Resistant staph turns up on Kane'ohe base
By William Cole
Advertiser Military Writer
A form of antibiotic-resistant staph previously observed in hospitals and prisons was diagnosed recently in three Marines and two family members at Kane'ohe Bay.
Methicillin-resistant Staphylococcus aureus, or MRSA, can infect hospitalized people weakened by disease or injury, but a strain that poses a risk to healthy people has emerged.
Dr. Paul Effler, state epidemiologist, said 30 percent of all staph cases reported in Hawai'i — most of them in hospital settings — are resistant to commonly used penicillin-related antibiotics. Nationally, the figure stands at 40 percent, he said.
The Marines, who were from the same unit, sought medical attention at the Branch Medical Clinic for "minor" skin lesions, officials said.
Effler said he is not aware of any large outbreaks of the drug-resistant strain of staph at military bases. But evidence points to MRSA spreading nationally and worldwide, and Effler said the trend is a "wake-up call" for the medical profession.
"It does indicate that we need to keep re-evaluating our antibiotic (use) patterns," Effler said. "What are we prescribing antibiotics for? How do we use them so we don't help accelerate the ability for pathogens to pick up resistance?"
The Marines and family members were treated with a non-penicillin medication and needed only outpatient care for the staph infection, which is almost always spread by direct physical contact or by indirect contact from touching contaminated towels, clothes, wound dressings, sports equipment or surfaces of workout areas.
Staph bacteria commonly are carried on the skin and in the noses of healthy people; infections can be as small as a pimple. MRSA infections within the community are typically skin infections but also can cause severe illness, as in the cases of four children in Minnesota and North Dakota who were infected by MRSA and died.
Navy medical workers said there have been isolated cases of MRSA in the general population for years, and the Kane'ohe Bay cases are not the first reported in the military.
Doctors worry that MRSA could also become resistant to vancomycin, a fallback antibiotic.
"We haven't had any isolates resistant to vancomycin — in fact there's only been a couple of cases identified in the history of medicine and so far, fortunately, not here in Hawai'i," Effler said. "But the fact that there's been a couple ultimately raises concern that that could become more widespread."
MRSA has spread in crowded prisons, but there have also been small outbreaks among athletes and children. Effler said anyone with MRSA should be isolated to undergo treatment. Good hygiene and hand-washing can help prevent staph infections, he said.
Reach William Cole at wcole@honoluluadvertiser.com or 525-5459.
