Emergency Physicians Urge Health Precautions to Fight Drug-Resistant Staph

WASHINGTON, D.C. The spread of a potentially life-threatening antibiotic-resistant staph germ that is responsible for more deaths in the United States each year than the AIDS virus has prompted the American College of Emergency Physicians (ACEP) to launch an education initiative aimed at protecting the public against the further spread of infection.

This emerging superbug, as its known, is causing ACEP to mobilize for two reasons, said Linda Lawrence, MD, FACEP, president of the American College of Emergency Physicians (ACEP). First, we are concerned about the possible spread of this potentially dangerous bacterium especially in schools, nursing homes and health-care settings so we are asking people to practice good hygiene, such as frequent handwashing, to help prevent public outbreaks. Second, ACEP is cautioning against the continued widespread overuse of antibiotics, a practice that has in part caused drug-resistant germ strains like this one to emerge.

At the same time, emergency physicians across the country are on the lookout for cases of antibiotic-resistant infections so these patients can be isolated and treated with the few types of antibiotics that remain effective, before developing potentially life-threatening complications or spreading their infection to others.

According to the Centers for Disease Control and Prevention (CDC) in Atlanta, the potentially deadly bacterium, known as methicillin-resistant Staphylococcus aureus (MRSA), has become impervious to front-line antibiotics, such as penicillin, and is becoming more widespread than public health authorities had thought. The microbe, a strain of a common, previously innocuous staph germ, was responsible for 94,000 serious infections and nearly 19,000 deaths in 2005 surpassing deaths from AIDS by more than 6,100 cases, according to an estimate published in the Oct. 17, 2007, Journal of the American Medical Association (JAMA). African Americans, the elderly and very young children are more susceptible to MRSA infection than the general population.

In addition, a separate report, published in the same JAMA issue, indicates that a strain of another microbe, Streptococcus pneumoniae, which causes ear infections in children, has become resistant to all antibiotics approved for pediatric use.

Taken together, these two reports reveal the need to develop stronger antibiotics that can effectively combat these common but potentially deadly infections while also illustrating the dangerous consequences of unnecessary overuse of antibiotics, said Dr. Lawrence.

Because of these interrelated concerns, ACEP is seeking to protect the public against drug-resistant infections while at the same time educating people on knowing when -- and when not to seek treatment with antibiotics for a range of illnesses.

Many sick people come to the emergency department and want to leave with a prescription for antibiotics, said Lawrence.  People need to realize that doctors cannot prescribe antibiotics for colds or the flu because they are caused by viruses, which do not respond to antibiotics. We need to educate our patients and the public about why overuse of antibiotics is contributing to a public health problem.

Because MRSA is easily spread by casual contact and can rapidly develop into serious life-threatening health conditions, Lawrence advised that minor abscesses, boils and other skin infections be monitored and treated promptly with antibacterial medications and good hygiene practices. She said patients should seek medical attention if these conditions persist, become progressive, painful or disfiguring, or if the patient develops a fever or other more serious symptoms of illness.

Lawrence also stressed the importance of combining caution with common sense. The public needs to remember that staph germs are a common cause of infection, and that 25 to 30 percent of people carry staphylococcus bacteria in their bodies. The difference is that the invasive MRSA strain can become fatal because it has become resistant to most antibiotics, she said.

In addition, Lawrence pointed out that many of these infections can be treated, if caught early enough, by applying heat compresses and lancing and draining sores, and by administering certain appropriate medications. The key is to prevent the germ from spreading to the lungs, vital organs or the bloodstream, where it can cause life-threatening illness, she noted.

Of course, the best protection is always prevention. Among the steps the public can take to prevent MRSA:

Practice good hygiene by frequently and thoroughly washing hands with soap and hot water or using a skin sanitizer containing topical alcohol.

Clean and disinfect cuts, abrasions, punctures and other wounds, and cover them with a bandage.

Avoid contact with other people's open skin wounds, bandages or infections.

Avoid sharing towels, razors, make-up applicators and other personal-care items that can transmit germs.

Seek prompt medical attention for any wound or condition that shows signs of infection (e.g., fever, swelling, redness, or bad smell, fluid draining from the area or increasing pain).

Be aware that common staph germs are more prevalent in public facilities, so more frequent adherence to good hygiene in such settings is recommended.

Source: American College of Emergency Physicians (ACEP)