That's No Spider Bite: Antibiotic Resistant Staph Infections Now Very Common

Aug. 16, 2006 — -- Their stories are numerous -- the people who know, firsthand, how common antibiotic-resistant skin staph infections have become.

Take Jessica Knowles of San Antonio whose entire family -- even her dogs -- have been battling on-again, off-again staph infections for several years.

"I've had it probably four to five times now. It's embarrassing, very embarrassing especially when it starts getting on my face," Knowles said. "It starts out feeling like you got bit by something, and you see a red spot like a pimple. It oozes. It doesn't stop."

Or Brandon Kafka of Seattle, who has battled several severe skin infections, including one that broke out across his face after he'd shaved.

"[It] hurt worse than anything I have ever felt," he said.

Now the Most Common Skin Infection in Many ERs

Their infections were caused by a bacterium called methicillin-resistant Staphylococcus aureus, or MRSA. Once confined mostly to hospitals and prisons, MRSA has branched out into the general population. It often infects people without warning, and is commonly mistaken as a spider bite.

A study published today in the New England Journal of Medicine shows just how widespread the bug has become. Researchers took hundreds of skin samples from patients who'd visited 11 emergency rooms in the United States with skin or tissue infections. Laboratory analysis showed that 59 percent of the time the culprit was MRSA, meaning the bug has reached broadly into the general community -- and that's bad news in the fight against antibiotic resistance.

"This underscores the need to avoid overuse of antibiotics in general so as to avoid the development of antibiotic resistance," said Dr. Greg Anderson, at the Mayo Clinic.

The new findings come of no surprise to people who have dealt with a staph infection. It is often a frustrating and ongoing ordeal: Since staph is a notoriously adept and common bacteria, the infection doesn't go away easily. It lives naturally in most people's noses, and for unknown reasons, it can suddenly turn against its host and start infecting the skin.

Once it takes hold, it is easily transmitted among family members, co-workers or schoolmates. And because doctors often unwittingly prescribe an ineffective antibiotic -- which occurred 57 percent of the time in the study -- it often lingers.

A 'Major Problem' for Kids

"MRSA has blossomed over the last few years," said Dr. John J. Messmer, an associate professor of family and community medicine at Penn State College of Medicine. "As the study discussed, staph organisms transfer the genetic ability to resist antibiotics to one another."

While the infection can hit anyone, it is a "major problem" among kids, said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University School of Medicine in Nashville.

"About six years ago, Vanderbilt investigators cultured the noses of many healthy Nashville children -- only 1 percent carried MRSA," Schaffner said. "When the study was repeated in 2004, 9 percent were carriers. You can see that the problem has exploded."

Solid numbers on MRSA are hard to come by. The Centers for Disease Control and Prevention doesn't require that doctors report community-acquired MRSA infections the way they're required to with most communicable diseases.

This infuriates Joy Smith of Stevenson, Ala., whose grandson has MRSA in both of his ears, which came from having tubes placed in his ears.

"This is something that the public needs to be more aware of, and the medical community needs to take a more proactive approach," she said.

'I Was in Excruciating Pain'

To determine if an infection is indeed MRSA, a skin culture must be taken. While this shows exactly which type of bacteria has infected the skin and which antibiotics can still kill it, it can take several days before laboratory results are conclusive.

"Many docs still are treating soft tissue infections using antibiotics that used to work very well," Schaffner said, noting that the new study does give a detailed description of which antibiotics do seem to still be effective in treating MRSA. "It is a matter of re-educating the profession."

In the meantime, many people in the United States, like Marcia Ferguson of Annapolis, Md., have had or will have antibiotic resistant skin infections.

"I am just now recovering from a skin infection caused by the staph bacteria. It has been a horrific ordeal," Ferguson said.

What started as red bump on the back of her leg quickly turned into widespread open sores on her legs and trunk. She went to her doctor and got some antibiotics. But her fever and her sores persisted, and she had to go to the ER.

"I was in excruciating pain. There were more red bumps, more blisters, and pus was leaking from most of them," said Ferguson, who has now mostly recovered but is still changing the dressing on her sores and taking Tylenol for the pain.

And, like so many people, she said, "I still have no idea how I caught it."