Drug-resistant infection: Cutting your risk

infection protection Don’t share towels, clothing, or athletic equipment.

Drug-resistant staphylococcus bacteria, which once threatened mainly the sick and elderly in hospitals and nursing homes, have spread beyond the institutional walls. They’re now striking young, healthy people at a growing rate. The bugs, mainly new strains of the types lurking in hospitals, are spread by contact with infected skin or simply by sharing towels, clothing, or other personal items. The infections can be severe, especially if doctors fail to culture the bug to check for resistance.

The nationwide prevalence of drug-resistant staph infections in community settings is not known, but a study in the April 2005 issue of The New England Journal of Medicine reported 1,647 cases in Atlanta, Baltimore, and parts of Minnesota alone. The study found that up to 20 percent of resistant staph cases now arise outside health-care settings.

Athletes who play contact sports may be especially vulnerable. Dozens of infections have been reported in high-school and college wrestlers and football players; five St. Louis Rams football players have also been infected. The U.S. Centers for Disease Control and Prevention has investigated other clusters of infection involving children at day-care centers, prison inmates, military recruits, and gay men, among other groups.

The resistant infections, which almost always start on the skin, may initially look like mild spider bites, but boils and abscesses can develop. If the problem is caught early, doctors may only have to drain the affected area, according to infectious-disease experts we consulted. But if treated late or with medications that no longer work, the bacteria can cause severe blood or lung infections.

The staph bacteria in hospitals have become resistant to most common antibiotics, though they generally respond to intravenous vancomycin (Vancocin). In the community setting, however, these infections can still usually be treated with common oral medications such as clindamycin (Cleocin) and trimethoprim-sulfamethoxazole (Bactrim, Septra).


WHAT YOU CAN DO

These steps can help protect you and your family against resistant infections:

• Inform your children and their coaches that players should never share towels or athletic equipment. Sports injuries should be thoroughly cleaned and covered to avoid infecting other people.

• Seek medical attention promptly for boils or skin infections that worsen or are accompanied by fever. To help slow the rise in drug-resistant bugs, don’t insist on antibiotics if your doctor says they’re not necessary. If you need an antibiotic, start taking it promptly. But ask your doctor about tests to identify the most effective drug, so that you can switch if necessary. Testing is especially important in communities where resistant staph infections are rampant or when the problem has recurred or hasn’t responded to treatment.

• Insist on clean hands in hospitals and other health-care settings. Expect all people who touch you--including visitors--to first wash their hands with soap or an alcohol-based solution. If you don’t see them do that, politely ask whether they have.

In choosing a hospital or nursing home, inquire about its procedures for controlling infection. Consumers Union, publisher of this magazine, has initiated a public campaign to require hospitals to reveal their infection rates to the public. For more information, go to the CU Web site at www.StopHospitalInfections.org.