Staph—a germ that generally comes in the form of pimples or rashes that heal on their own—has caused fatal pneumonia in at least 24 young and healthy people during the 2006-2007 flu season. US researchers—led by the US Centers for Disease Control and Prevention (CDC) warn that doctors need to be on the alert for a drug-resistant form of staph called methicillin-resistant Staphylococcus aureus or MRSA that leads to life-threatening pneumonia.
Dr. Alexander Kallen of the CDC led the study and confirmed that some patients died within four days and many were not initially treated for MRSA, suggesting their doctors did not know that they were dealing with MRSA-provoked pneumonia. “It’s obviously very concerning,” Kallen said. “This is a disease that can strike otherwise very healthy people—adults and children. Also, this is a disease that follows influenza.” Kallen also indicated that the disease has implications for preparing for the flu season and a possible flu pandemic.
Kallen’s team reviewed reports of community-acquired pneumonia caused by Staph aureus between November 1, 2006 and April 30, 2007 and found that, “Overall, 51 cases were reported from 19 states.” Their findings appear in the Annals of Emergency Medicine. “More than three-quarters—79 percent—of the staph-caused pneumonia patients were infected with MRSA,” Kallen said.
The patients’ average age was 16. One-third had confirmed influenza; however, nearly half—40 percent—were healthy. According to the researchers, 24 patients died within an average of four days following a pneumonia diagnosis. Those infected with the flu were about twice as likely to die from the staph-caused pneumonia. “The key message to realize is that during the winter season, especially when influenza is circulating, physicians need to be thinking about this as a cause.”
Staph aureus is common and generally about 30 percent of all people are colonized with staph at any given time. This means that these people have the staph bacteria living on their skin or in their noses, but are not ill. “You shake hands with someone and you get MRSA and MRSA colonizes you,” Kallen said.
Staph can get into the lungs and cause disease and some studies indicate that when people are infected with flu, the virus can help shut down the natural processes for ensuring the lungs clear, thus allowing the staph bacteria to grow in the lungs.
In April we reported a disturbing increase in the number of children dying from both the flu and MRSA. At that time, state and federal disease investigators began tracking the situation and Massachusetts’s health authorities linked two childhood flu deaths to MRSA and found that nationally, of 74 children known to have died from the flu in the US in 2006-07, 22 also had staph, most MRSA. The CDC expressed deep concern and began planning on executing a monitoring network for patients co-infected with flu and MRSA during the next flu season. Experts say that data and other findings could assist doctors in preventing flu-MRSA cases from turning fatal.
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