Health risks: Drug-resistant infections on the rise

Community acquired methicillin-resistant Staphylococcus aureus  (MRSA) infections may be common among ill children, according to Johns Hopkins researchers. They found that 6% of pediatric patients admitted to the ICU tested positive for MRSA infection upon admission to the hospital, though they had not yet manifested symptoms. MRSA has been an especially worrisome hospital-acquired infection, where poor hygiene practices among health care providers can spread the germ among vulnerable patients. In addition to increasing risk of further illness and death, treating hospital-acquired illness is exceedingly expensive. The fact that 6% of pediatric patients were "silent" carriers of MRSA when they entered the hospital is troubling. Since they had no symptoms its unlikely that their infections would have been detected before potentially exposing other sick kids in ICU. In the Johns Hopkins cases, routine screenings upon admission were used to detect the bugs.

Outside the hospital, new research into community-acquired MRSA has also found infection rates are 6-times higher among HIV patients than the rest of the population. A health study in the Cook County region near Chicago comparing infection rates from 2000 through 2007 found that rates of community-acquired MRSA have grown from 61 to 253 per 100,000 among HIV-negative people, and 411 to 1474 per 100,000 among HIV-positive folks. It's believed that health behaviors that put people at risk of HIV are also associated with increased MRSA risk.

Just as hospital-acquired MRSA infections among hospitalized patients may actually be on the decline, though, a new drug-resistant bacterium may be moving in. The number of Clostridium difficile  (CD) infections in hospital may be on the increase, according to data from 28 hospitals in the Southern US. CD is an anti-biotic resistant infection that causes diarrhea and potentially deadly colon-inflammation among hospitalized patients. Over a two-year period, the 28 hospitals experienced 847 CD hospital infections, at a rate that is 25% higher than the rate of MRSA infection. Researchers say that attention focused on MRSA has lowered its incidence, but also allowed lower-priority infections such as CD to become more common.

The Johns Hopkins research shows that routine screening for certain bacterial infections may be a good option for reducing transmission to hospitalized patients. And there are some steps that patients can take to protect themselves. But the main solution, according to reams of research as well as common sense, is simply to increase rates of hand-washing among clinical staff. Relatively simple campaigns to observe, measure and remind nurses to wash hands increased compliance from 10% to over 95% at Dartmouth Hitchcock Medical Center in New Hampshire. Interestingly, it can be more difficult to get physicians to change their hand-washing behavior.

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