Washington Blade - January 25, 2008
Chris Crain - Matt Shafer

communities in several major U.S. metropolitan areas is also affecting some patients at the Whitman-Walker Clinic, according to a Clinic spokesperson.

But Chip Lewis said in each case the Clinic has been able to treat the clindamycin-resistant MRSA infections with other medications.

"We do see drug-resistance to that particular drug, but we don't use it that often," he said. "We use others because most anything we see still responds to those other medications that we use."

Lewis said he could not quantify how many MRSA infections are seen at the Clinic, but added that they are "a pretty frequent" kind of infection.

District of Columbia Department of Health spokesperson LaShon Seastrunk said her department does not record MRSA cases and so could not comment on the degree to which the disease was affecting the Washington area.

The drug-resistant strain of MRSA came to national attention because of a medical study published earlier this month examining cases of infections in San Francisco and Boston. The study identifies the drug-resistant MRSA as a disease that almost exclusively affects gay men in those areas.

Another study, published April 2007, found that MRSA infections affecting gay men in New York City were also more resistant to certain antibiotics than MRSA infections in other communities.

Mainstream news outlets pounced on the story, running headlines like, "Gay men 13 times more likely to develop MRSA infections." One London tabloid called MRSA the "new HIV" and several news organizations deemed it a sexually transmitted disease. But few of the reports were accurate, according to one of the study's authors, Dr. Henry Chambers, professor of medicine at the University of California-San Francisco.

"We put the information out there, and how one is going to interpret what we put out, we can never know," Chambers said.

Most of the misreading can be attributed to a disconnect between the highly technical language of researchers and how those words are understood by the public, he said.

The claim that men who have sex with men are 13 times more likely to acquire this strain of MRSA than the general population is true, Chambers said, but those words need to be put into perspective. The study only looked at individuals in San Francisco with reported MRSA infections, so when the report says general population, it means those with an MRSA infection in San Francisco, not the population as a whole, Chambers said.

Dr. Rachel Gorwitz, a medical epidemiologist with the Centers for Disease Control & Prevention in Atlanta, said MRSA had been misrepresented as a "superbug."

"I guess the implication when people use the word æsuperbug' is that it can't be treated, and that isn't the case," Gorwitz said.

In ideal circumstances, most people can be treated by lancing the boil caused by the infection and covering the wound.

Anti-gay conservative groups seized on the report. In a Jan. 15 statement, Matt Barber, a policy director at Concerned Women for America, said the occurrence of the strain demonstrates how the medical community realizes that "homosexual conduct, especially among males, creates a breeding ground for often deadly disease."

"The human body is quite callous in how it handles mistreatment and the perversion of its natural functions," he said. "When two men mimic the act of heterosexual intercourse with one another, they create an environment, a biological counterfeit, wherein disease can thrive."

Christopher Graber, one of the authors of the study examining infections in San Francisco and Boston, said determining why the drug-resistant MRSA strain is primarily affecting the gay community is difficult because the disease can be spread through skin-to-skin contact and not just sexual intercourse.

"We've never really conceptualized [MRSA] as a sexually transmitted disease," he said. "The reasons why it's just gay men is ultimately unclear at this point."

Graber said the locations of the MRSA lesions in the patients examined in his study suggest that individuals were transmitting the disease sexually. He noted that the lesions often occurred in the groin, upper thigh, buttocks and pelvic regions.

Graber downplayed the danger of the disease, noting that MRSA infections are most often not fatal and that even drug-resistant strains can be treated with alternative antibiotics.

"MRSA gets a lot of press as being this flesh-eating bacteria that kills people left and right, but the really severe complications à are in a very, very rare proportion of infection," he said.

The drug-resistant strain of MRSA can be treated with trimethoprim-sulfa, an antibiotic often given to treat infections in HIV-positive patients, Graber said. Some tetracyclines are also effective in treatment, he said.

Most infections can be treated without the use of any medication.

Graber said practicing safe sex measures "probably would help to a certain extent" in preventing MRSA infection. However, he said individuals who practice safe sex measures were probably at less of a risk of contracting the disease.

"If you're practicing safe sex, in terms of using barrier protection, you kind of tend to be more careful overall and so you might less likely to have sex with someone who has kind of an active lesion." Graber said personal hygiene would be a more important factor in preventing infection, such as bathing after sex.

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