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Deaths from drug-resistant bacteria top those from AIDS
19,000 fatalities a year, study says

By Judith Graham | Tribune staff reporter
12:53 AM CDT, October 17, 2007,1,4016444.story?ctrack=1&cset=true

Nearly 19,000 Americans died in 2005 of invasive infections caused by drug-resistant staphylococcus bacteria—more than were killed by AIDS, according to a new study in the Journal of the American Medical Association.

The report, written by experts at the Centers for Disease Control and Prevention, is the latest research to note the alarming spread of methicillin-resistant staphylococcus aureus in communities across the U.S. and to document the bacteria's deadly impact.

MRSA is a superbug that does not respond to treatment with common antibiotics such as penicillin. More than 94,000 Americans contracted life-threatening MRSA infections in 2005, including blood and bone infections, pneumonia and inflammation of the heart's lining. Most appear to be traceable back to hospitals, nursing homes or medical clinics, the new CDC report found.

"This is really a call to action for health-care facilities to make sure they're doing everything they can to prevent MRSA," said R. Monina Klevens, the lead author of the report and a medical epidemiologist at the CDC.

This year, Illinois became the first state in the nation to require hospitals to report infection rates, test patients in intensive-care units for the bacteria and to take specific measures to prevent its spread.

Nancy Foster, vice president of patient safety at the American Hospital Association, called the study an "eye-opener" and said hospitals across the country will need to evaluate whether current strategies for combating MRSA are effective.

But a growing number of MRSA cases are also arising at community gyms and schools, and these, too, can be deadly. On Tuesday, a high school senior in Moneta, Va., died after being hospitalized for a week with an infection that spread to his kidney, liver, lungs and heart.

"I've never heard of a bacterial invasive disease with an attack rate anywhere near this high in children and the elderly," said Dr. Robert Daum, a specialist in MRSA and a professor of pediatrics at the University of Chicago.

It's not known how the Virginia student contracted the infection, but officials ordered all 21 schools in the district closed for cleaning Wednesday. The bacteria can live on common surfaces, such as a table, for days or weeks and can be transmitted when someone touches it.

The CDC study found 32 of every 100,000 people in the communities studied contracted invasive MRSA infections. Rates were twice as high for African-Americans (66 per 100,000) and four times higher for the elderly (128 per 100,000). For infants younger than 1, the rate for blacks was four times that of whites.

African-Americans may be more vulnerable because they have higher rates of chronic illnesses such as diabetes, which require more visits to health-care providers, Klevens said. Infected individuals may then unwittingly spread the bacteria to other household members.

The new CDC report is the most reliable overview of serious MRSA infections prepared to date. The data came from nine sites: Connecticut; Baltimore; the metropolitan areas of San Francisco, Denver, Atlanta and Portland, Ore.; and three counties in Minnesota, Tennessee and New York.

Instead of using administrative data, researchers checked medical records to confirm cases of invasive MRSA infections and double-checked laboratory results. An earlier CDC study that relied on administrative data had estimated 5,000 people die each year of dangerous MRSA infections.

Dr. William Jarvis, former acting director of the hospital infections program at the CDC, called upon the agency to strengthen recommended measures for preventing MRSA's spread in light of the new report's findings.

"The CDC recommends routine screening for HIV for everyone who goes to a doctor, but it doesn't even recommend routine screening for all hospital patients for MRSA," he said.

Dr. John Jernigan, deputy chief of prevention at the CDC, defended recent agency guidelines that call for health-care facilities to lower MRSA infection rates. The guidelines are voluntary and there is no timetable or national reporting of the data. But Jernigan said the recommendations will work if health-care facilities are serious about following them.



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