This Month's Clinical Focus:
INFECTIOUS
DISEASE
New Guidelines Issued for Drug-Resistant
Staph Infections (MRSA)
Infectious disease specialists seek to standardize treatment for potentially deadly germ. An infectious disease association has released the first national guidelines for the treatment of potentially deadly methicillin-resistant Staphylococcus aureus (MRSA) infections.
Initially found in healthcare facilities, MRSA infections have become an increasing issue for healthy people outside hospitals. They now represent 60 percent of all skin infections treated in emergency rooms. In most cases, MRSA -- strains of staph bacteria resistant to all first-line antibiotics -- causes painful, red swollen bumps that are frequently mistaken for spider bites and that can usually be treated successfully if caught early.
Invasive MRSA -- an infection that spreads from the skin into other parts of the body -- is less common, but far more serious. About 94,360 cases of invasive MRSA were reported in the United States in 2005, and more than 18,000 of those patients died -- a figure that surpassed those dying that year of AIDS.
Currently, there are wide variations in treatment
approaches -- something the new guidelines from the Infectious Diseases
Society of America (IDSA) hopes to address.
"MRSA has become a huge public health problem and physicians often struggle with how to treat it," guidelines lead author Dr. Catherine Liu, an assistant clinical professor in the Division of Infectious Diseases at the University of California, San Francisco, said in an IDSA news release. "These guidelines establish a framework to help physicians determine how to evaluate and treat uncomplicated as well as invasive infections."
Topics covered in the guidelines include how to manage skin and soft tissue MRSA infections, treating recurrent skin infections, using antibiotics for treating MRSA, managing invasive infections and treating newborns infected with it.
The guidelines have been endorsed by the Pediatric Infectious Diseases Society, the American College of Emergency Physicians and the American Academy of Pediatrics.
SOURCE: Infectious Diseases Society of America, news release, Jan. 5, 2011, article by By Robert Preidt
Infectious Disease Experts Call for Increased Focus on
Hepatitis C
Rates among drug users have not plummeted like HIV,
study finds. Among injection drug users, new cases of HIV infection have
declined dramatically in the past two decades, but the number of
new infections from the hepatitis C virus have dropped only a small
amount, a new study reports.
The findings suggest that efforts -- such as needle exchange programs and substance abuse treatment -- to prevent blood-borne transmission of infectious diseases have been successful against HIV but more needs to be done to reduce the transmission of hepatitis C virus (HCV), according to the study's leader, Shruti H. Mehta of the Johns Hopkins School of Public Health.
The researchers noted that HCV is nearly 10 times more transmissible by sharing needles than HIV. Sharing a needle just once can be enough to transmit HCV. The results suggest that "current prevention efforts delay but do not prevent HCV at the population level and will need to be further intensified to reduce risk of HCV infection to the level of HIV," the researchers wrote. They called for expansion of efforts on both the prevention and the treatment fronts to reduce the reservoir of HCV-infected injection drug users.
The study, which looked at infection rates among
injection drug users in Baltimore over a 20-year span, found dramatic
decreases in new HIV infections: from 5.5 cases per 100 person years in
1988-1989 to two per 100 in 1994-1995, and to zero cases in 1998 and
2005-2008.
Reductions in new HCV infections were not as dramatic: from 22 cases per 100 person years in 1988-1989 to 17.2 per 100 in 1994-1995, to 17.9 in 1998 and to 7.8 in 2005-2008.
Overall, new cases of HCV appeared to decrease only among younger injection drug users who had recently starting using the drugs, the study found.
SOURCE: Journal of Infectious Diseases, news release, Jan. 31, 2011; article by Robert Preidt
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