New MRSA Strain Spreading Among Gay Men

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.

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Are you say it is the evil "Christopaths" that are losing us mupirocin by not funding it? Doesn't seem to me that that is exactly the way antibiotics are lost.

By vanderleun (not verified) on 16 Jan 2008 #permalink

Vanderleun,

The religious right has fought to cut many public health programs that serve the gay community, such as HIV prevention. This increases the immunocompromised population, thereby creating a reservoir of people susceptible to S. aureus. This group can serve as a focus of infection, requiring antibiotic therapy. This leads to increased antibiotic use and MDR-MRSA.

oh come on. you take a population like "gay" males and their proclivities and give a bacterium the opportunity, you'll get evolution. it's not like HIV didn't make it's presence known in africa for lack of knowledge..

By genesgalore (not verified) on 18 Jan 2008 #permalink

it's real similar to the swine/avian/human influenza of 1918 etc. all those troop ships loaded with peeps in close quarters exchanging the nasty.

By genesgalore (not verified) on 18 Jan 2008 #permalink