Rohde: MRSA poses increasing public health danger

Here’s a little friendly but expert advice for anyone participating in sports, from the professional arena to the local park district gymnasium: Watch out for MRSA.

If you’re confronted by any kind of infection, get a test.

Methicillin-resistant Staphylococcus aureus doesn’t get anywhere near the attention of Ebola, but there are plenty among us — those who study it and those who’ve survived it — who believe there’s a major cause for alarm over the increasing spread of this potentially life-threatening staph infection.

MRSA is certainly no stranger to professional sports. It’s a growing concern in NFL locker rooms, in Major League Baseball and in the NCAA. High schools are vulnerable, as we’ve learned here our own backyard and again recently with the confirmed cases among members of a New York school’s sports team.

Several years ago I participated in a study to evaluate the prevalence of MRSA and other staph bacterial infections found — in a single day — in a college student athletic facility. Of the 125 environmental samples collected that lone day from various exercise equipment and other areas of the facility, the prevalence of MRSA was highest on free weights and mats.

The reason for the concern is compounded by these facts:

First, more people in the United States now die from MRSA than from HIV/AIDS. According to the latest information available from the Centers for Disease Control and Prevention, MRSA was responsible for an estimated 94,000 life-threatening infections and 18,650 deaths in the same year roughly 16,000 people in the U.S died from AIDS.

Second, MRSA is a superbug — it’s resistant to most common antibiotics. This means traditional medical approaches to infection control may be inadequate, and it makes MRSA and susceptibility testing of critical importance. Without these tests, a physician or health care practitioner may empirically treat a person based on an educated guess due to the symptoms and signs they’re showing. This can lead to missing the diagnosis of an antibiotic-resistant infection like MRSA and/or prescribing the wrong antibiotic.

The simplest and most common test is a culture test that identifies what specific type of bacteria is causing an infection. A susceptibility test determines the likelihood that a particular antibiotic or antifungal drug will be effective in treatment.

Third, once mostly a problem in hospital settings, a form of MRSA (known as CA-MRSA, for community-acquired) is now taking up residence in health care facilities outside hospitals (nursing homes, ambulatory surgical centers, etc.), in our own homes, in military barracks, in hotels and, yes, in schools and athletic settings.

There are major studies showing MRSA is more prevalent in contact sports like football, soccer, basketball and wrestling. That’s because participants in these sports have skin-to-skin contact with other players and can have cuts that allow the bacteria to enter the body. These infections are quick to exploit any opportunity to invade wounds, nasal passageways or mucosal membranes where they can rapidly produce infections that can become life-threatening.

In leading hospitals, there are a number of protocols and products that have shown to be effective in fighting MRSA. These should be adopted in our schools.

Arguably, my biggest cause for alarm and concern about MRSA is its virulence.

While it’s true that often the most severe infections are health care related, it would be a huge error to trivialize community-associated MRSA. In either form, it’s tough to kill once it’s in the body and spreads easily.

If MRSA bacteria enter the body, they can cause serious infections of the blood, heart, bones, joints and central nervous system. In my research, I’ve heard hundreds of horror stories of how MRSA has changed a life. They’re all compelling, including the one about the man who caught MRSA from his son, at home, and whose sores and severe pains were misdiagnosed as bursitis and mistreated with oral antibiotics based on an educated guess due to the symptoms and signs he was showing. No culture was provided nor asked for. Eventually, doctors had to amputate both of the man’s hands and his legs below the knees.

Ebola is a distant problem, geographically, and not a risk to everyone and anyone in the United States. MRSA is a different story: It’s here now and puts each and every one of us at risk.

Rohde is chair and professor of the Clinical Laboratory Science program at Texas State University.

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