A New Kid on the Block: MRSA

By Dave Burry

Last week I was working out in one of Louisville 's prominent sweat pits. These are my favorite kinds of gyms – no glitter, nothing glamorous, just some good old-fashioned free weights and a bunch of fans blowing around hot air. While awaiting my favorite machine I noticed the last guy using it left about 12 ounces of his body weight behind in the form of sweat. I thought to myself, “It's just perspiration, go get a towel and wipe it off.” For some reason my conscience said, “use another machine.” Part of my hesitation was due to a group of bacterial “superbugs” occupying our health-care facilities and our communities. This superbug's name is Methicillin Resistant Staphylococcus Aureus, also known as MRSA.

Staphylococcus aureus or Staph is a common form of bacteria found on human skin. The most common campsites are in the nose, armpits, groin area and genitals. When these guys congregate together on your body without causing an illness it is known as colonization. In most cases staph causes minor infections such as boils or pimples but the potential to cause serious infections is on the rise.

As our medical technology becomes wiser so does MRSA. Drug-resistant bacteria infecting people in the hospitals and the communities has been steadily increasing in recent years. Some staph bacteria such as MRSA have become resistant to the traditional antibiotics such as methicillin, penicillin, oxacillin and amoxicillin. It appears this phenomenon has occurred due to inappropriate prescribing and overuse of antibiotics and the bacteria's ability to mutate and acquire resistance.

MRSA is a treatable infection, but the correct antibiotics must be prescribed. In the past MRSA was mainly confined to its cushy settings in hospitals but has decided to venture out to our local communities. A three-year study conducted by the Baylor College of Medicine and the Texas Children's Hospital found that among staph aureus cases in children acquired in the community, the proportion of isolates that were MRSA had reached 76 percent in 2003. The Centers for Disease Control and Prevention stated that data from a perspective study in 2003 suggests that 12 percent of clinical MRSA infections are community associated.

Symptoms of staph or MRSA are almost non-existent. They often begin with an injury allowing the bacteria to enter the skin and form into an infection. Initially, it manifests into a pimple or boil but can quickly escalate into red swollen areas containing pus or other drainage. Simply draining the abscess or boil, thus not requiring antibiotics, can treat some cases of staph but a health care provider should perform this. If not treated correctly, serious cases of MRSA can include pneumonia or bloodstream infections.

In January of 2005, ABC news reported on a college football player who contracted MRSA following a game. The doctors prescribed five different antibiotics. In the end the doctors could not handle the infection and the individual died. Doctors in University of Chicago hospitals stated that 65 percent of staph infections coming into their emergency rooms are MRSA. It doesn't stop there; other college and professional football teams are reporting escalating cases of MRSA. This is due to athletes spreading the bacteria through towels, showers or contaminated equipment. If regular, drug-resistant bacteria are not enough, some bacteria have become multi-drug resistant. Harvard Medical School conducted a six-year study of the prevalence of bacteria resistant to three or more drugs. From 1998 to 2003, there was a significant increase in patients carrying multi-drug bacteria when admitted to a hospital.

MRSA is primarily spread through good old-fashioned skin-to-skin contact. High-risk settings include locker rooms, workout facilities, nursing homes, hospitals or crowded habitats. Hospitals will usually diagnose MRSA by taking a swab sample from a suspect wound or from the mucous membrane in the nose. The bacteria are then cultured in a laboratory setting. This will enable hospital personnel to identify the bacteria and prescribe the appropriate antibiotics to treat it. Things you may want to think twice about sharing with other individuals include, towels, soap, bandages, sheets, clothes and benches in saunas, hot tubs or athletic equipment. To arm ourselves against this new nemesis the CDC recommends individuals to wash hands thoroughly with soap and water or an alcohol sanitizer, keep wounds covered until healed, avoid contact with other people's wounds and avoid sharing personal items such as towels or razors. So the next time you're working out, whether in a sweat pit or a health club, carry a towel and don't leave your bodily fluids behind. There may be more at stake than you realize.

David Burry is co-owner of Greenleaf Management Inc., a Louisville-based consulting firm specializing in environmental health, workplace safety and wellness. David, a graduate of Trinity High School, has a B.S. in industrial risk management and a M.S. in environmental health, coupled with 16 years in the environmental/occupational health industry. You may contact David at 502-297-8783 or dburry@greenleafmanagement.com or visit his web site at www.greenleafmanagement.com. David and his wife, Linda, enjoy hiking, bicycling and scuba diving.