Staph Strain Infects More Healthy People

From: MrPepper11 (MrPepper11_at_go.com)
Date: 09/30/04 

Date: 29 Sep 2004 17:35:31 -0700

Associated Press 9/29/04
Staph Strain Infects More Healthy People

TRENTON, N.J. - Flesh-eating bacteria cases, fatal pneumonia and
life-threatening heart infections suddenly are popping up around the
country, striking healthy people and stunning their doctors.

The cause? Staph, a bacteria better known for causing skin boils
easily treated with standard antibiotic pills.

No more, say infectious disease experts, who increasingly are seeing
these "super bugs" — strains of Staphylococcus aureus unfazed by the
entire penicillin family and other first-line drugs.

Until a few years ago, these drug-resistant infections were unheard of
except in hospital patients, prison inmates and the chronically ill.
Now, resistant strains are infecting healthy children, athletes and
others with no connection to a hospital.

"This is a new bug," said Dr. John Bartlett, who chairs the committee
on antibiotic resistance at the Infectious Diseases Society of
America. "It's a different strain than in the hospital ... more
dangerous than other staph.

"Primary care physicians and ER doctors, they don't all know (about
this) and should," he said.

Bartlett, a professor at Johns Hopkins University School of Medicine,
treated three young Baltimore area women this year who got pneumonia
from this community-acquired resistant staph. All had to be put on
breathing machines, and one died, he said.

The infections will be a hot topic at the society's annual meeting
this week in Boston. The group has been warning that drug companies
aren't developing enough new antibiotics to avert a crisis.

Among the case reports to be discussed:

_In Los Angeles, doctors at UCLA Medical Center treated 14 people with
necrotizing fasciitis, informally known as "flesh-eating bacteria,"
over a 14-month stretch through April. Three needed reconstructive
surgery and 10 spent time in intensive care.

"This is about as serious an infectious disease emergency as you can
get," said Dr. Loren G. Miller. "We don't know how these people got
the infection — there doesn't seem to be a common thread."

_In Corpus Christi, Texas, doctors at Driscoll Children's Hospital saw
fewer than 10 cases a year of community-acquired resistant staph
infections in the 1990s, then saw 459 in 2003, with 90 percent in
healthy children. Half were admitted to the hospital to get
intravenous antibiotics; a few developed life-threatening lung and
heart infections or toxic shock syndrome.

_A Centers for Disease Control and Prevention (news - web sites) study
shows another new twist: The resistant staph strain caused pneumonia
in 17 people, killing five, during last year's flu season. Only one
had any risk factors for the infection.

"Nobody dreamt when we were in medical school that this would ever
enter the community," said Dr. Rajendra Kapila of University of
Medicine and Dentistry of New Jersey in Newark.

He has treated several patients with the infections at University
Hospital there, including an itinerant golf caddie who kept getting
abscesses on his neck until he landed in the hospital two years ago.
Kapila linked the infections to abrasions from the man's golf bag
strap.

In August, a man in his 40s with severe back pain turned out to have
such a severe staph infection in his spinal cord he was paralyzed
permanently, Kapila said.

Dr. John Segreti, an infectious disease specialist at Rush University
Medical Center in Chicago, estimates about 1 in 10 patients, some with
prior health problems, die from the infections.

Dr. Dan Jernigan, a CDC epidemiologist, said athletes, children and
military recruits are at higher risk. They are more likely to get cuts
and scrapes and share close quarters and items such as towels and
soap. Another factor is overuse of antibiotics, which tends to kill
weak bacteria and help hardier ones develop resistance.

"Clinicians will have to think differently about skin infections,"
Jernigan said. "We treat most skin infections without ever testing
them."

Testing will tell whether a strain is antibiotic-resistant, but the
tests are expensive.

There are no national statistics on these infections, but health
authorities are debating requiring doctors to report them.

CDC has reported on numerous infection clusters, including Colorado
fencing club members, college football players in Pennsylvania and Los
Angeles, and high school wrestlers in Indiana, and dozens of Pacific
Islanders in Hawaii. Many patients were hospitalized, including most
of the athletes. At least two outbreaks have occurred among Native
Alaskans since 1996, with many cases linked to steam baths.

In New Jersey, infection clusters were reported in 2003 and earlier
this year involving two high schools and members of one family.

In Stafford, Texas, Janet Johnson's 13-year-old son Nicholas had such
a severe infection — apparently after a minor football injury last
October — that he was hospitalized for 5 1/2 weeks and nearly died.
The staph infected his lungs, blood and bones, destroying hearing in
one ear and making it difficult to walk.

"He was like a stroke victim," she said, but he's doing much better
now thanks to extensive physical therapy, repeated surgeries and
continuing use of antibiotics.

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On the Net:
Infectious Diseases Society of America: http://www.idsociety.org