Express-News Medical Writer
A 10-year-old San Antonio boy died of an increasingly common, drug-resistant staph infection in Plano last week, prompting health officials to urge people to be alert for the skin infection and practice good hygiene to prevent it from spreading.
At least three other local people have died of methicillin-resistant Staphylococcus aureus, or MRSA, in the past two years, and several clusters have been reported in school athletic programs, day care centers and spas. But because doctors aren't required to report cases to health authorities, the scope of the problem is unknown.
That could change in September, as a pilot program approved by the Legislature will make Bexar County the only county in Texas where the skin infection is a reportable illness.
"MRSA is becoming a big, big problem — 10 times bigger than we initially thought," said Roger Sanchez, an epidemiologist with the Metropolitan Health District. "But because it's not reportable, we don't know the extent of the problem."
In the most recent case, the boy was visiting a sister in Plano, where he developed a rash on his stomach. His family gave him acetaminophen, thinking it might be chicken pox. He also had an abscess on his leg.
But within 72 hours, the boy become unresponsive and the family took him to a hospital where he died June 17. An autopsy determined the infection had spread to his blood and throughout his body.
Deaths from the MRSA are "fairly infrequent," Sanchez said. "But what we used to consider a common boil is no longer so. It could be an MRSA infection. And if that's the case, then it can become septic and enter the bloodstream and other organs of the body."
• Methicillin-resistant Staphylococcus aureus is a type of staph (bacteria) that is resistant to certain antibiotics, including methicillin and other more common ones such as oxacillin, penicillin and amoxicillin. Staph infections, including MRSA, occur most frequently among people in hospitals and health care facilities who have weakened immune systems.
• MRSA infections acquired by people who have not within the past year been hospitalized or had a medical procedure (dialysis, surgery, catheter, etc.) are known as community-acquired MRSA infections.
• Staph or MRSA infections in the community are usually manifested as skin infections, such as pimples and boils, and occur in otherwise healthy people.
The bacteria, which can cause skin infections that resemble a pimple or boil, are common. The Centers for Disease Control and Prevention estimates that perhaps 25 percent to 30 percent of the population carries the organism on their skin or inside their nose, usually without causing infection.
Initially, MRSA, which has been called a 'superbug,' was a problem in hospitals and nursing homes, where patients often have weakened immune systems. It still is. A national study released Monday at the Association for Professionals in Infection and Epidemiology meeting in San Jose, Calif., found as many as 1.2 million hospital patients a year are infected with MRSA — nearly 10 times as many as previously thought.
But community-acquired MRSA is a growing problem as well. The infection is easily spread from person to person, or through shared towels or other items.
"We're seeing quite a large number of (MRSA) abscesses that have to be drained on a daily basis at all of our locations," said Dr. David Gude, chief operating officer at Texas MedClinics, which operates nine clinics in San Antonio and a 10th in New Braunfels.
"Our experience is that we've been seeing over the last five years a gradually increasing amount of MRSA," Gude said. "People come in, think they have a bug bite, they have a pocket of pus that has to be opened up and drained."
The one-year pilot project in Bexar County would require medical laboratories to report MRSA infections to the health district. Health officials hope the data will tell them how common the infection is in the community, and whether it is occurring more often in certain groups or parts of the city.
"The thing to tell the public is, this bacteria is here to stay," Sanchez said. "It's not going anywhere. We have to learn to upgrade our level of hand-washing and hygiene. That's the first line of defense, hand-washing."