High Risk of MRSA in Bronx

Slideshow: How to prevent infection from MRSA. (Janurie Ulett)

By JANURIE ULETT

Bronx mother Michelle McKoy, 26, squirted an abundance of Purell sanitizer into her 6-year-old daughter’s hands.

“You can’t be too careful,” McKoy said as she instructed her daughter to rub her hands together. “You see the germs they be talking about on the news? It’s serious.” McKoy said she takes extra precautions, cleaning her children’s hands throughout the day to protect against bacteria like MRSA that have been recognized as a serious health threat by the Centers for Disease Control and Prevention.

Her concern is well advised. Studies have found that MRSA – Methicillin-resistant Staphylococcus Aureus, a type of staph bacteria that resists many antibiotics – once limited mainly to hospital patients, has become common in the community as well. A 2012 study by the Society for Health Care Epidemiology of America revealed the Bronx has substantially higher rates of MRSAs than other New York City boroughs due to lack of access to primary care health service.

The United Hospital Fund 2011 study on health insurance coverage in each New York City borough showed that in 2008 through 2009, the Bronx had a high rate of uninsured residents,  17.9 percent.

“Without primary doctors, Bronx residents are more likely to delay treatment, causing the infection to worsen and later resulting in the admissions to hospitals,”  said Tamara Moore, spokesperson for the Society for Healthcare Epidemiology of America.

Aside from the lack of healthcare, the standard of living also plays a key role in determining risks of infection. “Some studies have found associations between MRSA infections and minority groups and lower socioeconomic status, the hypothesis being those groups could lead to increase transmission and therefore higher incidence of infection,” said Melissa Dankel, a spokesperson for the Centers for Disease Control and Prevention.

Last year’s study by the Society for Healthcare Epidemiology of America also showed that the MRSA cases on the rise in New York are more common among specific groups.. Diabetics and those with HIV are more likely to have skin infection and sores that can easily lead to MRSA infections. Those who play contact sports have been known to spread infections.  Since the homeless have limited access to healthcare and lack personal hygiene, they are also very susceptible to contracting a life-threatening MRSA infection without knowledge or ability for treatment.

In the same study, researchers recognize the necessity for raising public awareness about the danger of MRSA, declaring that the health authorities should do more to educate the homeless in city shelters and residents of high-risk areas in the Bronx on how to recognize signs of an infection early.

“Shelters should develop closer partnerships with medical programs that would enable them to provide screenings,”  Moore said.

As antibiotic-resistant bacteria spread throughout the United States, The National Institutes of Health  published a 2007 study showing that invasive MRSA affects certain public health and intensive care unit populations disproportionately. “MRSA bacteria can transfer its resistance to other bacteria within its family,”  said Dankel. “Most infections still occur in people getting long term health care in hospitals, care facilities, or nursing homes.”

While the biggest risk factor for MRSA infection is open or broken skin, healthcare procedures can also leave patients vulnerable to MRSA, which typically spread it from patient to patient on unclean hands of healthcare workers or through the improper use or reuse of equipment.

Patients in healthcare facilities may have weakened immune systems and undergo surgery, making them more vulnerable to infections. When patients get MRSA in healthcare facilities, the infections are usually more severe and include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia.

Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections causing the bacteria to survive and continue to multiply, making it more harmful.  There are numerous factors that influenced the origin of MRSAs but a significant amount of blame has been centered on the prolonged misuse of antibiotics. Medical progress has actually increased the dependence on antibiotics, and overuse has led several bacteria to become resistant, causing thousands of annual deaths in the United States, according to the Centers for Disease Control and Prevention.

The overuse of antibiotics in agricultural animals is also seen as a key component as animals such as pigs, cows, and chickens are unnecessarily given high amounts of antibiotics to enhance their growth as seen in the 2012 Meat on Drugs Consumer Report. The CDC also warns that animal-to-human transmission also appears responsible for a small portion of human MRSA infections as a result of direct skin-to-skin contact between humans and pets.

While the general population should follow the basic prevention advice by thoroughly washing hands often and bandaging cuts and scrapes, those considered to have a higher risk for MRSAs are advised to be more vigilant for any physical signs such as red or swollen marks on the skin that might appear to contain pus or other fluids. In any case of possible infection, residents are instructed to see a physician immediately.

“Reducing MRSA in both healthcare and community settings continues to be a high priority for the CDC,”  Dankel said. “The agency is engaged in several short- and long-term surveillance infection tracking projects that involve collaboration with partners including health departments, individual hospitals, and academic medical centers.”

CDC officials say that further comprehension of what areas and demographics have higher outbreaks is essential for developing prevention plans that keep the public safe.