Washington Week: Student Voices (O)

Drug-resistant staph infections on the rise
By Elizabeth St. John
Arkansas Traveler (U. Arkansas)
10/09/2006

(U-WIRE) FAYETTEVILLE, Ark. — Staph infections are a problem for many students on college campuses and can be prevented with good hygiene and general cleanliness.

Staphylococcus aureus, often referred to as "staph," is a common pathogen in skin and soft tissue infections, said Sue Schultz, APN and family practice nurse practitioner at the Pat Walker Health Center.

These bacteria are carried on the skin or in the nasal cavities of many people and do not always lead to infection. However, the bacteria spread through contact and can cause infection, Schultz said.

Methicillin Resistant Staphylococcus Aureus, or MRSA, is a type of staph infection that is resistant to penicillin-type medications, she said. When a bacterium no longer responds to antibiotics, it is called a resistant strain.

Most MRSA infections, though, can be treated with good skin care and medication, Schultz said.

The common MRSA strain today, referred to as community-acquired MRSA, is a more resilient strain than ones in the past, and it spreads more easily, Schultz said.

MRSA used to be most common in hospitals where patients had suppressed immune systems, she said, but the most recent strain is commonly spread outside of hospitals between otherwise healthy children and adults.

Community-acquired MRSA infections are an increasing problem throughout the country, Schultz said.

"We certainly are seeing a lot more cases of these staph infections this year than we saw last year," she said.

Symptoms of staph infections usually start as bumps on the skin that resemble spider or bug bites, Schultz said. Within a couple of days, though, the bumps can become tender, raised, warm and firm.

Sometimes a yellowish pussy substance will drain from the bump, she said. These spots can be sparse or abundant, and they can occur on just one area of the body or on several areas, she said.

"Staph doesn't have a predilection for any particular body part," Schultz said.

If staph bacteria enter the body, they can cause infection that ranges from pimples and boils to blood infections and pneumonia, which can be fatal, according to the Centers for Disease Control and Prevention Web site.

"The majority of infections are not problematic," Schultz said, but they can become serious. "For the most part, it's not terribly harmful," she said, "but it can go from what looks like a little pimple to a big sore pretty quickly."

Staph infections can lead to swelling, scarring of the infected tissue, missed work and school, and for athletes, missed games, Schultz said. "It can lead to amputation if it gets bad enough and you ignore it for too long," she said. Very rare cases can also lead to death, she said.

However, staph infections can be treated.

"If you have a bump, you really need to take care of it," Schultz said. One small bump could be simply drained and bandaged, she said.

A health care professional would be able to perform this procedure in a sterile environment. Warm, moist compresses are also helpful, she said. If the infection is more serious, antibiotics would be prescribed, she said.

Once a person is infected, he or she can easily spread the infection to someone else or "you can give yourself more of an infection," Schultz said. Puss from the bumps the infection produces or simple friction can spread the infection.

Spreading of the infection can occur in locker rooms, public showers and other places frequented by many college students.

"It's really easy to spread staph," Schultz said.

Wearing flip-flops in public showers is one way to reduce the risk of initial infection, she said, as well as not sharing towels, clothing, uniforms, razors or other personal items. Non-washable athletic gear and equipment should be sanitized after use. People who are susceptible to staph infections should be checked regularly for suspicious skin lesions that might be MRSA, she said.

When a person is infected with MRSA, he or she can become reinfected on a different part of the body, according to the Arkansas Department of Health and Human Services Web site.

Staph bacteria can continue living on the person's body even after initial infection heals. This colonization of the germs can cause a later infection, according to the Web site. Occasionally, a healthy person can also become infected by coming in contact with the colonization of germs on another person's body, according to the Web site.

In an outbreak of MRSA in Alaska in 2000, prior use of antibiotics was a risk factor for infection, as resistance to antibiotics used to treat MRSA caused the antibiotics to be unhelpful to some people, according to the CDC Web site.

Therefore, proper use of antibiotics can be helpful in preventing MRSA infection, according to the Web site.

Once infected, further spread of the infection can be avoided by disposing of old bandages in a plastic bag, washing hands frequently and especially after touching infected areas, refraining from picking at any bumps, and using antibacterial soap to cleanse the affected area, Schultz said.

Take care of wounds and keep sores covered, she said. Wash clothing that came in contact with sores with hot water and detergent. Disposing of old shower sponges can also help, she said. If lesions are present on the underarms, disposing of roll-on deodorant is a good idea, she said.

Staph infections are relatively common on college campuses because students "have more exposure to the transition mode," Schultz said.

People who work out by using common equipment, who share clothing, who use common shower facilities and who frequent hot tubs are more likely to obtain an infection, she said.

In the 1940s, staph infections were first treated with penicillin, but a few years later, a strain of the bacteria resistant to penicillin emerged, Schultz said. In 1959, a semi-synthetic antibiotic called methicillin was introduced, and by 1961, methicillin resistance in staph was first noted in the United Kingdom, she said.

By 1968, there was methicillin resistance in the United States.

This is why the infection is now known as Methicillin Resistant Staphylococcus Aureus, she said.

In the 1980s, MRSA began to emerge as a pathogen in the community, as opposed to it previously being common in health care facilities, Schultz said.

In 1999, the deaths of four children brought community-acquired MRSA to national attention, she said.

The first population of people who were infected by community-acquired MRSA included children and teenagers who were involved in fencing and wrestling, Schultz said.

The fencers shared uniforms, and the friction of the unwashed uniforms against skin during fencing spread the infection. The wrestlers had contact with mats and other wrestlers, and this might have spread the infection, she said.

A vaccine for MRSA has been developed and has shown promise in prevention of infection with dialysis patients, according to the CDC Web site.

However, the vaccine has not been tested on other test groups and is not yet approved by the FDA, according to the Web site.

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