The Staphylococcus cycle — stay alert

Philip J. Goscienski, M.D.

September 2012

It's back. About every 30 years Staphylococcus aureus arrives in a fairly predictable cycle, just as the earth circles the sun. This time however, it's better equipped for mayhem. The current version that has so many healthcare workers concerned is resistant to an antibiotic that was quite effective until just a few years ago. It's known as MRSA — Methicillin-Resistant Staphylococcus Aureus.

Staphylococci are everywhere. Each of us carries billions on our skin most of the time. Fortunately, most variants are not only benign but they block the strains that are most harmful. That is, except when very aggressive strains show up, which tends to occur at 3-decade intervals. The harm that they inflict ranges from food poisoning to blood poisoning. During influenza epidemics they are responsible for many of the serious illnesses and deaths. Minor infections include boils and wound infections; more serious ones destroy bones and heart valves.

In the early days of penicillin it worked well but staph is a crafty germ. Antibiotic development has barely stayed ahead of this bacterium's ability to become resistant to the most sophisticated drugs. When methicillin-resistant strains began to appear several years ago they were identified primarily among hospitalized patients, causing so-called nosocomial infections. The frequency and the seriousness of these infections was a wake-up call to public health authorities. Innovative and aggressive control measures have been put into place to control spread among patients. Now however, it has become a community problem.

Community-acquired MRSA has increased significantly and there have been some unexpected situations. In the past, especially during widespread epidemics of influenza, dangerous staphylococci targeted older persons whose immunity was reduced by the aging process. MRSA's recent victims have included children and adolescents as well as individuals within the gay community.

Physicians haven't yet run out of effective ammunition but history shows that we may face that problem in the future — hopefully a distant one. For the moment it falls upon all of us to minimize the threat by avoiding infection in the first place.

Frequent hand washing using ordinary soap is the primary defense. Antibiotic soaps are not only unnecessary, they lead to antibiotic resistance. Hand sanitizers are useful but they are not as effective as soap and as-hot-as-you-can-stand water. Plain alcohol is useless.

Don't share personal items such as towels and razors. Cover any breaks in the skin

These infections will eventually pass — for another 30 years.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.