U.S. Deaths From Staph Surpass AIDS: Study Shows Majority of Cases of Drug-Resistant Infection Origi

Oct 17, 05:17 AM

Current Headlines: By Alexis Grant, Houston Chronicle

Oct. 17--About 18,700 people die in this country each year from drug-resistant staph infections, according to a federal study released Tuesday -- more deaths than the United States sees from AIDS annually.

The study by the Centers for Disease Control and Prevention, scheduled to be published in today's edition of the Journal of the American Medical Association, is the first of its kind to track methicillin-resistant Staphylococcus aureus, known as MRSA.

Based on data from 2005, the agency estimated that about 94,400 patients nationwide suffer an invasive MRSA infection each year. And in the vast majority of cases, the infections originated in health care settings.

"This is an alarming number of infections and a very significant number of deaths," said Dr. Monina Klevens, a medical epidemiologist with the CDC. "This is really a call to action for health care facilities to do a better job at preventing MRSA."

The once-rare, drug-resistant germ causes more than half of all skin infections treated in U.S. emergency rooms, the CDC reported last year. But until now, there was no solid data on the number of cases nationwide to serve as a benchmark.

The federal study tracked only the most serious type of MRSA, the potentially fatal infection that can cause pneumonia, bloodstream infections and surgical wound infections. Staph infections on skin, which look like pimples or boils, are more common and easier to treat. Both spread by person-to-person contact and are resistant to certain antibiotics.

Dr. Elizabeth Bancroft, a medical epidemiologist for the Los Angeles County Department of Public Health, wrote in an editorial in the medical journal that the 18,700 total exceeds the number of deaths attributable to AIDS in the United States that same year. The CDC reported this year that about 17,000 people in this country died of AIDS in 2005.

Similar trends here Hospitals in Texas are not required to report MRSA infections to the state, so no conclusive data is available on how the germ is faring here. But local doctors and experts say data collected by hospitals for their own use show Houston is following nationwide trends.

"I've seen more and more cases," said Dr. Luis Ostrosky, associate professor at The University of Texas Medical School at Houston and director of epidemiology for Memorial Hermann-The Texas Medical Center.

Memorial Hermann, like some other local hospitals, would not release data on MRSA cases. But Texas Children's Hospital offered statistics showing that the number of patients admitted to the hospital with the infection, or who contracted it during their stay, more than doubled since 2000.

Doctors there counted 1,342 MRSA cases in 2006, compared with 546 in 2000, according to Edward Mason, a professor of pediatrics at Baylor College of Medicine. Fewer than 2 percent of the cases involved patients who contracted infections during their stay, he said.

About 4 percent of the MRSA cases at Texas Children's involve the more deadly type tracked by the CDC, said Dr. Sheldon Kaplan, chief of infectious disease services there.

"Those are the ones that are really serious and may end up in the intensive care unit for weeks on a ventilator," he said.

One of his patients, Nolan Carr, was in that condition for about six weeks before being released from the hospital in mid-September. The boy, now 19 months, had a fever for several days, then a rash, and was vomiting blood when diagnosed with invasive MRSA. He had surgery to drain the infection from around his heart and lungs, said his mother, Vivian Harrold.

"I just felt like I was facing down a storm," said Harrold, who lives in Spring Branch.

Nolan is back home now and acts like a normal toddler, Harrold said. But he's still on oral antibiotics and sees a physical therapist twice a week to regain muscle strength, she said.

Fighting the numbers

Several local hospitals have adopted, or are considering, measures to reduce the number of staph infections transmitted in the hospital.

At the Michael E. DeBakey VA Medical Center, patients are screened with a nasal swab upon arrival and departure so those with infections can be treated. In the one unit where the practice has been ongoing for about a year, in-hospital transmissions have been reduced by half, said Patricia Byers, who oversees MRSA prevention for the hospital.

The CDC study showed that nearly 5,300 infections were reported in nine communities, including San Francisco and the state of Connecticut, between December 2004 and December 2005. Houston was not among the communities studied. Based on those numbers, the agency estimated about 94,400 patients nationwide had invasive MRSA infections during that period.

About 990 in-hospital deaths of patients with MRSA were recorded in those communities in 2005, which led to the nationwide death figure of 18,700.

alexis.grant@chron.com

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