In the 20s and 30s, hospitals use to be scrubbed continuously by then affordable cheap labor. As these costs went up, diligence went down and hospitals began to rely heavily on antibiotics to control infections. What they didn’t anticipate was that the hospital would become a boot camp for germs to become antibiotic resistant.
About 10% to 20% of MRSA infections are now seen outside of hospitals; of these, about twenty percent require hospitalization. The Alliance for the Prudent Use of Antibiotics characterizes CA-MRSA as “now epidemic within certain community populations.” The journal of the Canadian Medical Association called it the “superbug at our doorstep.”
Why MRSA has moved outside the hospital is not understood, according to the Centers for Disease Control. CA-MRSA did not originate from the hospital variety of MRSA (HA-MRSA) and is in fact genetically distinct. CA-MRSA is not only in communities—it’s invading hospitals too.
CA-MRSA differs significantly from the hospital variety (HA-MRSA). CA-MRSA, though more virulent than the hospital variety, is not as resistant to drug therapy and thus is more easily treated. On the bad side, CA-MRSA can spread more rapidly and cause much more severe illness than HA-MRSA. The community variety contains a toxin which fights white blood cells, lowering the body’s infection fighting abilities.
A limited number of antibiotics, such as Vancomycin and teicoplanin, and more recent developments, like linezolid, are effective against MRSA. It is presumed that MRSA will eventually find a way around any drugs which are invented to combat it, as the bacteirum’s historical character has proven. (Several new strains of MRSA have already appeared which are resistant to Vancomycin and teicoplanin.)
CA-MRSA can cause necrotizing fasciitis or necrotizing soft tissue infection (NSTI). Without treatment, NSTI can rapidly degenerate into death. Even with medical care, NTSI “fatalities are high.” Sepsis, toxic shock syndrome and fatal pneumonia are also possible from CA-MRSA. Sepsis is the tenth leading cause of death in the U.S.. Toxic shock syndrome (TSS) is a much rarer disease which can be fatal (in 1980 and 1981 women died of TSS associated with the use of super-absorbent tampons).
Particularly high risk locations for CA-MRSA are correctional facilities, daycare centers, dormitories, gyms, locker rooms, military barracks and public schools. Persons most at risk for MRSA are Alaskan Natives, athletes, Blacks, children, daycare attendees, elderly people, injection drug users, , gay men, military recruits, Native Americans, Pacific Islanders, people who live in crowded situations, postpartum women, pregnant women and prisoners.
The California Health and Human Services Agency demonstrates how easily CA-MRSA can spread by noting “A single infected athlete can quickly become the source of an outbreak that can affect the entire team.” Scientists, however, are working on innovative ways to outwit the diseases. Additionally, there are specific steps a person can take to diminish the chance of harboring MRSA. These measures are discussed in the next two chapters.