A CUP OF HEALTH WITH CDC
Dealing With Drug Resistant Bugs
Severe Methicillin-Resistant Staphylococcus aureus Community-Acquired
Pneumonia Associated with Influenza
April 27, 2007
[Announcer] This podcast is presented by the Centers for
Disease Control and Prevention. CDC – safer, healthier people.
[Matthew Reynolds] Welcome to A Cup of Health with CDC, a
weekly broadcast of the MMWR, the Morbidity and Mortality Weekly Report. I’m
your host, Matthew Reynolds. Antibiotic resistant bacteria is difficult to treat
and can be deadly. The bacteria Staphylococcus aureus can develop resistance
to a common class of antibiotics that includes penicillin. These strains are
called methicillin-resistant Staphylococcus aureus, or MRSA for short. MRSA
usually affects hospitalized patients, but infections are becoming more common
in the community. Here to discuss MRSA, the types of illnesses it can cause
in the community, and how best to deal with it, is Dr. Joan Brunkard, a CDC
Epidemic Intelligence Service officer assigned to New Orleans, Louisiana. Dr.
Brunkard and her co-workers recently published a report on MRSA pneumonia in
the community. Welcome to the show, Dr. Brunkard.
[Dr. Brunkard] Thanks, Matthew. It’s good to be here.
[Matthew Reynolds] Dr. Brunkard, I’ve heard a lot about
antibiotic resistant bacteria in the news lately. How do resistant bacteria
develop and what exactly is MRSA?
[Dr. Brunkard] MRSA is a type of staph bacteria that is resistant
to the common antibiotics, making it difficult to treat. It can lead to life-threatening
infections, including bloodstream infections and pneumonia. MRSA is spread from
person to person, so you don’t have to have taken antibiotics to get MRSA.
Antibiotic resistance is a global problem. It develops as bacteria find ways
to adapt to antibiotics, making them less effective or not effective at all
over time. Ways we as patients contribute to the problem of antibiotic resistance
include skipping doses of antibiotics or not taking all of our pills. Ways doctors
contribute to resistance include prescribing antibiotics when they’re
not needed, for example, for viral infections like flu or the common cold where
antibiotics won’t work.
[Matthew Reynolds] Does this mean that MRSA has no cure?
[Dr. Brunkard] No. Almost all MRSA infections are treatable
with a select few antibiotics. We want to make sure that we prescribe and use
antibiotics correctly so that MRSA doesn’t become resistant to that class
of antibiotics. Many MRSA skin infections for example don’t need antibiotics
at all--they can be drained by a doctor. Of course your doctor is the best person
to consult about how to treat an MRSA infection.
[Matthew Reynolds] Dr. Brunkard, I thought that only people
who are hospitalized are at risk of MRSA, but apparently this isn’t true.
Where do people usually become infected with MRSA?
[Dr. Brunkard] In the past, most people got MRSA infections
in the hospital setting. But recently reports of MRSA infections in the community
have increased. Most of these are skin infections. Ways people can become infected
with MRSA in the community include close skin-to-skin contact with someone who
has MRSA, and perhaps having open cuts or abrasions and coming in contact with
contaminated items or surfaces. And there’s some evidence that living
in crowded conditions and poor hygiene may also contribute. CDC has conducted
a number of investigations looking at clusters of MRSA in the community among
diverse groups such as school children, athletes, military recruits, men who
have sex with men, and prisoners. More recently, MRSA has emerged as a cause
of pneumonia. While rare, MRSA community-acquired pneumonia appears to occur
more frequently during the flu season.
[Matthew Reynolds] You’ve recently published a report
on pneumonia caused by MRSA. Tell us what you found.
[Dr. Brunkard] We found 10 cases of severe MRSA pneumonia
in previously healthy children and adults in Louisiana and Georgia. Four of
the six in our study died within several days of becoming sick. Eight of the
ten people were under 30 and had no underlying medical conditions. We think
this provides further evidence that MRSA pneumonia can be rapidly fatal and
often affects young, otherwise healthy people.
[Matthew Reynolds] You mentioned that several of the patients
in your study with MRSA pneumonia had prior skin infections. Should people who
have had MRSA infections in the past take any precautions?
[Dr. Brunkard] If you have a history of MRSA skin infections
and you become sick with severe flu or pneumonia, make sure to tell your doctor
about your past MRSA skin infections because you may be at a higher risk for
MRSA pneumonia, especially during flu season.
Simple things you can do to avoid MRSA skin infections in the first place include
covering any open wounds or scrapes, keeping your hands clean, and not sharing
personal items such as towels or razors. .
[Matthew Reynolds] Is there anything else you’d like
to tell us about your study?
[Dr. Brunkard] While rare, MRSA has emerged as a potentially
fatal cause of pneumonia, especially during the flu season. Based on this study
and a similar study in 2004, we want physicians to think about MRSA as a cause
of community-acquired pneumonia when patients present with severe respiratory
symptoms during flu season. And if you have severe flu-like illness, tell your
doctor if you have a history of MRSA skin infections because you may be at higher
risk for MRSA community-acquired pneumonia.
[Matthew Reynolds] Thank you for taking the time to talk with
us today, Dr. Brunkard.
[Dr. Brunkard] You’re welcome, Matthew. Thanks for having
me.
[Matthew Reynolds] That’s it for this week’s
show. Don’t forget to join us next week. Until then, be well. This is
Matthew Reynolds for A Cup of Health with CDC.
[Announcer] To access the most accurate and relevant health
information that affects you, your family and your community, please visit www.cdc.gov.