Persistent infections showing up everywhere
Last Updated February 7, 2007
One of the most common everyday bacteria, Staphylococcus aureus usually lives harmlessly on human skin.
But give it an opening — a cut, a deep abrasion, even a turf burn — and a staph infection can take a much more serious turn, putting even superbly conditioned athletes out of commission for long stretches.
The Toronto Blue Jays learned of this bug's viciousness during the 2006 season. They went without slugger Alex Rios for a month after he was sent to rehab with a pus-filled staph infection in his lower left leg. Pitcher Ty Taubenheim came down with a similar infection on his foot and spent time on the disabled list as well.
The Blue Jays took the unusual step of disinfecting their entire clubhouse — whirlpool, weight room, shower stalls, the works — and calling in the health inspectors for a close look.
They didn't find anything, which suggests perhaps a bigger problem.
The superbug phenomenon
Public health officials are now saying that some of the most hardcore cases of staph infections have jumped the antibiotic barrier and should be viewed as superbugs.
What's worse, they seem to be popping up in so many unforeseen places that they have been given the description "community acquired," as in community-acquired methicillin-resistant Staphylococcus aureus, or CA-MRSA to the initiated, a legitimate public health worry.
The hospital version of MRSA has long been known to physicians and is one of the main reasons public hospitals have stepped up infection control and hand-washing regimes in recent years.
Still, thousands of cases are reported annually, and it can be one of the leading causes of hospital deaths as staph infections take advantage of those with serious illnesses or compromised immune systems.
But the community-acquired version is a newer phenomenon. Staph infections are no longer just springing from the obvious places like hospital wards, prisons and tattoo parlours. More and more they are showing up in professional and high school sports teams as well as in daycares and fitness centres — virtually everywhere that sweat is exchanged.
Some researchers say these new strains originated in Australia, though they have now spread worldwide. The first big outbreak among pro sports teams took place in 2003.
In that year alone, five members of the St. Louis Rams football team, four members of the University of Southern California football team, a Miami Dolphin and at least half a dozen kids on high school football, wrestling and fencing teams in the U.S. were hospitalized with versions of staph infection, in some cases life-threatening, according to news reports.
One of the more interesting followup studies suggested that pro athletes may be infected by the more virulent strains of the bacteria because they tend to take more antibiotics over the course of their careers and acquire a higher level of antibiotic resistance.
Today, according to a just published article and commentaries in the Canadian Medical Association Journal, community-acquired staph infections, the kind that affect otherwise healthy individuals outside of hospital settings, are on the rise in a number of provinces."It's sweeping across the nation, no doubt about it," Dr. John Conly, a Calgary-based expert in infectious disease told the Canadian Press. "I think this is a pan-Canadian problem."
Symptoms and treatments
The two most virulent strains of community-acquired staph infections — strains known as US300 and US400 — are the two hardest to treat. Like others, they often show up as minor skin problems, or sores in the soft tissue of the mouth or nose that form blisters or pus-filled abscesses, so-called weeping wounds that never seem to heal.
In their more modest forms, staph infections lead to boils, pimple-like infections around hair follicles and, usually in kids, impetigo, honey-coloured blisters around the mouth or nose.
If staph bacteria get into the bloodstream they can cause sepsis, infection of the blood that can harm crucial organs; sometimes they lead to food poisoning and toxic shock.
For external cuts and scrapes, there is debate in the medical community on how to treat them: Some doctors don't recommend using antibiotic creams as a rule because, they argue, these can lead to more drug-resistant bacterial strains developing over time and affecting larger numbers of people.
For years, methicillin has been the antibiotic most commonly used to fight staph infections. But several strains are now resistant to it.
Conly urges family doctors to test open sores for the presence of drug-resistant bacteria so the appropriate medication is prescribed. Doctors are also urging people — and sports teams — to wash their hands more often and take greater care of their equipment, communal equipment especially.
Most staph infections can be treated with oral antibiotics. Even the more serious resistant strains can usually be treated in hospital with the strongest antibiotic vancomycin, assuming the infection is caught in time before it has damaged major organs.
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