The NY Times has an article about the MRSA (methicillin resistant Staphylococcus aureus) strain that is spreading rapidly among gay men. One factor is that a subset of the gay population is immunocompromised due to HIV, and consequently, is more likely to acquire MRSA skin infections.
This strain is very drug resistant, unlike most community-acquired MRSA (‘CA-MRSA’). Most CA-MRSA, while resistant to methicillin, is sensitive to clindamycin. However, this strain has acquired a plasmid (a transferable ‘mini-chromosome’) that confer resistance to commonly-used drugs to treat MRSA:
“This particular clone is resistant to at least three other drugs, clindamycin, tetracycline and mupirocin,” Dr. Chambers said in a telephone interview.
Of the alternatives recommended by the C.D.C. and the Infectious Diseases Society of America, trimethoprim-sulfamethoxazole (Bactrim), clindamycin and a tetracycline, “this strain is resistant to two of those three,” he added. “In addition, the new strain is resistant to mupirocin, which has been advocated for eradicating the strain from carriers.”
Losing mupirocin would be devastating, since mupirocin nasal drops are a vital tool for eliminating MRSA from people who carry MRSA without any signs of disease. In Boston, I’ve heard that linezolid resistance is also found at low levels (~1-2%) in gay men, so it looks like we’re on our way to losing that antibiotic too.
One of the depressing things about the ascendancy of the Christopaths is that they hate any public health interventions that involves gay people. In the case of antibiotic resistance, that’s not only evil, but it’s also stupid.
Related post: Tara has a good post about this strain.