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We've been hearing for some time now about the proliferation of drug-resistant staph infections caused by bacteria that are stronger than antibiotics. Today there's an indication that in at least one small portion of the universe, the infections are actually on the decline.

The rate of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections from central lines (intravenous catheters) in hospital intensive care units (ICUs) dropped by half between 1997 and 2007, according to research in tomorrow's Journal of the American Medical Association (JAMA). It’s unclear exactly how many Americans become sick with MRSA in ICUs every year, but an estimated 94,360 Americans contracted such infections in 2005, just over a quarter of them caught in the hospital, according to CDC research published two years ago in JAMA. MRSA is responsible for 5.6 percent of all central line-caused infections.

So it’s good news, but there are a few catches: If you do catch a staph infection in the ICU, it was still more likely during the time period studied that you’d have MRSA, rather than the much more treatable methicillin-susceptible Staphylococcus aureus (MSSA).

Nor does the research, by Centers for Disease Control and Prevention (CDC) researchers, speak to the chance of catching MRSA elsewhere in the hospital — never mind outside, which is where experts say the problem is worst.

"This is just a subset of the problem and we can't use it to speak to the whole problem," says study co-author Deron Burton, a lieutenant commander in U.S. Public Health Service. "But we are seeing success in reducing MRSA risk, because while ICU patients are smaller in number, they are highly vulnerable. To see we've had dramatic decline in high-risk patients is a very exciting finding about what's happening with MRSA in the healthcare facility."

Burton added that the data doesn’t make clear why MRSA is more common in the ICU than MSSA. Overuse of antibiotics has been speculated as a possible cause.

Hospitals in recent years have tried to reduce bloodstream infections by implementing more standardized hand-washing procedures for staff, methods of inserting catheters and taking them out sooner. But the study doesn’t show which of these infection-control methods, if any, accounted for the decline in staph and other bloodstream infections in the ICU, wrote Michael William Climo of the Hunter Holmes McGuire VA in Richmond, Virginia, in an editorial accompanying the study.

What's more, fewer than 6 percent of ICUs that submitted data to the National Healthcare Safety Network, a voluntary surveillance system that monitors the infections, contributed data for the whole length of the study. And it's unknown whether MRSA bloodstream infections transmitted through ventilators, or those in the skin and soft tissue, also decreased among those hospitals.

"Clearly, ICUs … have made substantial progress at reducing hospital-acquired infections, suggesting that real change is being made," Climo wrote. "Despite this progress, most ICUs are far from the goal of zero infections."

Image of MRSA/CDC/Janice Haney Carr/Jeff Hageman via Public Health Image Library

6 Comments

1. 1. candide 09:23 AM 2/18/09

   Let's see, people in Intensive Care Units are contracting infections, and its good news?
   
   "It’s unclear exactly how many Americans become sick with MRSA in ICUs every year" - yet the number has dropped by half??
   
   Sounds like a$$ covering BS to me.

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2. 2. jh443 02:35 AM 2/19/09

   Just out of curiousity... how does this decline compare to VRSA rates?
   

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3. 3. quiact 01:49 PM 5/8/09

   With medical institutions, and bacterial infections acquired within them, sometimes death is a good thing- for a vicious multi-cellular organism.
   There are a variety of different types of bacterial infections one can get from many different sources, yet some locations are more common than others. If bacteria are not beneficial for your health, as many bacteria are, they should die in order to restore your health.
   Bacteria are a simple life form, yet are incredibly productive and efficient. As with other life forms, they exist to reproduce, and does so about every hour. Bacteria mutate, evolve, and adapt according to the host in which they exist.
   To do this, it fully utilizes all available resources and energy to develop the protein that is essential for its survival in their host. Bacteria need exactly 7 genes to produce the essential ribosomes for their existence. Any more or less genes than 7, the bacteria is not maximizing its efficiency to survive and reproduce. Amazing.
   Strep infections are caused by what are called gram positive bacteria, and they are the most common bacteria that infect other humans. . Group A strep infections can cause diseases such as strep throat and pneumonia. Also, staph bacterial infections are gram positive as well that potentially infect humans, and do so often.
   Of all pathogenic, or disease-causing bacteria that exist, it is the MRSA, the methicillin resistant staff aureus bacteria, that are most concerning to health care providers in particular. This is because MRSA bacterial infections are the most difficult to cure when a patient suffers from their damage from being infected by these bacteria.
   Another difficult situation is when a patient is infected by VRE, Vancomycin Resistant Enterococci, which is another type of gram positive bacteria that exist.
   These MRSA and VRE bacteria are difficult to eradicate due to the fact that most antibiotics that are available to rid the patient of other bacterial infections, MRSA and VRE are resistant to the effectiveness of these antibiotics.
   MRSA and VRE infected patients are quite challenging for the health care provider who is attempting to cure patients infected with these particular bacterial infections.
   In many situations, pathogenic bacteria infect a patient already within a medical institution for another disease. When this occurs, it is called a nosocomial infection.
   

