127,000 to 278,000. During the same period, the number of annual deaths from MRSA infection increased from 11,000 to more than 17,000. By increasing awareness about the risk factors associated with and steps that can be taken to avoid MRSA infection, it may be possible to reduce or eliminate its spread.

MRSA infection is caused by a strain of Staphylococcus (staph) bacteria that has become resistant to the antibiotics commonly used to treat staph infections, which include methicillin and penicillin. Generally, MRSA is spread through skin-to-skin contact, openings in the skin (cuts or abrasions), contact with contaminated surfaces, crowded living conditions, or poor hygiene. MRSA frequently manifests first on the skin as a reddish rash with lesions resembling pimples which may begin to drain pus, or lead to cellulitis, abscesses, and impetigo. In addition, the initial skin infection can spread to almost any other organ in the body, resulting in more serious symptoms and potential complications.

Designations are made between types of MRSA infection based on the location where the infection took place. Hospital-acquired MRSA (also called health-care-acquired, HA-MRSA, or HMRSA) remains one of the most common types of infection. Individuals who are hospitalized, those with invasive medical devices such as catheters, and those residing in nursing homes are at an increased risk of acquiring HA-MRSA. Community-acquired MRSA (CA-MRSA or CMRSA) is another common type of infection, and is seen most frequently in individuals participating in contact sports or those living in crowded or unsanitary conditions. While the average adult death rate among individuals with MRSA is estimated at five percent of infected patients, individuals with HA-MRSA are at an increased risk of experiencing complications including organ damage.

Dr. Marc Siegel, an associated professor of medicine at New York University, and others recommend an evaluation of the overuse of antibiotics by humans as well as in livestock as a means of eradicating MRSA and reducing drug resistance in other strains of bacteria. In addition, experts note the importance of good hygiene practices  including washing hands frequently, keeping wounds covered with bandages until they have healed, and washing soiled clothes and sheets in hot water can help to prevent the spread of MRSA. The timely diagnosis of individuals infected with MRSA achieved through an analysis of a skin sample helps to better ensure not only treatment for the individual, but also a decreased risk of infecting others.

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On Drug Resistance

June 28, 2010

As the distribution of medications worldwide advances, individuals gain access to improved treatment options. Among the medications most frequently distributed are antibiotics. Though expanded access to medicines is “clearly desirable,” it can also create “challenges in preserving the efficacy of these drugs.” A recent report from the Center for Global Development (CGD) indicates that antibiotic distribution programs put in place by the World Health Organization, government agencies, and other groups may be contributing to the increased incidence of drug-resistant bacteria. According to Nancy Birdsall, the president of the CGD, “Drug resistance is a serious problem that doesn’t get serious attention.”

Antibiotics and antimicrobial agents are the most effective means of combating infectious disease. However, as a class of drugs, antibiotics are unique in that once an antibiotic is utilized, the bacteria it is intended to fight begin to develop a resistance and the effectiveness of the medication is diminished. According to British researchers who analyzed 24 previous studies, the excessive prescription and use of antibiotics for coughs and flu-like illnesses leads to antibiotic resistance. Studies indicate that the overuse of medications, inconsistent drug quality, and other factors hasten the adaptation of resistance to given antibiotic and antimicrobial agents.

This increased resistance to commonly used antibiotics can result in “superbugs,” such as methicillin-resistant Staphylococcus aureas (MRSA), which is the cause of more than 50 percent of staph infections in US hospitals. Additionally, in the developing world, drug-resistant strains of malaria, tuberculosis, HIV/AIDS, and other diseases are the cause of death for millions of children each year. According to Céire Costello Research Associate at the University of Bristol, “there are some concerns that some common infections are becoming increasingly difficult to treat.” This is seen with increasing frequency in many remote and medically underserved areas of the world where medication dispersal programs are especially  prevalent. Reports indicate that 60 to 80 percent of dysentery cases among children in Latin America are “resistant to the drugs recommended to treat it.”

By retaining the medications available now and developing new drugs, experts hope to be able to continue combat bacterial infections effectively. Because of the lengthy development and testing process associated with creating new medications for mass consumption, it is critical to ensure that drug resistance is minimized as much as possible. By urging providers to keep track of which antibiotics they prescribe and how frequently, it may by possible to help slow the rate of drug resistance. It is also essential for clinicians and individuals worldwide, particularly in the developing world, to be aware of the importance of not over prescribing or over using antibiotics.

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