Bay Area Reporter - November 22, 2007
Seth Hemmelgarn

In 2005, deaths from the infection outnumbered deaths from AIDS, according to one medical journal

But according the Centers for Disease Control and Prevention, MRSA - or methicillin-resistant Staphylococcus aureus - still affects only 1 percent of the population. And at least one doctor said that fears of MRSA might be overblown.

Dr. Erica Pan is an infectious disease specialist in the San Francisco Department of Public Health's communicable disease control and prevention section who has researched MRSA.

"People should be aware," Pan said, but calling it a "superbug," as some have, is an overstatement.

MRSA is not a new bug, and staph infections frequently become resistant to antibiotics.

"It's something that comes and goes from the public's attention," Pan said.

MRSA is a type of staph infection. According to the city's communicable disease control and prevention office, Staphylococcus aureus is a bacterium that lives on human skin, or inside the nose. For up to a third of the population, Pan said, bacteria can be colonized - or carried without symptoms. For others, however, an infection - usually minor - occurs.

The Journal of the American Medical Association published a report in its October 17 issue, based on nine surveillance sites around the United States from 2004 to 2005, that estimated there were about 18,650 deaths from MRSA in that time period. San Francisco was among the places studied. The CDC has estimated that about 17,000 people in the U.S. died from AIDS in 2005.

Pan said these numbers may be accurate, but notes fewer people are dying from AIDS because of increased treatment, so it's easier for MRSA to catch up. The JAMA report also noted most of the deaths were from invasive infections people got in a health care setting, rather than outside in the community. Invasive infections affect the blood, bones, or joints. According to the CDC, MRSA account for an increasing number of health care-related staph infections.

It's not totally clear if there are increased risks for people with HIV, Pan said. "Some studies say maybe people with HIV have an increased risk," she said, but other studies say they may not.

The JAMA report also noted MRSA was first reported among injection drug users in Detroit in 1981. A recent study by CDC staff in Georgia found possible associations between methamphetamine and MRSA among a largely rural community there. People who use methamphetamine may pick at their skin, causing it to break. That makes it easier for infection to occur.

Dr. Adam Cohen, a CDC epidemiologist involved in the study, said the Georgia study and a 2005 report involving methamphetamine use among HIV-positive men in Los Angeles highlight "the ways MRSA is spread and what you can do to prevent it."

Cohen said good hygiene is key. Methamphetamine use is believed to lead to increased sexual activity, but any skin-to-skin contact can spread MRSA, he said.

Pan said staph infections are most commonly spread through skin-to-skin contact, although cross-contamination is possible.

People should follow a few simple rules in order to protect themselves: Avoid direct contact with wounds or infected areas, wash your hands frequently and thoroughly for 15 to 20 seconds, keep wounds and scrapes covered, and avoid sharing razors and towels.

For more information, visit www.sfcdcp.org/index.cfm?id=100 or >www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html.

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