January 17, 2008 – A new
and highly drug-resistant strain of the
bacteria known as MRSA has been discovered with alarming frequency
among gay men in San Francisco and Boston according to a research study
released Monday.
The study, published in the Annals of Internal Medicine, indicated that
the new MRSA strain, known as USA300, has spread rapidly among men who
have sex with men in San Francisco and Boston. According to the
study, the bacteria appears to have spread through anal intercourse as
well as casual skin-to-skin contact and by touching contaminated
sources. The study also noted that infections were seen in
patients independent of their HIV status.
“The identification of a new and more virulent strain of MRSA that
appears to spread by sexual contact is an alarming new development,”
said Manuel Hernandez, MD, MBA, President of the LGBT Health, Education
and Research Trust (LGBT HEART). “The seriousness of this
bacterial infection signals the need for our community to be
ever-vigilant with regard to our health.”
Once confined mainly to hospitals, MRSA, short for
methicillin-resistant Staphylococcus aureus, has gained greater
notoriety as otherwise healthy individuals have acquired the bacteria
outside of the hospital setting.
MRSA infections can range from localized skin infections, abscesses and
ulcers, to the life-threatening condition known as necrotizing
fasciitis, more commonly referred to as the flesh-eating
bacteria. MRSA has also been known to cause pneumonia and
systemic blood infections, among other difficult-to-treat infections.
According to Dr. Hernandez, there are steps that can be taken to help
minimize the risk of contracting the multi-drug resistant MRSA strain.
“The San Francisco study suggested that washing with soap and water
after sexual intercourse may help reduce the risk of
transmission. We know from past experiences with other MRSA
strains that liberal use of soap and water can significantly reduce the
risk of transmission,” said Dr. Hernandez.
The treatment for multi-drug resistant MRSA varies and depends on the
severity of the infection, the patient’s baseline health status and the
results of bacterial cultures showing which antibiotics are an
effective treatment option. In the case of USA300, the MRSA
strain spreading through the gay male community, only one antibiotic
commonly used to treat MRSA appears to be effective. That
antibiotic, known as trimethoprim-sulfamethoxazole (Bactrim®), can
be used in oral or intravenous preparations. Other, less commonly
used antibiotics also show effectiveness against the virulent strain.
“Any patient who has the warning signs of a potential skin infection of
abscess should seek immediate medical attention,” stated
Dr.Hernandez. “Early detection and treatment, in addition to
intimate partner notification is critical to help minimize the effects
of a multi-drug resistant MRSA infection.”
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MRSA at a Glance:
What is it?
MRSA, short for methicillin-resistant
Staphylococcus aureus is a
bacterial infection.
How
do you get it?
Transmission of MRSA occurs through
direct contact with the
bacteria. This can occur through skin-to-skin contact, such as
during casual, intimate or sexual contact, or by direct contact with
any surface contaminated with the bacteria.
Some individuals are “carriers” of the bacteria, meaning they have the
bacteria in their nasal passages or on their body but they have not
developed an infection.
What
are the symptoms?
The symptoms of a MRSA infection vary
and depend on the type of
infection that occurs. Skin infections commonly present as an
area of redness that can be tender and/or warm to the touch. An
abscess, or boil, can also be seen at the site of infection. MRSA
that has spread throughout the body can cause fever, fatigue, nausea,
vomiting, lethargy and many other symptoms of systemic illness.
When
should I seek medical
care?
MRSA is a serious infection that
requires immediate
medical treatment. If you suspect you have a skin or systemic
infection, you should seek medical care immediately.
What
is the treatment?
The treatment for a MRSA infection depends on the severity of the
illness, the location of the illness, your baseline health status and
the results of bacterial cultures.
Skin abscesses (boils) should be evaluated immediately by a physician
for likely drainage and culture. Some patients can be treated
simply with oral antibiotics while more severe cases of MRSA may
require hospitalization and administration of intravenous
antibiotics. Patients who are HIV-positive or have other
conditions that may impact their immune system should make their
healthcare provider aware of this before treatment is initiated.
Carriers of the MRSA bacteria can be treated based on guidance from a
physician. However, the recent study that has identified this new
USA300 strain of MRSA has suggested that standard treatments for
carriers might not be effective. Consultation with a physician is
recommended for anyone suspected of being a carrier of the USA300
strain of MRSA.
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