Boston: Resistant-Bacteria Reports Cause Alarm

Five Boston men have been infected with a powerful, drug-resistant bacteria, strikingly similar to larger outbreaks in Los Angeles and San Francisco.

Beginning last fall, doctors at the Fenway Community Health Center started seeing patients with pneumonia, sinus infections, and skin conditions caused by methicillin-resistant Staphylococcus aureus (MRSA). The infection, which normally occurs in hospitalized persons who are seriously ill from other diseases, can elude a whole class of antibiotics.

Fenway physicians alerted CDC to the cluster of cases, and the Massachusetts Department of Public Health has launched an investigation. The men are all HIV-positive, but neither their physicians nor disease investigators can say with certainty that the patients' HIV status had anything to do with the infection. After treatment, all five men recovered without lasting complications.

"It's of great concern," said Dr. Scott Fridkin, a medical epidemiologist at CDC. "The reports are becoming more frequent, and it appears to be a growing problem."

Drug-resistant bacteria are especially perilous because patients infected with them typically do not know, and neither do their doctors. The patients are usually started on main-line antibiotics -- which do not work -- and the infection advances until doctors find an antibiotic that does work. The drug-resistant bacteria can spread to other people, igniting a cascade of resistant illness.

Drug-resistant bacteria arrived in Boston in the late 1960s and early 1970s and have remained a problem chiefly in hospitals, said Dr. Alfred DeMaria, state director of communicable disease control. "What's really news is the degree to which they are turning up in community-acquired settings," DeMaria said.

On the West Coast, similar infections have stricken hundreds, including 928 Los Angeles County jail inmates last year. So far this year, public health agencies in Los Angeles and San Francisco have reported clusters of antibiotic-resistant bacterial infections in those cities' gay communities.

Specialists recommended many of the same prevention measures used to stop other infections, including rigorous hand-washing. Patients with persistent skin infections should contact their doctors, and they are urged to keep any sores properly covered.

Back to other CDC news for March 3, 2003

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