Dangerous drug-resistant staph infections are showing up at an alarming rate outside hospitals and nursing homes in the U.S. New research found that in one part of the country, as many as one in five infections were picked up in the community.
Until recently, these hard-to-treat cases were seen only in hospitals and other healthcare settings where they can spread to patients with open wounds or tubes and cause serious complications. Now doctors are seeing resistant strains among inmates, children and athletes.
Researchers at the Centers for Disease Control and Prevention suspected that those outside infections might just be leaking out of hospitals rather than emerging from the general population. But their study in Baltimore, the Atlanta area and Minnesota proved that theory wrong.
Overall, they found 17% of drug-resistant staph infections were caught in the community and did not have any apparent links to healthcare settings.
"Close to one-fifth of what used to be a hospital-specific problem is now a community problem. And that's a large number," said the CDC's Scott Fridkin, M.D. "We didn't think it would be anywhere near that high when we started the study."
Their findings are published in today's New England Journal of Medicine.
In a second study in the journal, researchers reported that drug-resistant staph has acquired "flesh-eating" capabilities and caused 14 cases of rare necrotizing fasciitis in the Los Angeles area. All patients needed surgery and 10 were in intensive care.
"The bugs are winning, unfortunately, and we need to catch up," said Loren Miller, M.D., one of the researchers at Harbor-UCLA Medical Center. "We really need to rapidly develop antibiotics to catch up with the bugs and start using antibiotics more appropriately."
Three-quarters of the community-acquired cases in the CDC study were skin infections, but 23% of the cases were serious enough to require hospitalization.
CDC researchers checked up to two years of lab reports for drug-resistant staph. More than 80% of the 12,553 cases were excluded because the patients had been hospitalized, had a history of surgery or dialysis or had another risk factor.
About 17% overall, or 2,107 cases, were determined to be community-acquired staph. The rate was 20% in Atlanta, 12% in Minnesota and 8% in Baltimore.
The CDC research found that children under 2 were at higher risk, which could be because children get more cuts and scrapes. Blacks in Atlanta were found to be at higher risk than whites. In cases confirmed through interviews, half were in people who shared a bedroom, and only about one in 10 were in day care.