MRSA Strain With Outbreak Potential Among Reports at Disease Conference

Presentations also track antibiotic prescriptions, new drugs

From an October 24, 2010 Health Day news item

FRIDAY, Oct. 22 (HealthDay News) — An increasingly stubborn strain of methicillin-resistant Staphylococcus aureus, or MRSA, a common bacterial infection acquired in hospitals, has been identified in Ohio, according to research presented at the [2010] annual meeting of the Infectious Diseases Society of America.

The strain, ST239 MRSA, killed 22 percent of the people it infected within 30 days, the study found. It’s the first time that the strain, originally identified in Brazil, has been seen in the United States since the 1990s.

“It does have epidemic potential for outbreak,” the study’s co-author, Dr. Shu-Hua Wang, said. “It has increased capacity to cause invasive, serious infection.”

Wang’s group reported that 6.8 percent — or 77 — of 1,126 MRSA samples collected through the Ohio State University Health Network and seven rural hospitals in a three-year period from January 2007 to January 2010 were ST239.

Wang, who is an assistant professor of medicine at Ohio State, called for more genotyping of MRSA isolates.

A second study presented at the conference found that antibiotic prescriptions in the United States were much higher in the South than in the West, a finding that held for all types of antibiotics……

…..

Among other research being presented at the conference, which concludes Sunday in Vancouver, Canada: three new drugs appear to show promise in fighting MRSA and other bacteria when current antibiotics fail.

• Fusidic acid, which could fight S. aureus. “This is pretty exciting because it has no cross-resistance with any class of antibiotics so it could be used widely,” said Dr. Ronald N. Jones, chief executive of JMI Laboratories in North Liberty, Iowa, which makes the drug and funded the study being presented.
• JNJ-Q2. This potential agent belongs to a class of drugs known as fluoroquinolones and may be effective against S. aureus, including the methicillin-resistant form. “JNJ-Q2 was 16 times more potent than the existing marketed fluoroquinolones,” Jones said. The drug is moving into phase 2 and phase 3 trials, he said.
• A version of cephalosporin. It “may enable us to treat a broader spectrum of drug-resistant bacteria, although it probably won’t be on the market till 2013 or 2014,” Jones said.

Also being presented at the conference is a study involving a computer model that found that “universal contact precautions” — requiring anyone visiting a MRSA patient in the hospital to wear gloves and a gown — were more effective at preventing MRSA infection among patients in intensive-care units than were other strategies.

But the approach was expensive. The study’s lead author, Dr. Courtney A. Gidengil, an instructor in pediatrics at Children’s Hospital of Boston and Harvard Medical School, said that other strategies might be less effective but they are also less costly.

Another study presented at the conference found that carbapenem-resistant Enterobacteriaceae, or CRE, which carries a high mortality rate, is becoming more prevalent in the Chicago area.

Editor Flahiff’s note: If you need assistance tracking down studies in this news item, contact a reference librarian at your local public, academic, or medical library. Alternatively, you may contact me at jmflahiff@yahoo.com. I will reply within 48 hours. At the very least, I will provide contact information for a study’s author(s). Many study author’s are happy to share at least citations to their works, if not full text of their studies.

 

Related reports

[April 1]

AHRQ Researchers Study How Community-Acquired Methicillin-Resistant Staphylococcus aureus Is Managed in Health Care Settings

 

Findings from three new AHRQ-funded reports on community-acquired methicillin-resistant Staphylococcus aureus (MRSA) are now available.  The reports result from two-year projects conducted by AHRQ’s Practice-Based Research Networks in Colorado, Iowa, and North Carolina. Select below to access each report.

• Management by Primary Care Clinicians of Patients Suspected of Having Community-Acquired Methicillin-Resistant Staphylococcus AureusInfections—State Network of Colorado Ambulatory Practices and Partners. Researchers tested interventions for two health networks to optimize treatment for skin and soft tissue infections consistent with the community-acquired MRSA guidelines developed by the Centers for Disease Control and Prevention. They found the intervention resulted in an increase in antibiotic use and the proportion of prescribed antibiotics that covered MRSA.
• Community-Acquired Skin Infections in the Age of Methicillin-Resistant Organisms—Iowa Research Network Practices, University of Iowa. Researchers assessed how family physicians in rural areas managed patients with skin and soft tissue infections after introducing Centers for Disease Control and Prevention guidelines. They used chart review and/or follow-up to compare infection management and antibiotic therapy in patients before and after the CDC guidelines were introduced. They found that providers were more likely to prescribe antibiotics that covered MRSA at the initial patient visit after the guidelines were implemented.
• Cellulitis and Abscess Management in the Era of Resistance to Antibiotics (CAMERA)—Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill & Duke Clinical Research Institute.  Researchers worked with nine primary care practices to improve the quality of care for individuals with skin or soft tissue infections. As a result, they developed recommendations and strategies for diagnosing and managing community-acquired MRSA in these settings. For example, researchers recommend that practices develop documentation and coding presentations; integrate templates into electronic medical records for describing skin and soft tissue infections; and hold workshops in the management of skin and soft tissue infections.