Dangerous staph strain on the rise

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Dangerous staph strain on the riseBy PATRICIA GUTHRIEThe Atlanta Journal-Constitution Published on: 09/12/05 Dublin High School football player Drew Griggs almost didn't live to see this season.Six months ago, a new "superbug" that is showing up in locker rooms and among children attacked him, leaving him tethered to an artificial lung for weeks. Related:• for Disease Control and Prevention• Georgia United against Antibiotic Resistant Disease• More health newsTIPS ON STAPH PROTECTION AND PREVENTION: • The best advice, health experts say, is the mantra of every childhood: Wash your hands.• "Hygiene sometimes just isn't a priority with some people," says state epidemiologist Cristina Pasa. "So my public health message is basically this — bathe."• Practice good hygiene away from home:• Wash hands thoroughly with soap and hot water throughout the day.• When showering, use liquid soap from a dispenser, not bar soap.• Do not share towels, bed linens, razors, clothing, other personal items.• Cover mats with a towel at athletic clubs, wipe down weights before using.• Shower immediately after working out.• Cover all cuts and abrasions.• Do not get in a hot tub or whirlpool until wounds are healed.• Watch for early signs of staph infections: Red, swelling, pain and/or pus around a cut, abrasion or insect bite. • Seek medical attention at the first sign of infection.• Make sure your doctor cultures the wound.• Take all antibiotics as prescribed; don't share or save them.Sources: Centers for Disease Control and Prevention, University of Georgia, Medical College of Georgia. "The doctors told us if he had not been in such good shape, he wouldn't have made it," Bonnie Griggs said of her only son. "He was in the hospital 35 days, then a week in rehab and then he stayed out of school for several more weeks."Drew Griggs is one of five patients suffering from a tenacious strain of staph bacteria to be treated at Children's Healthcare of Atlanta at Egleston Hospital this year. Two children have died, said Jim Fortenberry, director of critical care medicine at Egleston.Community-acquired methicillin resistant Staphylococcus aureus, or CA-MRSA, has become a "common and serious problem," often requiring hospitalization of children, the Centers for Disease Control and Prevention reported this spring."This [strain] seems to come in through wounds or attach itself to the lungs with relative ease. It's a much more virulent and aggressive bacteria when it gets in the wrong place," Fortenberry said.Staphylococcus aureus, or staph, is a common germ that many people carry in their nasal passages, under fingernails or on the skin with no ill effects. But given an opportunity — a skinned knee, insect bite, surgical incision — it invades the body. Usually, minor infections result.When the body's immune system weakens, staph can attack. In Griggs' case, he was sick with the flu when staph jumped in and covered his lungs. Months earlier, a bad cut on his leg had been treated for staph."Drew was basically on his deathbed," said Roger Holmes, coach of the Fighting Irish football team and one of many Dublin residents who visited the sedated, motionless athlete at Egleston. "Now he's back to his normal self, thanks to a lot of prayer and obviously great work by his doctors."On Friday night, the 17-year-old suited up for the first time this season.It 'has just taken over'For years, antibiotic-resistant staph infections have caused illnesses and fatalities in hospital and nursing home patients and among those living in crowded conditions. Two years ago, clusters of cases, first mistaken for spider bites, were reported among inmates of Georgia's Department of Corrections, which now takes preventive measures against the spread of staph.Then it started showing up among college and professional athletes and in military quarters.Now it's everywhere."This thing has just taken over. What we're seeing is everybody being affected," said Dr. Henry Blumberg, infectious disease specialist at Emory School of Medicine and Grady Memorial Hospital. "There's two predominant strains or clones that have emerged."Frank Berkowitz, an Emory infectious disease specialist and Grady pediatrician, said, "It's like seeing a new disease."Metro physicians report seeing an increase of skin abscesses, caused by CA-MRSA (pronounced ca-mersa in medical circles.) It's not uncommon, they say, for families to pass the germ around.Standard antibiotics for skin infections won't kill it. It's susceptible only to newer sulpha antibiotics.However, some patients may go untreated or go home with an older, ineffective antibiotic because some doctors don't recognize the new staph strain, Berkowitz said."It's important now for doctors to actually take a culture and to be aware that MRSA is occurring in the community," said Rachel Gorwitz, CDC medical epidemiologist.Staph can lead to bone, joint and bloodstream infections, pneumonia, and the infection known as flesh-eating bacteria.But most infections caused by the new staph strain are treatable. Local doctors stressed that the public shouldn't be alarmed."But parents need to have heightened awareness of a child or teenager who has a cut that doesn't heal within five days," Fortenberry said.Antibiotic resistanceCommunity-acquired MRSA became a notifiable disease in Georgia this year, meaning physicians are required to report cases to the state Division of Public Health.Since January, about 200 cases have been reported, said state medical epidemiologist Katie Arnold. But that may not reflect the true number, she said.Fighting staph infections is a recurring challenge of modern medicine. Penicillin became powerless against staph bacteria within a decade. Heavy use of another class of antibiotics, methicillin, then led to another antibiotic resistant strain, known as MRSA.Improper overuse of antibiotics leads to the tough new bugs. But the practice of prescribing antibiotics for viruses and flu — for which they are worthless — continues, studies show.The Southeast is one of the nation's biggest offenders of inappropriate antibiotic use, said Jim Wilde, director of Medical College of Georgia's Children's Medical Center emergency department."Resistance is increasing faster than new drugs can be developed," said Wilde, also head of a group of physicians and health educators called Georgia United against Antibiotic Resistant Disease. "Unless this trend is stopped, one day we might find ourselves without effective antibiotics."Athletes prone to spreadStaph infections require skin-to-skin contact to spread. Germs can pass directly from person to person or via shared items, such as razors, bedding and towels.The bug thrives in humid, crowded conditions, such as locker rooms and gyms.Clusters of cases have been reported among professional and collegiate athletes, particularly among football, baseball and wrestling.Ron Courson, director of sports medicine at the University of Georgia, said he makes a point of educating athletes about the bug."In last two years, we've had six cases out of 1,200 athletes, so it's minimal exposure," he said. "We want to keep it that way. We talk to our athletes:'Don't share towels, don't share razors, don't share equipment, wash uniforms immediately.'"While professional and college sports have taken heed of "the bug in the locker room," the message has yet to penetrate high school sports, Courson said."High schools may be more at risk just because they may not have as many resources as colleges and professional sports," Courson said.School officials in Fulton, DeKalb and Cobb counties, and the cities of Atlanta and Marietta said they didn't know of any extra efforts to protect students against the new strain of staph, beyond usual good-hygiene measures.In Savannah, Chatham and Camden County school nurses received a lesson on the new bug last month."We've equipped them with a fact sheet with staph prevention measures, and we're hoping it gets included in the packet that is sent to parents," said Cristina Pasa, epidemiologist with the state's Coastal Health District.Pasa also has spoken with local high school coaches and athletic trainers, and sometimes, directly to students themselves, she said.Bonnie Griggs almost lost a child to the latest strain of staph. She's also a coach of the Dublin High School girls softball team and a physical education teacher.But her southeast Georgia school district, like many, has yet to initiate any awareness efforts aimed at staph infections."As far as officially teaching the coaches and trainers, no, there hasn't been any information," Griggs said. "There should be formal education. A lot of people have a misunderstanding about staph just being in the hospital."I've learned that's not what it is."

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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