Treatment of MRSA Can Be Expensive

Oct 27, 01:02 AM

Current Headlines: By KRIS WISE

People infected with the worst cases of MRSA can face weeks in the hospital and medical bills that mount into the thousands of dollars.

But medical officials say the strain of staph infection that's made news recently in West Virginia can be treated much more easily, as long as it's caught early.

The version that's spreading is the community strain of the infection, very different from the hospital-based superbug that is resistant to most antibiotic remedies.

Health care personnel said there's no reason for panic, but that a lot of misconceptions about the infection have people on edge.

"We have gotten so many calls," says Danae Bixler, an epidemiologist for the state. "I was on call (Monday) and I was on the phone almost all of the time. The person here Friday was on the phone all day. And unfortunately, this is not new."

West Virginia officials first started hearing reports in 2003 about the strange skin infection circulating in the general public. That was decades after MRSA - methicillin-resistant Staphylococcus aureus - was first detected in hospitals.

That more severe strain is now mostly seen among very ill patients in hospitals, nursing homes and other long-term health care facilities. Often, the infected patients, and those who get MRSA infections deep into their bones and bloodstreams, wind up spending weeks in the hospital and must rely on IV-administered drugs to knock out the infection.

Only a few strong antibiotics have been proven successful in treating such cases, including vancomycin and Cubicin, and a new oral drug called Zyvox. All are expensive.

Bob Wright, a pharmacist at Advance Pharmacy in Charleston, said one day's dose of vancomycin is about $32 and a day's worth of Cubicin is $172. But the cost of treatment, which can last for a month or more, is several times the cost of the medicine, because the drugs have to be administered intravenously.

One day's dose of Zyvox is $164.

It's a far different therapy than what's usually required for the kind of MRSA making the rounds in the Mountain State and throughout schools and close-knit communities across the country.

The more common infection usually takes hold in a cut, scrape or other wound. It often passes from person to person through direct skin contact.

That's one reason it is frequently detected among athletes.

"The new community strain did not evolve from the hospital strain," Bixler said.

She said it most likely evolved in the community as a result of the overuse of antibiotics. Many modern viruses and infections have grown to be immune to the most commonly prescribed drugs.

"In 2003, it was a rarity for us, it was an oddity," Bixler said.

Calls about the infection first started coming from West Virginia corrections officials, and it was passing from inmate to inmate in the prisons and jails.

Nationally, the trend was the same.

Soon after, reports starting coming about MRSA showing up in small clusters among families and groups in tight-knit towns.

"There was a group of people where one family did their laundry at somebody else's house, and there were cases (of MRSA) in both families," Bixler said.

The state began investigating the reports throughout the spring and summer, and many medical professionals were then unfamiliar with the new community-based strain.

"Now, it's the most common cause of skin infections in West Virginia," Bixler said.

During a recent meeting of general practitioners and clinicians throughout the state, Bixler said she asked the group how many were finding community MRSA as the most common skin ailment among outpatients.

Everyone present raised his or her hand.

In the past few weeks, public school students in at least four counties have tested positive for MRSA.

Officials at West Virginia State University also confirmed this week that nine football players had contracted the infection, and the school had to temporarily shut down its locker rooms and hire professional cleaners to disinfect certain areas.

Public school officials in Kanawha County have spent much of this week answering calls from parents concerned about the spread of the infection. School Superintendent Ron Duerring issued a mass phone message to parents assuring them the school system was trying to keep things clean and urging them to enforce hand washing among their children.

Dr. Fred Kerns, an infectious disease specialist in Charleston, said Tuesday that two people had come into his office that morning with skin abscesses infected with MRSA.

The infection, essentially, is everywhere.

According to a report from the Mayo Clinic, the bacteria is present in the nose or on the skin of about 30 percent of the population.

"It's important to realize there are a large number of people who carry the disease but aren't actually infected," Kerns said. "It can flare up."

That happens when a person who carries MRSA or is exposed to it gets the infection in a wound.

People inflicted will notice a cut or scrape that hasn't healed or a small spot on their skin that some say resembles a spider bite.

Typical treatment includes cutting and draining the infected area, and sometimes that's enough to get rid of the infection.

"A lot of skin infections, if they're caught in the early stages, might not even require antibiotics," Bixler said. "A lot of people might remember their parents or grandparents lancing a boil at home. That's what we do."

Bixler said treatment typically involves drainage and frequently cleaning the wound.

When that doesn't work, "there are a lot of pills that are very good," Kerns said. "But many people (in the medical community) need to reset their thinking, because what might have worked 10 years ago doesn't work today."

Often, a doctor can prescribe a series of oral antibiotics other than the penicillin-based drugs that seem to have no effect on MRSA. Among the most common are Bactrim, doxycycline, clindamycin and Cipro, Kerns said.

The treatment takes much less time and costs a lot less than what might be required for hospital MRSA or more serious bone infections.

Officials at public schools and in colleges and university are issuing warnings to students to keep all wounds covered and to notify administrators if they've been diagnosed with the infection.

Schools in one Virginia county actually shut down temporarily last week after a 17-year-old student died when a MRSA infection spread to his heart and muscles.

The Centers for Disease Control and Prevention reported 94,000 MRSA infections and 19,000 deaths last year.

Health care experts say fatalities are most common among those more susceptible to serious infection, such as very young children, the elderly and people who are already ill.

Contact writer Kris Wise at kriswise@dailymail.com or 348-1244.

Originally published by DAILY MAIL STAFF.

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