Cases of aggressive, drug-resistant staph infections among Monroe County residents fell 22 percent from 2005 to 2009, suggesting efforts are working to stop the bacteria from spreading in hospitals, nursing homes and outpatient settings such as dialysis centers.
The bacteria is methicillin-resistant staphylococcus aureus, nicknamed MRSA, or oxacillin-resistant staph, ORSA. Both terms indicate that the bacteria can no longer be killed by antibiotics in the penicillin family. Patients may require six weeks of intravenous antibiotics and surgery to treat the illness, which can cause life-threatening damage to bones, joints, bloodstream, surgical sites, heart valves and lungs.
MRSA raised concerns among local parents in 2007 when several mild cases — skin infections — occurred in schoolchildren in Monroe County at about the same time as a Brooklyn middle school student and a Virginia teen died of MRSA infections. Some officials called for tracking all cases nationwide, but that didn’t happen. The severe form of the infection tends to strike older adults.
The largest study of the severe infection, covering cases from 2005 to 2008 in nine representative communities including Monroe County, was published Wednesday in the Journal of the American Medical Association. The nine metropolitan areas, which together have 15 million residents, had 21,503 episodes of invasive MRSA infection in the four years.
Eighty-one percent of the infections were linked to recent health care, and most of those were bloodstream infections. Most MRSA infections occur after a patient has surgery, receives a catheter or otherwise undergoes medical care that allows bacteria an opportunity to get past the skin.
The largest drop in cases — nationally and locally — was in those diagnosed during hospitalization, at least 48 hours after being admitted. Among Monroe County residents, such cases dropped from 139 in 2005 to 96 in 2009, a 31 percent decline.
Others in the study got infected with MRSA either after returning home from the hospital or outpatient care or without any recent medical care. Hospitals have emphasized infection-reduction strategies ranging from practitioners consistently washing hands between patients to wearing masks and gowns and draping patients before inserting a central line.
The result: “It is safer to come and be treated at the hospital,” said Dr. Ghinwa Dumyati, a University of Rochester infectious disease physician and Monroe County Department of Public Health epidemiologist. She led the Centers for Disease Control and Prevention project to track lab-confirmed infections in Monroe County. Hospitals and health care providers are remaining vigilant.
On the same day as the good news about MRSA, a study was published in The Lancet Infectious Diseases journal about a germ called gram-negative bacteria that’s highly resistant to nearly all antibiotics. It’s been found in patients in India and Pakistan and in U.K. patients who had elective surgery in India. The infections are less deadly than MRSA and hospitals likely can use the same precautions to keep that super- bug from spreading.