Staph: Changing face of drug-resistant infections.
HUNTER residentsare more likely to die from a “golden staph” infection picked upin the community than they are frommeningococcal disease, yet it isstill considered a hospital-based problem, a local expert says.
Associate professor John Ferguson, a microbiologist and infectious diseases specialist at John Hunter Hospital, led a study into the prevalence of methicillin-resistant staphyloccus aureus (MRSA),also known as golden staph,which showed most infections were now acquired in the community rather than in hospitals.
The research, published in the Medical Journal Of Australia this week, found thatcases of hospital-associated golden staph were declining, with56.9 per cent of patients havingno contact with healthcare in the previous 12 months.
It found patients with community-associated MRSA were more likely to be younger than 40, indigenous Australians, orresidents of an aged care facility.
Dr Ferguson said national surveillance of the infection was becoming increasingly urgent, as more patients wereacquiring –and in some cases dying from –serious infections contractedwithin the community.
“At the moment, public health doesn’t know where the MRSA outbreaks are occurring, because it’s not a public health notifiable disease,” Dr Ferguson said.
“They don’t perceive this as being a public health problem, they have seen it as a problem purely based in the hospitals, which is clearly not the case.
“We believe it’s warranted tomake it notifiable, so that when the labs detect MRSA they notifythe public health infrastructure so we can get a fuller picture of the populations it is affecting.”
Dr Ferguson saidinfection control and “antimicrobialstewardship strategies” needed to change in the community.
“We needprograms to make sure antibiotics are given to the right people for the right amount of time, and not just sprayed around,” he said. “Hospitals have a system in place to reduce their use, butthe situation in general practice and in aged care facilities is relatively uncontrolled. We know that the use of antibiotics is quite high, and wethink that is fuelling the MRSA problem.”
Dr Ferguson said in Hunter New England Health there were about 30 cases of bloodstream infections per year caused bygolden staph, which had a one-month mortality rate between 25 and 30 per cent.
“For some perspective, the number of bloodstream infections due to meningococcal diseasein Hunter New England Health probably accounts for eightto 10 per year, max,” Dr Ferguson said.
“Some years we have less than that. So MRSA has higher mortality than meningococcal disease.”