Doctors at 'super bug' conference share latest on MRSA

This isn't bird flu. The antibiotic-resistant infection known as MRSA is here now, and it's already an epidemic.

Over a dozen schools in the Chicago suburbs have reported infections with the "super bug" in the past month. And the publicity is getting to parents.

Dr. Nadia Abu-Nijmeh, a pediatrician in Aurora, said parents used to react calmly when she diagnosed MRSA and handed over a prescription for antibiotics.

"Recently, with the hype in the news, they're becoming more scared of it because it sounds like a horrible thing," she said. "But we've been dealing with it for a long time. In most cases, the kids are OK."

How worried should you be, and how can you protect your family? We checked with several experts speaking at a recent medical conference on super bugs to get some answers.

Is MRSA on the rise?

Yes. The incidence of community-acquired MRSA infections has increased in the past decade, a fact that was highlighted last month in a much-publicized article in the Journal of the American Medical Association.

The study raised awareness of methicillin-resistant Staphylococcus aureus, or MRSA, and prompted media reports of local cases. But the recent cases are probably just more reporting -- not more incidences, said Dr. Lynwood Jones, chairman of infection control for Alexian Brothers Hospital Network, which hosted the super bugs symposium.

"You have to be concerned, but not panic-stricken," Jones said.

How dangerous are MRSA infections?

Most people with MRSA have skin infections that are treatable with antibiotics, said Dr. Robert Daum, a pediatric infectious disease specialist at the University of Chicago Medical Center. Less frequently, the infection invades the bones, vascular system and lungs, and can be life-threatening.

"The bacteria likes to go to weak places," Abu-Nijmeh said. "Usually, you have to have a break in the skin."

How do you know it's more than a spider bite?

MRSA skin infections often resemble a pimple or spider bite. So how do you know if it's just a spider bite? According to Daum, it usually isn't. The venomous spiders usually blamed for these bites don't even live in northern Illinois, Daum said.

"I always ask, 'Did you see the spider?' " Daum said. "The answer is never."

If you're concerned about a wound, especially one that's draining, call your doctor.

"If your child has a fever, rashes or abscess, have him seen by his pediatrician," Jones said.

How is MRSA treated?

Antibiotics can control most infections, though some people need them for extended periods of time.

Researchers are working to develop stronger antibiotics to fight these and other bacteria that have grown resistant. They're also working on possible vaccines.

"When you have a infection that's this hard to treat, pediatricians need to speak up and demand a vaccine," Daum said.

Should schools with infected students be sanitized?

It's not a bad idea, but probably won't solve the problem, Daum said.

Schools are targeted because that's where students congregate. But families could just as easily be passing MRSA to each other, he said.

"This is a very contagious disease," Daum said. "When we ask patients if a family member has a skin infection, 60 percent say yes."

According to the U.S. Centers for Disease Control and Prevention, most infections occur from contact with an infected person or with personal items like shared towels or razors. Students should not share football pads or other athletic equipment. Good personal hygiene will help prevent infections.

Abu-Nijmeh said she sees more MRSA infections in the summer, when children are more likely to suffer cuts, scrapes and mosquito bites. Kids are infected at home or in day care settings. Babies sometimes develop infections in the diaper area, she said.

Normal house cleaning is important, but you don't have to go overboard with disinfectants, Abu-Nijmeh said. Try to wipe down children's toys once a day with antiseptic cleaner. Clean and cover any wounds.

"Bacteria is all around us anyway, it's not just MRSA," she said. "If you want to prevent serious disease, you need to practice good hygiene. Hand washing is very important."

What if you're a carrier?

An estimated one-third of the population carries Staphylococcus aureus on their skin or in their nasal passages without becoming sick.

Knowing your MRSA status might be important if you're about to undergo surgery. Bacteria on the skin can enter the body through an open wound.

That's why some hospitals screen all inpatients for MRSA. People who test positive will be isolated and "decolonized" with special cleansers and nasal ointment.

Health care workers and families experiencing repeated infections also sometimes choose to decolonize. But it's not fool-proof. MRSA often comes back, Daum said.

Doctors don't have enough evidence to show which drugs to use and how to apply them, or even who should be included. "Do you decolonize the dog? The dog can transmit MRSA," Daum said.

About half the time, a family that attempts to decolonize will have a subsequent infection anyway, despite their best efforts to clean and disinfect, Abu-Nijmeh said. Doctors also worry MRSA will develop resistance to mupriocin, the ointment used to clear MRSA from the nose.

"Many people can't decolonize," Jones said. "The best way to decolonize is still out there."

Are other resistant bacteria increasing?

Yes. Clostridium difficile, or C. diff, is a bacteria that infects the colon, usually after antibiotics have wiped out the healthy bacteria in a person's intestinal tract.

C. diff spores produce toxins that cause inflammation and diarrhea. New strains of the bacteria are causing more severe complications, especially in people over age 65. It's resistant to most antibiotics.

Most C. diff infections are picked up in nursing homes or other health care settings. But the bacteria also exist out in the community, and some people pick up infections outside of the hospital, said Dr. Dale Gerding, an expert in C. diff at Loyola University Chicago Stritch School of Medicine.

"It's found in water, in soil, and in homes," he said. "It might be in your kitchen."

A quarter of people who develop diarrhea as a result of antibiotics have C diff, Gerding said. The rate has tripled since 2000.

To lower your risk, avoid unnecessary antibiotics, Gerding says, and wash your hands.

"Alcohol is not going to get rid of spores on your hand," he said. "We still recommend hand washing."

Where can I get more information?

Daum recommends the Web sites maintained by the U.S. Centers for Disease Control and Prevention and the Minnesota Department of Public Health.

Check out the CDC's site at www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html. Minnesota's site is www.health.state.mn.us/divs/idepc/diseases/mrsa/index.html.