Mike the Mad Biologist

Staph Deaths Exceed AIDS Deaths in U.S.

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:

staphprevalence
(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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Comments

  1. #1 David B.
    October 17, 2007

    This makes me soooo angry. We’ve been hearing about antibiotic overuse and misuse for something like 30 years and yet doctors continue to do it! My ex would go to a quack doctor who would prescribe antibiotics for a cold!

    Since the cure has lost it’s effectiveness I’m preparing a post about prevention and living responsibly with MRSA and CA-MRSA.

    http://www.theskinofmyteeth.com

    David B.

  2. #2 Gabie
    October 17, 2007

    Not trying to spam you, but would desperately like input on whether this argument/interpretation is somehow wrong: Flesh-Eating Superbug Not So Bad, Really

  3. #3 Minute Man
    October 18, 2007

    Immigrants are bringing this into emergency rooms, which they use as primary care.

    This is what we get.

  4. #4 Zahra
    October 18, 2007

    At the risk of feeding the trolls…

    Claiming that this problem is the fault of immigrants reveals a fundamental misunderstanding and ignorance of the science behind bacterial resistance. Even if we grant that immigrants are somehow more prone to bacterial infections, it doesn’t explain the multi-resistance. The only cause of that is excessive or inappropriate prescription of antibiotics, or improper use of antibiotics. Period.

    Which is to say nothing about the politics behind such a statement. If you don’t want immigrants to use the ER for things like the common cold (which they would be FORCED to do), the solution would appear to be extending health care to all people in the US. Problem solved.

  5. #5 Mike the Mad Biologist
    October 18, 2007

    Gabie,

    I can’t access the link (access denied)

    “Minute Man”,

    you’re a hate-mongering moron. The group most likely to have MRSA are the elderly; non-elderly Hispanics (which I’m sure is what a bigot like you means by “immigrants”–you’re probably not referring to Eastern European or Irish immigrants, for example) are less likely to carry MRSA than whites. Go crawl back up Lou Dobbs’ ass.

  6. #6 Minute Man
    October 19, 2007

    The fit survive, the weak perish.

    I learned that in Biology class.

    Learn it.

    Know it.

    Live it.

  7. #7 Trisha Springstead RN
    October 20, 2007

    MRSA, Staph and VRE have been around a long time. Now there are Vector Borne Diseases for which we have no cure.
    Go to http://www.iraqinfections.com
    Many people are diagnosed with MRSA without a Clinical Swab of wounds and Nares.
    Do you think every one of these people have MRSA, the CDC is doing a lot of Covering up on other Epidemics and just giving them a Blanket Diagnosis of Staph or MRSA.
    Do We think they will spend 300 or more dollars on Cultures and Sensitivities for these people. HELL NO.
    They look at a wound and say “OH That is MRSA”
    Science needs to prove to me clinical diagnoses and Cultures to Go along with it.

  8. #8 mirc
    March 26, 2009

    Where do you get “racist” from, PhysioProf..
    thanks a lot.

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