News
A familiar foe, and a treatable one
MRSA — Methicillin-resistant Staphylococcus aureus. The new panic-demic?
First of all, it's not exactly new.
Second, it's not fun, but it's not unduly alarming, either.
And, stressed Dr. Kirk Bortel of MidMichigan Urgent Care, it's treatable.
"We've had confirmed cases of MRSA for over three years," he said. "This has, all of a sudden, become a hot topic although we've seen it for the past few years in Midland. It's there."
What's probably set off some alarm bells, Bortel said, is the progression of MRSA from more densely populated regions, where it would be expected to thrive, to the outlying areas. "You have the hospital strain (HA) and the community-acquired strain (CA)," he explained. "It used to be mainly in larger cities, larger settings. It's just getting out to more peripheral settings now.
"I was at a conference many years ago and it was in a large city out East. Their culture rate of staph at the hospital was 70 percent MRSA at the time. We had none. It didn't exist in Midland."
But it does now. "We probably see it here (at MidMichigan Urgent Care), whether it's a followup or a new case, most every day. We've been doing that for a while."
To take the fear factor down a notch, "It's more invasive than the old staph we all grew up with, but on the whole a common, treatable disease, although it's a lot more virulent bacteria than what used to be," Bortel said.
Humans are walking germ factories and always have been. "When we were kids, we were colonized with staph; we got a wound and we would get impetigo. Today, if you're colonized with MRSA, you may possibly get an abscess. That's the basic difference," Bortel explained.
If you do develop an abscess, Bortel said, go visit your doctor. The health care community knows what to do. "If we see someone we suspect has MRSA, we open up the wound, drain it, generally pack it and see them back for followup visits. In most of the cases that's it. Drain the abscess and keep it draining; that will cure the infection in a sizable amount of people."
But not everybody, and that's what's gotten the attention. "Sometimes you do need to add antibiotics to that," Bortel said. "There is still some variance among MRSAs as to what they're susceptible or not susceptible to. There are two or three oral antibiotics that we use in outpatients that will work the majority of the time. In this community, some that are typically used are Bactrim, doxycycline or Cipro. Those are the ones that it's sensitive to."
Understandably, Bortel would like to see that list increase. "What you would hope for is that you'd have tens of thousands of staph in a pile. A number of them are MRSA, a number are not. If you stop exposing that pile to antibiotics, the hope is that these old, efficiently working staphs will slowly take over the crowd. Obviously we're not seeing that nationwide, we're seeing the opposite; but we have great silver bullets right now. It's treatable as it is right now. Hopefully, it will continue to be that.
"Are there exceptions? Yes. Can MRSA cause some significant problems? Yes, it can; it's a nasty bug. But the majority of cases are treatable, easily treatable."
Which is why Bortel questions the necessity of closing schools. "As far as I know, there's not any indication to close the schools. On the CDC website it says not to close schools," he remarked. "Right now there are people in the local schools who are colonized with MRSA. We close the schools, clean everything up and the school is colonized with MRSA the next day. It's not like you're going to get rid of it by sterilizing the school. It's there. What takes care of it is good hygiene and common sense. And in the long term, we need to stop the overuse of antibiotics if we want these superbugs to decrease."