Tough infection gets under people’s skin

There’s a relatively new antibiotic-resistant skin infection spreading through communities,… There’s a relatively new antibiotic-resistant skin infection spreading through communities, and it could even be on Pitt’s campus.

It’s an evolution of the common Staph bacteria — bacteria carried in the skin or nose of 25 percent to 30 percent of the population — that began appearing in U.S. hospitals just 50 years ago, according to the Centers for Disease Control and Prevention, a section of the U.S. Department of Health and Human Services.

The infection is regularly emerging in people who have no recent exposure to hospitals, so the general pubic is at risk.

Community-acquired methicillin resistant Staphylococcus aureus, or CA-MRSA, accounts for only 1 percent of all Staph infections, but it currently has health officials extremely concerned over the rise of diagnosed cases.

“The whole issue with community-acquired [MRSA] or any Staph is it’s transferred by skin-to-skin contact,” Dr. Elizabeth Wettick, a senior physician at Student Health Services, said. “There are some cases with people getting really sick and needing IV antibiotics, but that’s rare. If the number of cases we see begins to increase, we could have a problem.”

The main difference between normal Staph and CA-MRSA is that Staph can be treated with typical antibiotics called beta-lactams, which include methicillin and penicillin, but those once-common solutions are ineffective against CA-MRSA.

“The mechanism of resistance to the beta-lactams in these [CA-MRSA] strains is the presence of a transpeptidase,” Dr. Jennifer Trent, who has published more than 40 articles and six book chapters on dermatologic surgery and wound care, said.

The function of the transpeptidase, also known as penicillin-binding proteins, is linking the cell wall in the formation of a cell.

“The novel PBP that exists in MRSA is PBP2a, which has an altered binding site for the antibiotic,” making it different from the PBP present in easily treatable Staph and also building a methicillin resistance, Trent said.

“[MRSA strains] are more attuned to the solution,” Dr. Scott Curry said, an infectious disease fellow at UPMC. “Normally you’d just give the patient a standard antibiotic that was a relative to penicillin, and it went away.”

There’s a 50 percent chance patients with MRSA will get better, regardless if their Staph is treated or not, Curry said.

“That’s a bit counterintuitive. We’ve always assumed that if you get MRSA and you give [patients] methicillin, it will fail and they’ll get sick, but that doesn’t appear to be the case.”

Curry said Student Health Service and other health departments around the country are attentive to MRSA because it can cause severe community problems in college dorms.

Staph infections have always been a problem, but now people look closely at the type of infection, culture it and send it to a laboratory to determine the type of Staph as not to subject something like MRSA to outbreak.

“When there is a big MRSA breakout at Pitt, we’d think of the student gyms as one of the main places that’s infectious disease sufficient,” Curry said. “Those facilities have large numbers of students that are in communication with each others’ skin via that equipment. So anybody with a MRSA infection will spread it pretty efficiently through the Pitt gyms.”

Thankfully, according to the CDC, there are no reports of MRSA in any health club setting, which includes Pitt’s student gyms at Trees Hall and the Petersen Events Center.

Mark Schaeffer, Pitt’s campus fitness coordinator, said his personnel are still trying to play a preventative role since no Staph is present in the facilities.

“The goal is for students to have a safe and healthy place to exercise,” said Schaeffer. “We want them to be healthy, that’s the whole purpose of exercising.”

If you’re at the gym, Schaeffer said, wash the equipment before and after use. There are full bottles of sanitizer and cleaning rags next to each equipment station for students to utilize. In addition, Schaeffer’s staff cleans all the equipment and common areas once a day.

“The MRSA is really speculation at this point,” Schaeffer said. “I don’t think people need to be overly concerned to the point where they stop coming to the gym.”

Preventing Staph is simple. Wash your hands with soap and hot water for 20 seconds or more, or use alcohol-based hand sanitizers instead. Keep your cuts clean with antibiotic ointment and cover them with bandages.

“Almost always what it boils down to is bad hygiene,” Curry said. “Washing with soap and water, even though it seems a little bit rudimentary, is something lacking in the cases the CDC tracks down.”