Staph fatalities may exceed AIDS deaths

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Staph fatalities may exceed AIDS deaths

By LINDSEY TANNER, AP Medical WriterTue Oct 16, 7:37 PM ET

More than 90,000 Americans get potentially deadly infections each

year from a drug-resistant staph " superbug, " the government reported

Tuesday in its first overall estimate of invasive disease caused by

the germ.

Deaths tied to these infections may exceed those caused by AIDS, said

one public health expert commenting on the new study. The report

shows just how far one form of the staph germ has spread beyond its

traditional hospital setting.

The overall incidence rate was about 32 invasive infections per

100,000 people. That's an " astounding " figure, said an editorial in

Wednesday's Journal of the American Medical Association, which

published the study.

Most drug-resistant staph cases are mild skin infections. But this

study focused on invasive infections — those that enter the

bloodstream or destroy flesh and can turn deadly.

Researchers found that only about one-quarter involved hospitalized

patients. However, more than half were in the health care system —

people who had recently had surgery or were on kidney dialysis, for

example. Open wounds and exposure to medical equipment are major ways

the bug spreads.

In recent years, the resistant germ has become more common in

hospitals and it has been spreading through prisons, gyms and locker

rooms, and in poor urban neighborhoods.

The new study offers the broadest look yet at the pervasiveness of

the most severe infections caused by the bug, called methicillin-

resistant Staphylococcus aureus, or MRSA. These bacteria can be

carried by healthy people, living on their skin or in their noses.

An invasive form of the disease is being blamed for the death Monday

of a 17-year-old Virginia high school senior. Doctors said the germ

had spread to his kidneys, liver, lungs and muscles around his heart.

The researchers' estimates are extrapolated from 2005 surveillance

data from nine mostly urban regions considered representative of the

country. There were 5,287 invasive infections reported that year in

people living in those regions, which would translate to an estimated

94,360 cases nationally, the researchers said.

Most cases were life-threatening bloodstream infections. However,

about 10 percent involved so-called flesh-eating disease, according

to the study led by researchers at the federal Centers for Disease

Control and Prevention.

There were 988 reported deaths among infected people in the study,

for a rate of 6.3 per 100,000. That would translate to 18,650 deaths

annually, although the researchers don't know if MRSA was the cause

in all cases.

If these deaths all were related to staph infections, the total would

exceed other better-known causes of death including AIDS — which

killed an estimated 17,011 Americans in 2005 — said Dr. Elizabeth

Bancroft of the Los Angeles County Health Department, the editorial

author.

The results underscore the need for better prevention measures. That

includes curbing the overuse of antibiotics and improving hand-

washing and other hygiene procedures among hospital workers, said the

CDC's Dr. Scott Fridkin, a study co-author.

Some hospitals have drastically cut infections by first isolating new

patients until they are screened for MRSA.

The bacteria don't respond to penicillin-related antibiotics once

commonly used to treat them, partly because of overuse. They can be

treated with other drugs but health officials worry that their

overuse could cause the germ to become resistant to those, too.

A survey earlier this year suggested that MRSA infections, including

noninvasive mild forms, affect 46 out of every 1,000 U.S. hospital

and nursing home patients — or as many as 5 percent. These patients

are vulnerable because of open wounds and invasive medical equipment

that can help the germ spread.

Dr. Buddy Creech, an infectious disease specialist at Vanderbilt

University, said the JAMA study emphasizes the broad scope of the

drug-resistant staph " epidemic, " and highlights the need for a

vaccine, which he called " the holy grail of staphylococcal research. "

The regions studied were: the Atlanta metropolitan area; Baltimore,

Connecticut; Davidson County, Tenn.; the Denver metropolitan area;

Monroe County, NY; the Portland, Ore. metropolitan area; Ramsey

County, Minn.; and the San Francisco metropolitan area.

____

On the Net:

JAMA: http://jama.ama-assn.org

CDC: http://www.cdc.gov