MRSA study alerts medical community to increased incidence

National report - Results of a recently released study charting the startling increase in incidence of both community- and hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) are no surprise to many dermatologists, who advise more thorough testing of patients for the presence of the potentially dangerous bacteria - and more care in prescribing antibiotics.

In June, the Association for Professionals in Infection Control & Epidemiology (APIC) released results of a study showing that 34 of every 1,000 hospital inpatients are infected with MRSA - a rate about 10 times higher than a 2000 Centers for Disease Control and Prevention study that identified more than 125,000 MRSA infections annually.

The APIC study surveyed infection control professionals at 21 percent of U.S. hospitals last year.

Ms. Warye says one of the most significant findings is that 67 percent of the MRSA cases were not ICU or ER patients, but patients who were hospitalized for more routine medical care, such as pulmonary conditions, cancer or diabetes.

"This tells us that MRSA cases are found throughout the hospital and are not isolated," she says. "MRSA is also being found in healthy adults and shows up as a bump on the skin that looks like a spider bite or lesion. Private practice dermatologists may well see more incidents of MRSA than dermatologists associated with hospitals."

"I think that most dermatologists would agree that community-acquired MRSA is definitely on the rise," says Dr. Ganesan, assistant professor in the department of dermatology at the University of California, Irvine. "In my clinical practice, community-acquired MRSA is very prevalent."

Joel Schlessinger, M.D., director of Skin Specialists P.C., Omaha, Neb., is more emphatic.

"We are now seeing patients in numbers that I never imagined years ago who are infected with MRSA," says Dr. Schlessinger, who is president of the American Society of Cosmetic Dermatology & Aesthetic Surgery.

"These patients span all ages, from 2-year-olds who picked it up in day care to the usual elderly patients who were hospitalized and picked it up while in the hospital," he says. "I recently saw a patient who had scalp irritations that wouldn't heal. Six months prior, I had cultured them and found staph. She was placed on an antibiotic regimen of Septra (trimethoprim and sulfamethoxazole, Monarch Pharmaceuticals) and cleared, but never came back for follow-up until one week prior to going to camp for the summer.

Rise tied to antibiotic use

Ms. Warye says the primary reason for the rise in MRSA infections is the misuse and overuse of antibiotics over the years. As a result, she says, MRSA has become resistant to most antibiotics.