We frequently hear prominent people in the community complain about the effect the lay media have on society. I often question the degree to which the media influence the public’s perception of a given issue. Over the past few months, the media have turned their attention toward the very serious problem of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection, yet this problem has existed for some time. I wish the media had noticed earlier.
Many of you have probably spoken recently with patients concerning their very valid fear of contracting MRSA infections. I myself have been fielding a number of phone calls prompted by flyers sent home by the schools. Why are we suddenly hearing more about community-acquired MRSA infections? Because despite health-care practitioners’ concerns over the years, the media have finally deemed this a problem.
Community-acquired MRSA as a source of skin and soft-tissue infections has become the rule rather than the exception. The effect of nosocomial MRSA, which is differentiated from its community-acquired cousin primarily by its more extensive resistance, has been well documented. The latest available information indicates that nearly 14% of MRSA cases can be attributed to the community-acquired form of the infection (JAMA. 2007;298:1763-1771).
Although this seems to be a trivial percentage, the occurrence rates are more disturbing when the incidence of S. aureus skin and soft-tissue infections is considered. Antibiotic-susceptible forms of the disease were once the norm, but studies now show that 72% of skin and soft-tissue infections caused by S. aureus are in fact atributable to community-acquired MRSA (Ann Intern Med. 2006;144:309-317).
Furthermore, studies have shown children younger than age 2 years to have higher rates of MRSA infection than the general population (N Engl J Med. 2005;352:1436-1444). Thus it’s clear that empiric treatment directed toward suspected S. aureus infections should be selected on the assumption that MRSA is the causative organism.
So what do we do? Developing more potent antibiotics might seem like the logical answer. However, I think the overuse of such drugs helped get us here in the first place. The CDC is clear regarding the prevention of MRSA infections, and health-care providers can serve as a vital link to this information by educating our patients. Hygiene is the main strategy for preventing the spread of MRSA: Persistent hand-washing or the use of alcohol-based hand sanitizers is essential. And, when patients suffer cuts or abrasions, we must explain to them how any opening in the integument can create a pathway for invasive S. aureus organisms. Finally, people must carefully monitor their exposure to others with cuts or abrasions. This can be particularly difficult in the case of young children.
The outcry on the part of the media regarding community-acquired MRSA infection is very positive, bringing to light a serious problem that threatens the health of many people. The lay media are extremely effective weapons in the fight against disease. I only wish they would be more timely in responding to the issues we raise. For example, health professionals railed against the growing obesity problem for years before the media announced the crisis, or at least acknowledged the gravity of the problem.
As the saying goes, “better late than never,” but I hope that in the future, the media come aboard earlier when we identify threats to public health.