Since penicillin’s discovery in 1928 and its use to treat infections beginning in the 1940s, bacteria have been fighting back. Through years of genetic adaptations, microbes have successfully sidestepped many of the antibiotics developed to destroy them — building resistance to even penicillin derivatives like amoxicillin and Keflex.
Today, public health officials are entrenched in battle against an unusually tough strain of microbe known as MRSA, or methicillin-resistant staphylococcus aureus.
Originally cropping up in a hospital in 1961, a second version of this “superbug” recently has emerged in crowded community settings such as schoolyards and locker rooms — leading to a rash of skin infections and, in rare cases, death. This type of staph infection — known as community-acquired MRSA (CA-MRSA) — differs clinically and genetically from the health-care associated MRSA (HA-MRSA).
 
Everywhere you go
Staph aureus, along with other bacteria, is a natural inhabitant of the body. Five to twenty percent of people carry it on their skin and in their nose and throat — inadvertently spreading it to athletic gear, yoga mats, clothing, door handles, faucets and other objects. Susceptible people then pick it up with their hands or through a skin abrasion — often developing a hot, swollen, painful red bump that looks like a “spider bite.”
“Almost 40 percent of the staph aureus isolates cultured at the Pullman hospital lab are CA-MRSA,” said Timothy Moody, Whitman County physician and public health officer.
Moody said HA-MRSA is most often associated with surgical site infections, pneumonias and septicemias (bloodstream infections), which usually are resistant to all but one antibiotic called vancomycin. CA-MRSA, on the other hand, tends to cause skin infections like boils and abscesses or infected cuts and scrapes. And these infections, though resistant to methicillin, are often surprisingly sensitive to the use of older antibiotics like bactrim or even plain penicillin.
 
WSU protocols
Bruce Wright,
physician and director of WSU Health and Wellness Services, said several cases of MRSA were seen in the student clinic during the fall but all responded well to treatment. HWS is collaborating with the Athletic Department, University Health and Safety Committee and Environmental Health and Safety to distribute information about MRSA — and to form strategies to help decrease risk to campus personnel.
“The number one prevention for MRSA is hand washing!” said Margaret Bruya, professor and assistant dean for Academic Health Sciences at the Intercollegiate College of Nursing at WSU Spokane. “It helps stop the ‘horizontal transmission’ — person-to-person spread of the bacteria.”
She also met recently with health officials to discuss infectious disease among students, staff and faculty in general.
“We have decided that if someone has shown a positive culture for MRSA, there is no reason to limit their activities as long as they continue to use good management — seeing the doctor, draining the infection, bandaging and using antibiotics,” she said. “If the lesion is on the face or hands, we will decide it on a case-by-case basis.”
So far, Bruya said, no students with MRSA have been seen in WSU Spokane Health and Wellness Services.
 
Personal hygiene
Like Moody and Wright, Bruya advises personal hygiene as the first line of defense against MRSA. Beyond appropriate hand washing techniques (see diagram) and medical treatment, she advises people “not to share personal items like razors or towels, be careful with ‘cosmetic shaving,’ disinfect athletic equipment and frequently wash your bed linens and gym clothes.”
Avoiding skin-to-skin contact with infected individuals is important to prevent spread of the bacteria. Moody recommends staying home if you have a draining wound that can’t be covered and avoiding contact sports until the wound is completely healed.
Bactericidal solutions are available for cleaning surfaces, he said, but “extensive cleaning of buildings and facilities, such as schools, is unlikely to help.”
For more information on MRSA in the workplace, see ONLINE @ www.cdc.gov/niosh/topics/mrsa or www.tpchd.org/page.php?id=336.