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December 7, 2004

Bacterial Threat - Schools take Precautions Against MRSA

Topics: Medicine

A Dec 02 Salisbury Post (UK) article warns of a bacterial threat from MRSA at local high schools:

Athletic directors and coaches at local high schools are taking precautions against the spread of an infection that has received a fair amount of publicity of late. MRSA is a staph infection that's caused by skin bacteria. It typically starts out as a pimple or boil and is difficult to clear up without special antibiotics. Recently, concern among coaches and parents has been that the infection is likely to be spread by student-athletes, especially those involved in skin-to-skin sports like wrestling or football.

MRSA is a methicillin-resistant Staphylococcus aureus, a gram-positive bacteria. A very recent article in J Hosp Infect. 2005 Jan;59(1):27-32 will provide you with a good background for an understanding of how serious this problem is in hospitals for example, a far cry from school yards and athletic fields. If it is a problem for hospitals, it doesn't take much of an imagination to understand how it can be a problem for school athletic directors. As reported in the journal article:

Staphylococcus aureus is a leading cause of serious hospital- and community-acquired infections. The discovery of serologically distinct capsular polysaccharides on the surface of clinical isolates has allowed the development of vaccines and passive protective immunity. Patient characteristics, infection characteristics and the surface and capsular polysaccharide serotype distribution in patients with S. aureus infections complicated by bacteraemia admitted to VA hospitals in Maryland between 1995 and 2000 have recently been studied. Nine hundred and ninety-three blood cultures from 331 patients were positive for S. aureus. Thirty-eight percent of patients had diabetes, 11% had end-stage renal failure, and 23% were injection drug users. Forty-two percent of infections were caused by methicillin-resistant strains (MRSA), and 60% were acquired during hospitalization. Serotyping of the first available isolate per patient using polyclonal antibodies showed three major phenotypes-42%, type 8 (T8) capsule; 50%, type 5 (T5) capsule; and 8%, 336 polysaccharide. MRSA isolates were significantly more likely to be T5 than methicillin-susceptible isolates (66% vs. 39%, P<0.001). The proportion of T5 MRSA increased significantly (years 1-2: 41%; years 3-4: 65%; years 5-6: 90%, P<0.001). The large sample of patients with serious S. aureus infection confirmed that capsular polysaccharides T5 and T8 cause most human infections, and together with serotype 336, account for nearly all those with bacteraemia. ( PMID: 15571850)

On the more promising side of the problem is that a humanized monoclonal antibody that exhibits a high affinity and specificity and for the Staphylococcus aureus MSCRAMM((R)) (Microbial Surface Components Recognizing Adhesive Matrix Molecules) protein ClfA has been studied at Inhibitex Inc. in Alpharetta, GA, USA. Preclinical in vivo testing revealed that a single administration of Aurexis((R)) significantly protected against an IV challenge with a methicillin resistant S. aureus (MRSA) strain in murine septicemia and rabbit infective endocarditis (IE) models. Safety and pharmacokinetic data from a 19-patient phase I study support continued evaluation of Aurexis((R)) in phase II studies. Vaccine. 2004 Dec 6;22 Suppl 1:S39-43. 'PMID: 15576200'.

Posted by Hyscience at December 7, 2004 8:20 AM

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