Book details MRSA’s evolution, adaptation
The focus of Maryn McKenna’s book “Superbug: The Fatal Menace of MRSA” is right under your nose. Well, not actually under, more like in.
The award-winning science and medical journalist has written a meticulously detailed account of MRSA, or methicillin-resistant Staphylococcus aureus. It’s made headlines in the past few years for sickening and killing healthy, young people and for its ability to win out against the antibiotics meant to destroy it. And, like all staph, it lives all around us — an estimated 4 million Americans are carrying the bug unknowingly.
“MRSA lives on our skin and in our nostrils,” McKenna said. “It passes from person to person by skin-to-skin contact or by contact with a surface that someone has touched. It won’t make you sick immediately, but it can live on your skin without causing illness until some unpredictable future date.”
Doctors started seeing MRSA in the ’60s, and it was quickly labeled a hospital bug — something that attacked those whose immune systems were already compromised. But by the 1990s, hospital staff started seeing the infections in healthy, young people coming into the emergency room. McKenna explains that by evolution and natural selection, MRSA went from one to two to three different strains and birthed an offshoot — a community strain, that affected those considered healthy.
“MRSA acquired slightly different characteristics that, for different strains, made hospitals, the outside world and now livestock friendly places in which to live and reproduce,” McKenna said.
But how? The methicillin-resistant part of the name is key to understanding the mutation. In earlier decades, doctors were able to control and kill staph infections by using a barrage of antibiotics, but it wasn’t too soon after that the bacteria learned to adapt.
“Over the decades, starting in 1961, MRSA has evolved protections against dozens of antibiotics that we use in medicine every day: almost everything ending in -illin; three successive generations of cephalosporins; a group of drugs called monobactams; and others,” McKenna added. “For the most serious infections, there can be only one or two drugs that work. And because MRSA is diverse, it often takes some careful lab work, or several trials of drugs on a patient, to find the right combination that does work.”
“Wash your hands,” McKenna said. “It really makes a difference.” She follows that simple but often forgotten advice with using hand sanitizer and watching for signs of a community-strain infection. It may look like a spider bite, but if it hurts more than something so small should, ask your doctor to test for MRSA.
“If you’re in the hospital or a loved one is,” she added, “pester everyone who comes into the room about washing their hands.”
Remember when your doctor told you to always finish an antibiotic? MRSA is a lesson in why. Scientists have been battling MRSA for decades, and with each leap science makes, it seems that MRSA takes two. The proverbial leapfrog has health professionals and scientists alike grappling for an answer.
McKenna’s carefully organized tome outlines the past, present and future of the bacteria, and there’s a reason she explains that MRSA “may be the most frightening epidemic since AIDS.”
“What we need to do is to learn to recognize it and to spread the word of its increased prevalence so that individual people and health care professionals recognize infections when they occur and get the right treatment,” she said. And never stop asking.
“We should be asking the government to assign more money for research into this problem,” McKenna added. “We should ask public health agencies to count it better, so we know how big the epidemic really is. We should ask health care to stop its persistent infighting over the best infection-control strategies, and make preventing MRSA and other infections more of a priority.”
