Tough bacteria worries doctors

If you think you have a spider bite, take a second look.

The skin inflammation may be signs of an increasingly common type of staph infection known by the initials MRSA.

“We have had a huge increase in the number of people coming in with this type of infection,” said Dr. Yuan-Po Tu, an internist at The Everett Clinic.

“This is a super bug,” he said. “The problem with this bug is it doesn’t respond” to common antibiotics.

Doctors say it’s one symptom of a trend they’ve warned about for years: overuse of antibiotics.

MRSA, or Methicillin Resistant Staphylococcus Aureus, is a fairly common bacteria, but it causes skin infections that are difficult to treat because of its resistance to antibiotics, said Dr. Jo Hofmann, communicable disease epidemiologist for the state Health Department.

“There’s usually something you can use,” she said, “but those options are smaller every year.”

Tu said he’s concerned that people may not realize how common MRSA infections have become. Many people think they have a spider bite instead of a skin infection and don’t get treated, he said.

“In general, we don’t have spiders in this area that can cause any kind of bite … anything that causes more than a little red mark,” Hofmann said.

MRSA’s staph bacteria are commonly found on the skin and in the nose and can cause infections in a cut, burn or wound.

MRSA cannot only cause skin infections, “but also has the ability to cause infections at distant sites” in the body, Tu said. “It doesn’t occur that often, but when it does, it is very scary.”

Tu told of one patient, a carpet layer, who came to the clinic with a skinned knee. The patient reported having a fever for three days. His knee was “red hot” to the touch, Tu said. The patient had a skin infection that usually can be treated with medications.

“For whatever reason, he didn’t look right,” Tu said, adding he decided to hospitalize the man. Tests showed he had the MRSA bacteria in his bloodstream, “which is very, very serious.” The man was given intravenous antibiotics and recovered.

In addition to bloodstream infections, MRSA can cause pneumonia and bone infections.

Traditionally, MRSA was more common in hospital settings. But recently, The Everett Clinic, which has its own in-house lab, has documented an increase in positive test results for MRSA bacteria, he said. It can be found with common skin problems such as infections, carbuncles and even a pimple that is scratched and becomes inflamed.

“Right now, we’re doing 30 to 40 cultures a week,” said Tu, who works at The Everett Clinic’s Hoyt Avenue facility in Everett.

Two years ago, about 1 in 8 clinic patients with an infection who were tested had MRSA bacteria that were resistant to antibiotics, he said. “Now it’s nearly every other one.”

Part of the increase, he acknowledged, is because doctors are testing more for the bacterial infection. The Everett Clinic, with nine medical clinics and two outpatient surgery centers, has 270,000 patients. Positive test results are being found in patients at all the clinics.

“I believe there truly is more of this than there was,” he said. “It’s not a city of Everett problem. It’s a state of Washington, and now, a national problem.”

The Snohomish Health District is getting reports of increasing numbers of local MRSA cases. An analysis is under way on the information from The Everett Clinic, said Nancy Furness, the district’s manager of communicable disease.

MRSA is not on the list of diseases that are required by the state to be reported to public health officials. So it’s impossible to know precisely how rapidly it’s spreading. Some hospitals and clinical labs, including The Everett Clinic, voluntarily report the disease. “The rates are going up everywhere,” Hofmann said.

“Anything that’s resistant to multiple antibiotics is harder to treat,” Hofmann said. “People failing initial treatment, instead of getting better, they come in with something that’s worse.”

One report this year from King County showed 65 percent of patients tested for MRSA had the infection, she said.

Public health officials saw the disease begin to snowball in the Eastern U.S. years ago, Hofmann said, but more recently “has really kind of taken off on the West Coast.”

Reporter Sharon Salyer: 425-339-3486 or salyer@heraldnet.com.

When to get medical care

* If an infection does not clear up or if it comes back.

* If there’s signs of infection, such as fever, pain, spreading redness, local swelling or heat, or drainage from a cut or wound.

Sources: Spokane Regional Health District and Tacoma-Pierce County Health Department

When to get medical care

* If an infection does not clear up or if it comes back.

* If there’s signs of infection, such as fever, pain, spreading redness, local swelling or heat, or drainage from a cut or wound.

Sources: Spokane Regional Health District and Tacoma-Pierce County Health Department

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