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4. 4. quiact 01:51 PM 5/8/09

   Greater than 5 percent of nosocomial infections are determined to be MRSA infections, it has been reported. As a result, there are about 100,000 serious hospital infections, as well as about 20,000 deaths from MRSA infections annually.
   Since there are several types of pathogenic bacteria that exist, a diagnostic test called a culture and sensitivity is usually performed at a clinical laboratory to assure the correct antibiotic is selected for treatment, as the bacteria are identified with this diagnostic method.
   Typically, fluid from the area suspected of being infected is obtained from the patient suspected to have an infection and smeared on what is called a petrie dish. And then these dishes are incubated for 2 to 3 days. Gram positive bacteria stain during this process a dark violet or blue. Gram negative bacteria would be pink in color, and are capable of harm as well to a human being.
   When the culture is complete, technology that is available offers recommendations on the appropriate class or brand of antibiotic to treat the pathogenic bacteria present in another person- presuming the bacteria will not be resistant to the antibiotic recommended, as this happens on occasion.
   Usually, classes of antibiotics that are used to treat gram positive strep infections that are not VRE or MRSA bacteria are cephalosporins, macrolides, or general penicillins. If the microbe that is causing the infection is resistant to the antibiotic from such classes that are administered to the infected patient, other options should be considered for anti-microbial therapy.
   With two very powerful antibiotics in particular, which are methicillin and vancomycin, their frequent use in infected patients has resulted in VRE and MRSA bacteria that are now resistant to these antibiotics.
   When a patient is infected with VRE or MRSA bacteria, other selections for antimicrobial therapy that provide more efficacy should be selected for a patient infected with these types of infections. Such brands and types of antibiotics for MRSA and VRE bacteria include Zyvox, which has both IV and oral dosage options, and an antibiotic called Cubicin.
   However these antibiotics for antibiotic resistant bacteria are given usually due to infections that have progressed to a more serious nature within a patient infected in such a way, so a cure is not immediate when these antibiotics are selected for such patients.
   Progressive medical conditions with such infected patients include sepsis, or blood infection, osteomyelitis, or bone infection, as well as pneumonia, which is a serious lung infection. A hospital stay is normally required with such patients infected with MRSA and VRE infections that cause such diseases.
   This is because when the antibiotics that potentially cure the patient of these microbes are selected, they are usually given via IV administration, and are administered normally for several days, if not several weeks.
   

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5. 5. quiact 01:52 PM 5/8/09

   There are numerous classes and types of antibiotics available, yet bacterial resistance to most of these antibiotics, with the exception of the two mentioned earlier, constantly remain a serious concern for the health care provider, and the MRSA and VRE infected patient.
   With MRSA at the top of the list of concerns for the health care providers, this infection continue to occur progressively, which amplifies the concerns of others.
   Medical institutions should possibly consider quarantine for those patients at their locations that have been determined to be infected with the MRSA and VRE bacteria more often in the future.
   http://www.cdc.gov/ncidod/dhqp/ar_mrsa_spotlight_2006.html
   Dan Abshear
   

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6. 6. Tim33966 02:35 PM 11/4/09

   An ounce of prevention... http://www.infectioncontrolservice.com

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