MRSA infection relatively common

[Shiloh]

Source: http://www.mysanantonio.com/news/local_news/64681467.html


Web Posted: 10/18/2009 12:00 CDT
MRSA infection relatively common


By Don Finley - Express-News


In a single month this year, Bexar County had more ? probably a whole lot more ? than 600 cases of a potentially dangerous staph infection that normally isn't officially counted.

And because of that large number, the Texas Department of State Health Services, which released a report containing those findings last week, concluded it would probably be impractical to add MRSA ? methicillin-resistantStaphylococcus aureus ? to the long list of diseases that doctors must report to public health officials by law.

The findings, part of a pilot study approved by the Legislature in 2007, found that Bexar County's rate of MRSA ? a common, drug-resistant skin infection that can quickly become serious ? was similar to that of two smaller Texas communities in the study at 470 cases per 100,000 people. A handful of similar studies across the country have found rates as high as 1,667 per 100,000, and as low as 274.

But officials admitted the new study had limitations that probably obscured the true level of disease. Originally approved by state lawmakers as a yearlong pilot project aimed at determining whether making MRSA a reportable condition would be practical and of value, the study quickly drew complaints from busy health care workers that it would be too burdensome.

So the duration of reporting was cut from 12 months to one ? March of this year. And almost all cases were submitted by hospital laboratories, which tend to see sicker patients than private labs and clinics. Some of these labs, such as University Hospital's, also perform tests for outpatient clinics.

?I would say (the study) was a significant underestimate,? said Dr. Bryan Alsip, assistant director of the Metropolitan Health District, which originally proposed the study. ?In terms of just sheer prevalence, it's a daily thing for any outpatient clinic in this community, and in the country, for that matter.?

MRSA often appears as a pimple or boil. In severe cases, the bacteria can spread to the bloodstream, bones, joints and lungs. Several Bexar County residents have died from MRSA in recent years, including one recent patient also infected with swine flu.

And while it began as a hospital-acquired infection, many people now are infected in the community. An estimated 1 percent to 2 percent of the population carries the bacteria in their nose or on their skin, where it can enter the body through a cut or sore. It's also spread by person-to-person contact or, less commonly, through exposure to contaminated surfaces.

The study, which included Brazos County and the Amarillo area, identified 775 MRSA cases ? 613 of those in Bexar County. Patients ranged in age from 1 month to 100 years. Half were 40 and older. About a quarter of the patients were interviewed and a dozen risk factors identified.

?I think there was a perception when this law was passed that we could find places where transmission occurs,? said Jeff Taylor, an epidemiologist with the state health department who led the study. ?We knew that's not what we would find. It's not in this particular gym in this community. It occurs everywhere.?

INSET:
Who gets MRSA?

In March, state and local health officials examined 775 MRSA cases, 613 in Bexar County. These were their risk factors*:

* 22 percent had been hospital inpatients
* 19 percent had surgery
* 13 percent had contact with another MRSA patient
* 12 percent worked out in a gym
* 10 percent had a previous MRSA infection
* 8 percent were health care workers
* 7 percent lived with someone with MRSA
* 7 percent lived in a long-term care facility
* 5 percent were on a sports team
* 2 percent were incarcerated
* 2 percent got a tattoo

*Occurred in the previous 12 months. Some had multiple risk factors.

 

[Shiloh]

Re: MRSA infection relatively common

Source: http://www.amarillo.com/stories/102309/new_news5.shtml


Web-posted Friday, October 23, 2009

Tracking MRSA costly, burdensome
Monthlong study finds not all cases might be identified

By David Pittman
david.pittman@amarillo.com


A trial study in Potter and Randall counties has led the state to conclude that requiring local health officials to track cases of a dangerous form of staph infection would prove costly and burdensome.

The monthlong study, mandated in a bill passed by lawmakers in 2007, required hospitals, labs and doctors' offices to report each case of MRSA they saw. MRSA, the common name for methicillin-resistant Staphylococcus aureus, is a staph infection resistant to most antibiotics. Many cases are mild skin infections, but in the worst cases, it can enter the bloodstream and cause death.

Bexar and Brazos counties also participated in the study, conducted in March. It was conducted to determine the efficacy of a statewide reporting program. The state recently released the findings from the study.

"With potentially over 100,000 reports annually, adding MRSA infections to the reportable disease list would create challenges for local and regional health departments and the Texas Department of State Health Services to implement and sustain reporting," the report found. "In addition, clinical and hospital laboratories may not have the capabilities and resources to report each person diagnosed with an MRSA infection."

Amarillo hospitals and local public health officials have considered MRSA infections a growing problem in the community and in recent years have taken steps to control and understand infections.

The March study found 95 cases in Potter and Randall counties, which translates annually to 480 per 100,000 people. Amarillo and Canyon's incidence rate was about the same as San Antonio and College Station.

Amarillo Public Health Department Director Matt Richardson said the study confirms that the staph is common in the area.

"Unfortunately, we don't have an effective public health intervention like a vaccine or medication as a prevention, so the reporting process is not as useful as other conditions," Richardson said. "Since we don't have a vaccine or pill to give, we simply rely on education efforts to remind folks about hand washing, wound care, personal hygiene and what symptoms to look for."

Public health officials believe they can use the information from the study to identify trends in infections, target certain demographics and develop ways to stop the spread of disease.

The report said that without sufficient financial support, labs, hospitals, and local and regional health departments would have a difficult time complying with the laborious and expensive task of filing up to 100,000 reports - that's the estimated number of cases statewide - each year.

"That just takes time," Department of State Health Services Epidemiologist Jeff Taylor said.

It likely would require additional staff members to file those reports, he said.

The lengthy process of monitoring the cases diminished the department's ability to track other reportable conditions. Some labs declined to comply with the reporting, saying it was an "unfunded" cost, the report said.

INSET:
Infection rates

# Number of infections in March for Potter and Randall counties by age:

0 - Less than 1 year old

11 - 1 to 4 years old

4 - 5 to 9

12 - 10 to 19

11 - 20 to 29

12 - 30 to 39

12 - 40 to 49

11 - 50 to 59

7 - 60 to 69

15 - 70 and older

Total: 95

Source: State Department of Health Services