dept of Community Health and CDC Investigating Case of Vancomycin Resistant Staph Infection

July 3, 2002

 

The Michigan Department of Community Health and the Centers for Disease Control and Prevention (CDC) are investigating a case of vancomycin resistant Staphylococcus aureus in a Michigan resident.  Vancomycin is an antibiotic commonly used in treating serious infection.

 

"We have no reason to believe there is any threat to the general public and will aggressively continue this investigation with the assistance of the Centers for Disease Control and Prevention," said Michigan Department of Community Health Director, James K. Haveman, Jr.  "It is encouraging that this organism appears to be readily identified in the laboratory and susceptible to other antibiotics in order to fight this infection." 

 

Local health care providers alerted the Department of Community Health to this case, and an investigation was initiated to determine the extent of the infection.  Infectious disease experts from the Centers for Disease Control and Prevention (CDC) were sent to Michigan to work collaboratively with state epidemiologists and laboratorians on the investigation.  The purpose of the investigation is to determine whether this bacterium has spread to any direct or indirect contacts of the patient and to ensure effective infection control procedures are properly followed. 

 

State and federal investigators are collecting swabs from known and potential contacts.  These specimens are then tested for the presence of this resistant bacterium at the Department of Community Health laboratory.  Several hundred of these tests have already been completed, and to this point no other vancomycin resistant Staphylococcus aureus infection has been identified.

 

"I appreciate the cooperation we have received from this individual and the health care providers involved and would urge all involved health care workers, the press and the public to recognize this individual's right to confidential health care treatment," said Haveman.

 

Staphylococcus aureus is a bacterium commonly found on the skin and in the nose of healthy people.  Occasionally, this bacterium can get into the body and cause an infection.  This infection can be minor, but it has the potential to cause serious, life-threatening blood infections or pneumonia.  If infection does occur, the majority of these organisms are successfully treated with a range of antibiotics.

 

In 1997 a Michigan resident was found to have a Staphylococcus aureus infection with decreased susceptibility to vancomycin.  That particular case, along with other similar cases with lower level resistance from elsewhere, added to the long-standing concerns in the medical and public health communities about the development of antibiotic resistant bacteria.  When antibiotics are used there is a chance that bacteria will adjust to them and then not be affected by them.  Certain bacteria can develop antibiotic resistance by picking up genes that code for this resistance from other kinds of bacteria.  This naturally occurring process of gene sharing among different species of bacteria is what appears to have made Staphylococcus aureus organisms more highly resistant to vancomycin in the present situation.

 

"Appropriate hand washing, particularly in the health care setting, is one of the most effective ways to prevent transmission of bacteria like Staphylococcus aureus," said Michigan Department of Community Health Chief Medical Executive, Dr. David R. Johnson.  "In addition, patients should not request and health care workers should not provide antibiotics without a clear need for them.  When antibiotics are prescribed, the full course should be taken as directed."

 

Using proper infection control practices will prevent spread of all antibiotic-resistant microorganisms, including antibiotic resistant Staphylococcus aureus.  CDC recommends contact precautions when caring for patients with these infections; this includes placing the patient in a private room, wearing gloves and a gown during patient contact, washing hands after contact with the patient and infectious body tissues or fluids, and not sharing patient care items with other patients.  The complete CDC guidelines for preventing spread can be found at: http://www.cdc.gov/ncidod/hip/10_20.pdf.

 

CDC has developed a series of 12 steps that can reduce the development and spread of resistant organisms.  Among those steps are preventing infections, using infection control precautions to prevent spread of the resistant organisms, and using antimicrobials appropriately.  Appropriate use of antibiotics (i.e., use only when needed to treat bacterial infections and careful evaluation of antibiotic choice directed by results of proper diagnostic testing) should reduce the emergence of resistance strains.  The CDC Campaign for Prevention of Antimicrobial Resistance guidelines for clinicians to prevent the development of resistant microorganisms can be found at: http://www.cdc.gov/drugresistance/healthcare/ha/12steps_HA.htm. 

 

Michigan is fortunate to also have a well-established collaborative project--the Michigan Antibiotic Resistance Reduction Coalition (MARR)--that has been working to bring issues of resistance to the attention of providers and consumers alike.  Further information on this issue can be found at: http://www.mi-marr.org.