Staph infection scare hits close to home

It was Family Weekend when Lindsay Moore found out she had it.During a time usually reserved for catching up with parents and siblings and enjoying a football game at Amon Carter Stadium, Moore, a senior graphic design major from El Paso, noticed that a simple bump on her right elbow had turned into an open cut, with a sharp tint of red.

“At first, I didn’t really pay attention to it, but then it started to hurt a lot,” Moore said. “It was probably the most painful thing I’ve ever been through.”

Moore went to the Health Center, where she was told she had been infected with Staphylococcus aureus, better known as staph infection.

But Moore dodged a bullet and avoided Methicillin-resistant Staphylococcus aureus (MRSA), the “superbug” that has made headlines thanks to a recent editorial in the Journal of the American Medical Association. The study estimated that more than 90,000 people were infected with MRSA in 2005, with close to 19,000 deaths that year alone – surpassing the annual death toll average for the AIDS virus.

Moore shivered when recalling the feeling of helplessness having staph gave her.

“I couldn’t bend my arm,” Moore said. “It hurt so bad.”

Getting It Clean

The Staphylococcus aureus bacteria, which is the lifeblood for the MRSA infection and is usually found on the skin or nose area, is transmitted through open wounds or cuts on a person’s body, and has the potential to be carried or colonized even by those people who have not fallen ill to the infection.

“About 2 to 4 percent of all of us have this organism living on our skin or in our noses,” said Suzanne Whitworth, a doctor who specializes in pediatric infectious diseases at Cook Children’s Hospital in Fort Worth. “In a small percentage of that 2 to 4 percent, illness or infection can occur. This can be in the form of skin boils, cellulitis, pneumonia, blood-stream infection, or bone or joint infection.”

Mary Rae, TCU’s director of Health Services, said the Health Center usually sees about two staph cases a week, but the type of staph infection Health Center personnel see most often is that of community-acquired MRSA.

Community-acquired MRSA, though potentially dangerous, is not the type of MRSA accounting for the largest number of fatalities in the Journal of the American Medical Association’s recent study. According to the study, the vast majority – about 85 percent – of the fatal staph cases are connected to MRSA strains that are either hospital-acquired or healthcare-associated. In other words, the MRSA cases that most often result in death are ones stemming from living in a hospital or healthcare environment or from when a patient is recovering from a type of medical procedure or treatment.

Rae said the low numbers associated with community-acquired MRSA of the study that examined 16.5 million patients puts TCU at a low risk for having any type of potential staph outbreak.

“When you look at the data from patients ages 18 to 34, the extrapolated data was 460 in the entire U.S. in that age group,” Rae said. “In that group, if you break it down to community-acquired, it’s just six or seven (cases). We find that very reassuring.”

Despite the low risk of an MRSA outbreak on the TCU campus compared to a retirement home or a hospital, there is still a cause for concern.

Jimmie Borum, a sixth-year clinical instructor for the Harris School of Nursing, said students could become more vulnerable by being immunosuppressed. She said immunosuppression can build up in a college student’s system because of several reasons: stress, diseases such as AIDS, poor eating habits, sleep deprivation and steroid usage.

Karen Bell, the assistant dean of Campus Life for Health Promotion, said the university is in the process of making information provided by the Tarrant County Health Department available in the residence halls. Rae said the university will also make this information available on its Web site, which is still in the process of being updated.

Although the increased level of information can only help in preventing a potential outbreak, Borum said she knows how extreme and out-of-hand the infection can get if if it is not treated properly or if prevention methods are not what they should be.In addition to being carriers of the infection, people can also be infected through outdoor athletic activities such as football or any intramural sport that can be played outside on grass. Borum said that because MRSA can be found in soil, open wounds that come in contact with dirt are at risk of getting infected.

Rae said it is pivotal for students to practice staph infection prevention in all facets of their everyday life. She recalled a couple instances last year when a group of girls got infected as a result of – of all things – a day of beauty.

“A couple of girls had infections, and when we kind of looked into it and put things together, they most likely acquired it getting a pedicure,” Rae said. “Part of the prevention is to be really careful about what you expose yourself to. You just don’t know how clean a facility is.”

Dangerously Beautiful

It’s a sunny, late-October day in downtown Fort Worth as women file one-by-one into Stylemakers Salon.

While taking care of a client during a 12:45 p.m. hair appointment, Shelly Baeatty is open and honest about her disgust for salons that have strengthened the link between pedicure treatment and staph infections.

Beatty, the president of Stylemakers, Inc., said her salon has gone to disposable pedicure units to increase staph prevention measures following the February 2006 death of a woman who was infected by MRSA – an infection directly related to a visit to Angels Nails in Fort Worth.

“The disadvantage is (disposable units) don’t get that sudden, great hot-water feeling,” Beatty said, “but then you don’t have to worry about losing your life to a staph infection either. Kind of like when you have sex with someone, you have sex with everyone they’ve ever had sex with.”

Beatty said it takes time and effort to maintain a high level of staph prevention.

“Proper solution is very expensive,” Beatty said. “It has to be replaced every day. A lot of places don’t do that. They’ll leave that stuff in there all week long.”

Salons that still use the plum units, Beatty said, are supposed to be cleaned thoroughly for about 15 minutes through drainage, rinsing and solution application – a practice that a lot of salons do not tend to follow.

“Here’s what happens: One person gets out, they drain it, they fill it and the next person gets in,” Beatty said. “They just don’t do it. It takes too much time. You’re talking about 15 minutes of downtime in between pedicures that most of these places that are charging $20 per pedicure.

“They don’t have time,” Beatty said. “It makes their chair unusable for about 15 to 20 minutes.”

Beatty emphasized that MRSA has become an unavoidable part of today’s society.

“Staph is everywhere,” Beatty said. “It’s all over the place. It’s at the bank; it’s in the restroom; it’s on your purse; on every door you touch. The problem is, if you have a susceptibility to it, then it’s going to affect you.”

To Prescribe or Not To Prescribe

Even if patients insist on wanting to use antibiotics against common bacteria, Rae said, doctors such as her must present the cons of prescribing antibiotics to patients who may not need them.

“The more antibiotics we prescribe, the more likely bacteria will become resistant to the ones that we know what work,” Rae said. “If doctors and healthcare providers aren’t worried about it, they need to be.”

People such as Borum think the dependence on antibiotics has become a little much.

“We’ve used antibiotics too much,” Borum said. “I think it is the responsibility of the doctors in being judicious when prescribing antibiotics.”

When deciding when to prescribe antibiotics, the responsibility lies on both doctors and patients to be aware of when the situation calls for it, Rae said.

Until researchers keep perfecting drugs to solve the “superbug” mystery, the growing danger that these bugs can mutate and spawn off into a stronger infection remains “a tragedy,” Borum said.

“We cannot develop drugs quickly,” Borum said. “It takes years. By the time we may have a drug to treat one mutation, it has gone on to mutate into another form so we’re always behind the eight-ball on that.