Researchers from the Centers for Disease Control and Prevention (Kallen et al. 2010) have found that MRSA rates between 2005 and 2008 went down an average of 9.4% per year, as measured among nine U.S. metropolitan areas. The metro areas included 15 million people.
Good news, right? Not so fast.
Between the lines of this report was the fact that 82% of the infections reported were hospital onset or health care-associated onset. What does this mean? It means that all but 18% of the infections were contracted while being in the hospital!
In this review of nine metro areas, over 21,000 episodes of invasive MRSA infection were reported. Of these, over 17,000 were caused by health care. Of these cases, over 15,000 MRSA Superbug infections were found within the bloodstream. This means that the MRSA bacteria (methicillin-resistant Staphylococcus aureus) had become strong enough to invade and infect the blood and internal organs.
The hidden fact inside of these statistics is that during these three years, hospitals and health care facilities have put a major emphasis on preventing MRSA infections. They have instituted many new policies to prevent MRSA infection transmission. After all, infecting new patients with a new, antibiotic-resistant Superbug is bad for business, isn’t it?
So even with this prevention system in place, health care facilities are still involved in the infections of tens of thousands of patients a year nationally, and the total infection rate nationally may exceed 100,000 per year. Remember, this study covered only about 5% of the U.S. population (15 million divided by 300 million). If we extrapolate the Kallen research, we find that well over 400,000 cases of MRSA infection may have occurred nationally over this three year period.
The CDC reports that in 2005 alone, over 94,000 people developed serious MRSA infections, and over 18,000 died in the hospital from or related to a MRSA infection. So a count of more than 100,000 cases per year overall (including not reported by hospitals) is not outside of the realm of possibility.
Furthermore, in a study of 300 hospitals nationwide (Naseri et al. 2009) made between 2001 and the end of 2006, the increase in MRSA infection rates averaged 16% among children in the head and neck regions. Neck and head infections directly affect the brain and nervous system, which are much more dangerous to the patient than infections to the lower extremities.
Antibiotic-resistant bacteria are also migrating to different geographical regions. This was shown in research illustrated in a 2007 study by Indiana researchers (Denys et al. 2007) on antibiotic resistance among several pathogenic bacteria. Bacteria samples were collected from 76 medical centers among nine regions across the U.S. The results indicated that methicillin-resistant S. aureus (MRSA) levels varied from 27.4% in New England to 62.4% in East South Central. Vancomycin resistance in Enterococcus faecium ranged from 45.5% in New England to 85.3% in the East South Central U.S. Penicillin-resistant Streptococcus pneumoniae levels ranged from 23.3% in the Pacific region to 54.5% in the East South Central region. This indicated that these bacteria are moving from higher infection levels to lower infection levels.
We can conclude that methicillin-resistant Staphylococcus aureus is still a major threat within the United States, and is spreading regionally and globally.
Illustrating this is a study done by researchers from Aga Khan University in Pakistan (Thaver et al. 2009). In this study, three major bacterial infection rates were analyzed among children in developing countries. The bacteria infections included Escherichia coli, Staphyloccoccus aureus, and Klebsiella. Shockingly, they found that 72%-78% of E. coli have become ampicillin resistant and cotrimoxazole resistant, and 19% of E. coli have become resistant to the third generation antibiotic, cephalosporin. The Klebsiella species have become nearly completely resistant to ampicillin, 45% resistant to cotrimoxazole, and 66% resistant to the third generation cephalosporin. In addition, 46% of S. aureus had become resistant to the “go to” antibiotic cotrimoxazole.
This information illustrates that world-wide growth of antibiotic-resistant Superbugs is increasing. This also means that while hospitals in the US might be preventing some hospital MRSA transmissions, antibiotic-resistant Superbugs in general are growing dramatically. The Superbug crisis is thus far from over.
Kallen AJ, Mu Y, Bulens S, Reingold A, Petit S, Gershman K, Ray SM, Harrison LH, Lynfield R, Dumyati G, Townes JM, Schaffner W, Patel PR, Fridkin SK; Active Bacterial Core surveillance (ABCs) MRSA Investigators of the Emerging Infections Program. Health care-associated invasive MRSA infections, 2005-2008. JAMA. 2010 Aug 11;304(6):641-8.
Naseri I, Jerris RC, Sobol SE. Nationwide trends in pediatric Staphylococcus aureus head and neck infections. Arch Otolaryngol Head Neck Surg. 2009 Jan;135(1):14-6.
Thaver D, Ali SA, Zaidi AK. Antimicrobial resistance among neonatal pathogens in developing countries. Pediatr Infect Dis J. 2009 Jan;28(1 Suppl):S19-21.
Denys GA, Koch KM, Dowzicky MJ. Distribution of resistant gram-positive organisms across the census regions of the United States and in vitro activity of tigecycline, a new glycylcycline antimicrobial. Am J Infect Control. 2007 Oct;35(8):521-6.