There’s a superbug out there that has killed a schoolchild, sickened strapping New York City firefighters and reached into the heart of Queens, infecting a St. John’s University undergraduate, but experts say the miracle defense is on your sink.
A panel of infectious disease specialists at New York Hospital Queens (NYHQ) held a briefing on the hysteria surrounding Methicillin-resistant Staphylococcus aureus (MRSA), for healthcare professionals, community leaders and the media in an attempt to avert public panic and counter misinformation about MRSA.
According to Dr. James Rahal, director of Infectious Diseases at NYHQ, “The best defense is simple soap and water.”
Rahal explained that there are many strains of Staphylococcus bacteria and most are relatively benign, “even helpful in that they compete with MRSA.”
The same is true for Streptococcus bacteria. Rahal observed the human body is colonized by varieties of these bacteria - some of which are antibiotic resistant strains - on the skin and inside the body.
“MRSA isn’t rare or unusual,” Rahal said, “I venture to say that every one of us is carrying it right now, but not enough to overcome the immune system.”
“There are more bacteria than human cells in the body,” Rahal said.
Problems arise when the number of bacteria overwhelm the body’s defense. This phase is called contagion - “infection, in layman’s terms,” he explained.
“We advise frequent hand washing, using tissues when sneezing or coughing and covering wounds with bandages,” Rahal went on, “we have found Bacitracin ointment to be effective against MRSA in small wounds.”
Rahal and the panel were careful not to trivialize the seriousness of infection.
“Anyone with a wound, pimple or boil which rapidly worsens, becomes tender or has a discharge [pus] requires immediate attention,” he said, adding, “We’re advising that such discharges be cultured in the lab to determine if MRSA is evident.”
Panelists pointed out that although MRSA is resistant to the penicillin family, other antibiotics were effective. World War II-era “sulfa” drugs and variants from families other than penicillin can also be used.
The panel agreed that the first line of defense is “decolonization.” For those not well-versed in science, that means washing.
“Plain soap and water is sufficient,” Rahal said, dismissing the need for “anti-microbial” products under ordinary circumstances. “The simple act of scrubbing under a stream of water - even without soap - will reduce the number of bacteria,” Rahal said, adding, “But tell your kids that they can’t just wet their hands, they have to scrub.”
“The thing to remember is that no amount of personal or environmental hygiene is going to result in a sterile environment,” Rahal advised. “Even the operating room is never sterile, just because there are people in it.”
Carl Urban, a microbiologist who is head of the Infectious Disease Research Laboratory at NYHQ, quoted Sir William Osler (1849-1919) often called the father of modern medicine: “Soap and water and common sense are the best disinfectants.”
To put into sharp focus the need to rely on hygiene rather than drugs as a first line of defense, the panel outlined the history of MRSA.
Simply put, starting with the discovery of penicillin in the 1940s, some bacteria “learned” to produce an enzyme which breaks down the antibiotic. By the 1950’s penicillin-resistant bacteria were widespread in hospitals.
The 10-year cycle of bacteria developing resistance to antibiotics was repeated in the 1960s with Methicillin and later Oxacillin (though the name MRSA was retained.)
As a cautionary note to calls for “disinfecting” of schools following MRSA infections, Rahal related the failure of a program in England.
“After penicillin-resistant bacteria became widespread, they attempted environmental decolonization by spraying Methicillin around hospitals” he recounted. “The result was that MRSA started appearing in their hospitals in four years, rather than ten.”
Dr. Wehbeh Wehbeh, an infectious disease physician at NYHQ, offers simple advice: “Wash the kids and not the schools.”
TIPS TO COMBAT MRSA
Here are some important facts to remember about combating MRSA and bacteria in general:
1. Everyone has bacteria growing on their skin, and often in their body.
2. The best way to avoid infection is to wash your hands frequently, with plain soap and water.
3. Cover cuts and bruises, and use antibiotic ointments. Resistant bacteria aren’t resistant to everything, just specific drugs.
4. Over use of “anti-microbial” products can do more harm than good if you’re healthy.
5. Don’t share handkerchiefs, eating or drinking utensils.
6. Politely ask people who sneeze or cough to use tissues to cover their nose and mouth.
7. If you get a cut, pimple or boil which spreads rapidly, has a discharge and is painfully tender, seek medical attention immediately.
