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The New York Times
Health
New Bacteria Strain
Is Striking Gay Men
By LAWRENCE K.
ALTMAN, nytimes.com on the Web, January 15, 2008
A new, highly drug-resistant strain
of the “flesh-eating” MRSA bacteria is being spread among gay men in San
Francisco and Boston, researchers reported on Monday.
In a study published online by the
journal Annals of Internal Medicine, the bacteria seemed to be spread most
easily through anal intercourse but also through casual skin-to-skin contact and
touching contaminated surfaces.
The authors warned that unless microbiology laboratories were able to identify
the strain and doctors prescribed the proper antibiotic therapy, the infection
could soon spread among other groups and become a wider threat.
The new strain seems to have “spread rapidly” in gay populations in San
Francisco and Boston, the researchers wrote, and “has the potential for rapid,
nationwide dissemination” among gay men.
The study was based on a review of medical records from outpatient clinics in
San Francisco and Boston and nine medical centers in San Francisco.
The Castro district in San Francisco has the highest number of gay residents in
the country, according to the University of California, San Francisco. One
in 588 residents is infected with the new multidrug-resistant MRSA strain, the
study found. That compares with 1 in 3,800 people in San Francisco,
according to statistical analyses based on ZIP codes.
A separate part of the study found that gay men in San Francisco were about 13
times more likely to be infected than other people in the city.
The San Francisco researchers suggested that scrubbing with soap and water might
be the most effective way to stop skin-to-skin transmission, particularly after
sexual activities.
MRSA, for methicillin-resistant Staphylococcus aureus, was once spread chiefly
in hospitals. But in recent years, a number of healthy people have
acquired it outside hospitals.
Nearly 19,000 people died in the United States from MRSA infections in 2005, the
Centers for Disease Control and Prevention has reported.
The infection can cause unusually severe problems, including abscesses and skin
ulcers. The bacteria can invade through the skin to produce necrotizing
fasciitis, giving them the popular name of flesh-eating bacteria. They can
also cause pneumonia, damage the heart and produce widespread infection through
the blood.
Among gay men in the study, MRSA was spread by skin contact, causing abscesses
and infection in the buttocks and genital area.
The new strain is closely related to earlier ones. Both are known as MRSA
USA300.
The strain is much more difficult to treat because it is resistant not just to
methicillin, but also many more of the antibiotics used to treat the earlier
strains, said Dr. Henry F. Chambers, an author of the new study.
The new strain contains a plasmid called pUSA03.
“This particular clone is resistant to at least three other drugs, clindamycin,
tetracycline and mupirocin,” Dr. Chambers said in a telephone interview.
Of the alternatives recommended by the C.D.C. and the Infectious Diseases
Society of America, trimethoprim-sulfamethoxazole (Bactrim), clindamycin and a
tetracycline, “this strain is resistant to two of those three,” he added.
“In addition, the new strain is resistant to mupirocin, which has been advocated
for eradicating the strain from carriers.”
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