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Senior Citizen Health & Medicine
Senior Citizens Four Times More Likely to be Hit by
Drug Resistant Staph Infection
JAMA study says MRSA more prevalent than assumed and
no longer contained in health care setting
Oct. 16, 2007 - Infections caused by methicillin-resistant
Staphylococcus aureus (MRSA) appears to be more prevalent than
previously believed, affecting certain populations disproportionately –
senior citizens in particular - and is being found more often outside of
health care settings, according to a study in the October 17 issue of
Journal of the American Medical Association. Methicillin is used to
treat penicillin-resistant infections.
This study found the incidence rate of invasive
MRSA for 2005 was 31.8 per 100,000 persons, but it was a staggering
127.7 per 100,000 for senior citizens (age 65 and older). That makes
senior citizens four times more likely to be hit by this potential
killer than are other adults.
An editorial in the same edition of JAMA calls the
rate of invasive MRSA found in this study “astounding.”
MRSA has become the most frequent cause of skin and
soft tissue infections among patients going to emergency departments in
the United States, and can also cause severe, sometimes fatal invasive
disease.
"As the epidemiology of MRSA disease changes,
including both community- and health care–associated disease, accurate
information on the scope and magnitude of the burden of MRSA disease in
the U.S. population is needed to set priorities for prevention and
control," the authors write.
R. Monina Klevens, D.D.S., M.P.H., of the Centers
for Disease Control and Prevention, Atlanta, and colleagues conducted a
study to determine the incidence of invasive MRSA disease in certain
U.S. communities in 2005 and to use these results to estimate the
prevalence of invasive MRSA infections in the U.S.
The study consisted of a population-based
surveillance for invasive MRSA in nine sites participating in the Active
Bacterial Core surveillance (ABCs)/Emerging Infections Program Network
from July 2004 through December 2005.
Reports of MRSA were investigated and classified as
either health care–associated (either hospital-onset or community-onset)
or community-associated (patients without established health care risk
factors for MRSA).
There were 8,987 observed cases of invasive MRSA
reported during the surveillance period.
Most were health care–associated, with -
● 5,250 (58.4 percent) community-onset infections,
● 2,389 (26.6 percent) hospital-onset infections,
● 1,234 (13.7 percent) community-associated infections, and
● 114 (1.3 percent) that could not be classified.
After adjusting for age, race and sex, the
incidence rate of invasive MRSA for 2005 was 31.8 per 100,000 persons.
Incidence rates overall were highest among persons
65 years and older (127.7 per 100,000), blacks (66.5 per 100,000), and
males (37.5 per 100,000). Rates were lowest among persons age 5 to 17
years (1.4 per 100,000).
"Based on 8,987 observed cases of MRSA and 1,598
in-hospital deaths among patients with MRSA, we estimate that 94,360
invasive MRSA infections occurred in the United States in 2005; these
infections were associated with death in 18,650 cases," the authors
write.
Molecular testing identified strains historically
associated with community-associated disease outbreaks recovered from
cultures in both hospital-onset and community-onset health
care–associated infections in all surveillance areas.
"In conclusion, invasive MRSA disease is a major
public health problem and is primarily related to health care but no
longer confined to acute care. Although in 2005 the majority of invasive
disease was related to health care, this may change," the researchers
write.
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MRSA in Healthcare Settings |
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By Centers for Disease Control and Prevention
Released: October 3, 2007
MRSA has been featured in the news and on
television programs a great deal recently. MRSA stands for
Methicillin-resistant Staphylococcus aureus. This type of bacteria
causes “staph” infections that are resistant to treatment with usual
antibiotics.
MRSA occurs most frequently among patients who undergo invasive medical
procedures or who have weakened immune systems and are being treated in
hospitals and healthcare facilities such as nursing homes and dialysis
centers. MRSA in healthcare settings commonly causes serious and
potentially life threatening infections, such as bloodstream infections,
surgical site infections, or pneumonia.
In addition to healthcare associated infections, MRSA can also infect
people
in the community at large, generally as skin infections that may
look like pimples or boils and can be swollen, painful and have draining
pus. These skin infections often occur in otherwise healthy people.
>>
Click here to read more at CDC
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Editorial:
Antimicrobial (Antibiotic) Resistance — It’s Not Just For Hospitals
In an accompanying editorial, Elizabeth A.
Bancroft, M.D., S.M., of the Los Angeles County Department of Public
Health, Los Angeles, writes that antimicrobial resistance is an
increasing problem.
"The rate of invasive MRSA [as determined by
Klevens and colleagues] was an astounding 31.8 per 100,000. To put this
number into context, the estimated rate of invasive MRSA is greater than
the combined rate in 2005 for invasive pneumococcal disease (14.1 per
100,000), invasive group A streptococcus (3.6 per 100,000), invasive
meningococcal disease (0.35 per 100,000), and invasive H influenzae (1.4
per 100,000)."
Dr. Bancroft adds that if the projection on the
number of deaths (18,650) is accurate, these deaths would exceed the
total number of deaths attributable to human immunodeficiency virus/AIDS
in the United States in 2005.
"The reports in this issue of JAMA [including the
study by Pichichero and Casey on drug-resistant S pneumoniae] reveal
that infections with significant antimicrobial-resistant pathogens, the
types formerly seen only in hospitals, now have onset in the community.
“Old diseases have learned new tricks.
Consequently, new collaborations between the public health and medical
communities are needed to identify and control antimicrobial resistance.
“It is not practical for public health departments
to perform surveillance for MRSA or other highly prevalent resistant
organisms without a robust system of electronic laboratory reporting. In
the meantime, population surveillance can be achieved by public health
personnel working with hospitals and laboratories in their jurisdictions
to develop aggregate antibiograms [an examination that measures the
biological resistance of substances causing disease].
“Clinicians also should be encouraged to report to
the health department any new trends in antibiotic resistance that they
identify."
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