(UPI) -- Once it was confined to infections that occurred in hospitals, but now a potentially lethal, multi-drug resistant bacteria is now found about as often in the general community as it is in healthcare facilities.The bacteria, methicillin-resistant Staphylococcus aureus (MRSA), have been identified in 40 U.S. states, said Francoise Perdreau-Remington, professor of medicine at the University of California, San Francisco.
'We found that, in a survey of hospitals in San Francisco a 6.8 percent rate of MRSA among patients and a rate of 8.6 percent of MRSA among individuals in the community,' she said recently at an infectious-disease meeting sponsored by the American Society for Microbiology.
'Community-acquired MRSA is no longer distinguishable from hospital-acquired MRSA,' she said at the 46th annual Interscience Conference on Antimicrobial Agents and Chemotherapy. She said there were facilities in the United States where the MRSA rate exceeds 50 percent of all S. aureus infections. Remarkably, as many as 86 percent of the infections in one hospital are connected to one strain -- called USA 300.
She said that the extension of MRSA into the community in large numbers is alarming. Even more troubling was that among those patients was a person harboring a vancomycin-intermediate resistant S. aureus. The strain`s genetic makeup gives the bug the ability to transform into true vancomycin resistance and spread those resistance factors to other bacteria.
A vancomycin-resistant strain of S. aureus could be a devastating human catastrophe, due to virulence of the bacteria, its prevalence in individuals -- an estimated 30 percent of people carry the bug -- and the lack of treatment. Vancomycin is still considered the last line of defense against MRSA, although other agents such as linezolid may be used to fight the pathogen.
Control of MRSA, however, is possible, researchers said Thursday at a news briefing. Christina Vandenbroucke-Grauls, professor of medicine at the Vrije Universiteit of Amsterdam, the Netherlands, described how a seek-and-destroy program that involved isolating patients colonized with MRSA reduced the infection rate to less than 1 percent in hospitals in the Netherlands.
Patients were screened for the disease at admission, and patients in high-risk groups were isolated until it could be determined if they had MRSA before being released into the general hospital population. Doctors and healthcare workers were required to conduct stringent hygiene procedures whenever treating any person identified with MRSA.
The program allowed doctors to identify one group of MRSA carriers that had not been known before -- individuals who work in pig farming. 'We have found at least 100 people with MRSA who work with pigs,' Vandenbroucke-Grauls told United Press International.
The screening program identified a young child with MRSA infection and through questioning found her father was a pig farmer, which, up to then, was a group not considered to be at greater risk of contracting the disease.
When her father was tested, he turned out to be positive, said Vandenbroucke-Grauls, as did other members of his family, his co-workers and the pigs. Studies indicated that pigs are often fed with products laced with antibiotics.
Since the initial discovery of MRSA in the child, more cases have been found in people who work on farms or in slaughterhouses.
In Switzerland, Patrice Francois, head of the genomic research laboratory at University Hospital in Geneva, said the rate of MRSA has been suppressed by similar isolation and hygiene procedures that accompany use of a rapid genomic test that can determine if a person has an MRSA strain in hours, rather than the period of days that standard testing takes.
'While screening is expensive, in the end, screening people is less expensive than spreading MRSA infections,' Perdreau-Remington told UPI when asked if the European model of infection control could be exported to the United States. 'We just have to have the will to do it.'