An impending epidemic: MRSA

A new study has found that drug resistant staph infection (Staphylococcus Aureus) has spread to urban poor in Chicago. The researchers reports a seven fold increase in patients with MRSA infections at Stroger Hospital’s emergency room and Cook County medical clinics between 2000 and 2005.

According to the study, the incidence of CA-MRSA skin and soft tissue infections increased from 24 cases per 100,000 people in 2000 to 164.2 cases per 100,000 people in 2005.

Until the late 1990s, MRSA was found exclusively in hospitals. Beginning in 1998, a community-associated form of the bacteria (CA-MRSA) emerged globally, with more potential toxins than hospital-acquired MRSA. Risk factors for CA-MRSA include jail or prison time, exposure while playing certain sports, intravenous drug use, overcrowded housing, tattooing and poor hygiene.

MRSA stands for methicillin-resistant Staphylococcus aureus, a potentially virulent bacteria that doesn't respond to several antibiotics used to treat common staph infections. People struck by the bug frequently develop painful skin boils or abscesses and, in rare circumstances, deadly pneumonias, blood infections and other life-threatening conditions.

"MRSA is becoming epidemic in the community," warned Dr. Bala Hota, the lead author and assistant professor of infectious diseases at Rush University Medical Center.
"It's unknown why USA300 (the MRSA strain dominant in Chicago) is so good at spreading in communities or where it comes from or even how it's transmitted."

The pathogen commonly resides in nasal passages or on skin and can be transmitted easily by casual contact with another person or a contaminated surface. Whether on a bedside table or an X-ray machine, a stethoscope or Bible, it can survive for days. Also, millions of Americans have been found to be unknowingly "colonized" with MRSA but show no symptoms.

According to scientists, County Jail might be an important reservoir of infection as it provides an overcrowded, unsanitary environment ideal for the growth of MRSA. The bacteria can be passed between inmates on mattresses, towels, soaps, etc. as these are mostly shared. And these infections are then transferred in the broader community as nearly 350 inmates come into and leave the jail everyday. Many of these inmates return to poor neighborhoods and public housing complexes, raising the risk of infection.

Also, the hospital environment has been found to harbor these bacteria. In one of the routine examinations, patient exam tables, counter tops, computer keyboards and patient chairs in a busy AIDS clinic tested positive for MRSA in Johns Hopkins Hospital. Thus an increased vigilance in hygiene and infection control practices is required.

The Chicago Department of Public Health is working on an MRSA educational Campaign, targeting the medical providers so that they can prescribe appropriate antibiotics. Also, measures are being taken to maintain hygienic conditions at the jail and in the housing complexes. However, these steps are not adequate and a lot more needs to be done.

According to Michael Vernon, director of communicable disease control for Cook County’s Department of Public Health, the jail officials, the public health officials and the researchers need to come together and plan requisite surveillance and control measures.