According to the Boston Globe, a new study indicates that deaths from the bacterium Staphylococcus aureus (‘staph infections’) have exceeded AIDS/HIV deaths in the U.S (italics mine):
Deaths tied to these infections may exceed those caused by AIDS, said one public health expert commenting on the new study. The report shows just how far one form of the staph germ has spread beyond its traditional hospital setting.
The overall incidence rate was about 32 invasive infections per 100,000 people. That’s an “astounding” figure, said an editorial in Wednesday’s Journal of the American Medical Association, which published the study.
Most drug-resistant staph cases are mild skin infections. But this study focused on invasive infections — those that enter the bloodstream or destroy flesh and can turn deadly.
Researchers found that only about one-quarter involved hospitalized patients. However, more than half were in the health care system — people who had recently had surgery or were on kidney dialysis, for example. Open wounds and exposure to medical equipment are major ways the bug spreads.
In recent years, the resistant germ has become more common in hospitals and it has been spreading through prisons, gyms and locker rooms, and in poor urban neighborhoods.
The new study offers the broadest look yet at the pervasiveness of the most severe infections caused by the bug, called methicillin-resistant Staphylococcus aureus, or MRSA. These bacteria can be carried by healthy people, living on their skin or in their noses.
….The researchers’ estimates are extrapolated from 2005 surveillance data from nine mostly urban regions considered representative of the country. There were 5,287 invasive infections reported that year in people living in those regions, which would translate to an estimated 94,360 cases nationally, the researchers said.
Most cases were life-threatening bloodstream infections. However, about 10 percent involved so-called flesh-eating disease, according to the study led by researchers at the federal Centers for Disease Control and Prevention.
There were 988 reported deaths among infected people in the study, for a rate of 6.3 per 100,000. That would translate to 18,650 deaths annually, although the researchers don’t know if MRSA was the cause in all cases.
If these deaths all were related to staph infections, the total would exceed other better-known causes of death including AIDS — which killed an estimated 17,011 Americans in 2005 — said Dr. Elizabeth Bancroft of the Los Angeles County Health Department, the editorial author.
….A survey earlier this year suggested that MRSA infections, including noninvasive mild forms, affect 46 out of every 1,000 U.S. hospital and nursing home patients — or as many as 5 percent. These patients are vulnerable because of open wounds and invasive medical equipment that can help the germ spread.
This is all the more disturbing in light of another recent paper that summarizes what has happened with hospital staph infections between 1998-2003:
(for larger version, click here)
Basically, the per hospital stay probability that you would get a staph infection rose from 0.74% to 1.0%, which is roughly a 7% increase per year. More serious infections (i.e., those following invasive, complicated surgery) also increased dramatically. In 2003, the estimated national cost of staph infections alone was $14.3 billion (that’s like seven weeks in Iraq!). Keep in mind that these estimates are based on the ICD-9 codes, and my experience has been that these codes are an underestimate, sometimes a severe one. Some other studies that I know about (they’re not finished yet) suggest that the cost of hospital acquired infections is in the range of $50-80 billion annually.
There’s something else to note. The increase in staph infections is largely due to an increase in MRSA, which because of its drug resistance and innate virulence, is much harder to treat. The MSSA infections have only increased slightly. This is a subtle, but important point: the antibiotic resistance problem doesn’t just mean harder-to-treat infections, but more infections overall.
Until we get serious about infection control and national prescribing practices, we are letting the inmates run the asylum. The problem will only get worse.
Related post: Tara of Aetiology has a good summary of MRSA.
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