Mentioning MRSA to someone outside of the medical field often elicits a blank stare or a vague look of confusion and mistrust. In fact, going so far as to mention Methicillin Resistant Staphylococcus Aureus (MRSA) is usually enough to end a conversation completely. For the most part, the destructive, life-altering scope of MRSA isn’t known to the general public—nor is the risk of acquiring MRSA in the hospital. Knowing many patients and health care workers, I’ve seen prognoses that have varied from life-threatening and permanently disabling, to non-deadly, but career ending. This is the story of two acquaintances of mine: one who contracted MRSA in the community at large, and another who contracted MRSA while at the hospital.
Down on her luck, living in a small, government subsidized apartment, my first acquaintance was forced to share her space with several other near-homeless individuals. Crowded in a tiny room, many of her roommates were poorly fed and suffered from mental illness. As is the case in many situations of extreme poverty, drug abuse and poor hygiene were rampant—as were skin infections. Such close-knit quarters were a breeding ground for CA-MRSA, or Community Acquired MRSA. Community Acquired MRSA differs, in that it’s a) often more aggressive b) less resistant to antibiotics than its hospital counterpart.
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Everyone is looking for a better way to save these kids. Every kid we take care of, it’s like our own child; that’s why we were here - Dr. John Bradley, Chief of Infectious Disease at Rady Children’s Hospital
A Carmel Valley private school was closed last month due to the possibility of one of the students having a MRSA infection. All campus activities were shut down and classes cancelled on a Thursday afternoon until being reopened the following Monday. It was suspected a female student returning from a retreat that very day to the school had potentially been infected. A letter posted on the campus website announced that the private school would be thoroughly cleaned and sanitized by trained personnel. “We feel that we are best serving the interests and well-being of our students, families and employees by taking this precaution.”
According to the national Centers for Disease Control and Prevention, MRSA rates have been on the decline in hospital settings in the last decade while community-acquired cases have increased a notable degree. Just ten years ago MRSA infections were very rare in San Diego, but as Dr. John Bradley points out, the disease is becoming more “resistant and more virulent than ever.” MRSA infections can take the outward appearance of physically damaged skin: painful red areas, a raised bump, abscesses and open sores. MRSA can also induce symptoms of fever and chills. Early detection and treatment, especially in children, reduces the potential severity MRSA as it can be life-threatening and often lead to limb amputation. The invasive cases are extremely dangerous as they can cause a child to die within a few days.
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A recent Seattle study published in the American Journal of Infection and Control found very high rates of MRSA colonization among dental students at the University of Washington. This is cause for concern as we are now only beginning to understand the extent of the MRSA problem outside of the hospital setting. Of the 61 dental students tested, one in five were positive for carrying this superbug within their nose. In addition, samples testing for evidence of MRSA on equipment surfaces, dental chairs, and floors proved that four out of seven dental clinics at the University carried this superbug.
Although the CDC is urging that this study not be taken as a representation of typical rates in dental and hospital settings, the true prevalence of MRSA in our communities is not fully known. Another recent study conducted with dental school students in buffalo, N.Y. presented an even greater rate of infection of infection with 31% of 84 people testing positive for the superbug.
Clearly, the rates of community-acquired MRSA colonization are on the rise. MRSA is found on the skin or most commonly in the nose and those who are colonized may not not even know it as they often do not show signs and symptoms of infection. These studies are therefore one step towards helping us understand the true extent of the MRSA problem. Further study into this topic is needed in order to present a more accurate picture of community-acquired rates of MRSA.