Deadly bedbugs? Bedbugs and MRSA

[Guest guest]

Deadly bedbugs? At least one expert thinks so

A Cornell University scientist sees a likely link between bedbug bites in

hospitals and cases of serious—even fatal—drug-resistant staph infections;

health workers say the theory makes sense but needs more study.

It's not that bedbugs harbor staph in their blood and transmit it by biting, the

way mosquitoes do with viruses, she says. Rather, bedbug bites can create hiding

places where MRSA can take hold.

Bedbug infestations in hospitals may be aggravating another problem for those

institutions—people getting sick from drug-resistant Staphylococcus they pick up

in the hospital.

Cornell University scientist Jody Gangloff-Kaufmann, an entomologist who

specializes in the study of bedbugs, says she is convinced there is a link

between patients getting bitten by bedbugs and coming down with these dangerous

and even lethal infections. Though called methicillin-resistant Staphylococcus

aureus, or MRSA, the strain also resists penicillin and several other popular

antibiotics.

" What we are starting to see is that hospitals just cannot get rid of MRSA until

they get rid of bedbugs, " said Ms. Gangloff-Kaufmann, who has a PhD in the study

of insects. It's not that bedbugs harbor staph in their blood and transmit it by

biting, the way mosquitoes do with viruses, she says. Rather, bedbug bites can

create hiding places where MRSA can take hold.

That scenario makes sense to Philip Tierno, director of clinical microbiology

and immunology at NYU Langone Medical Center—at least in theory. " It's just

common sense. But I'd like to see a study, " he said. Though Mr. Tierno says his

own hospital has no bedbugs, he has studied their habits.

Once bedbugs get their two fang-like probosci into a victim, they usually bite

one or two times more. But then, Mr. Tierno said, " That's it, they are

satiated. " Bedbugs can go as long a six months or a year without needing more

blood, which may explain why they do not directly transmit disease from one

person to the next.

The bugs' bites deliver anticoagulants, anti-inflammatory substances and a

short-lived anesthetic, he said. That means that people do not at first realize

they have been attacked, but 15 minutes to a half hour later, the bites emerge

as welts which then start to itch.

" The biggest problem comes when you scratch. If you have staph on you then you

introduce that organism into the scratch and you could get a secondary

infection, " Mr. Tierno said.

Infections with MRSA are becoming increasingly common, both inside hospitals and

in the surrounding communities. People often harbor the bacteria in their noses

or elsewhere on their bodies without causing any signs of illness. But if the

organism gets into a cut, or into the system of a person who is already ill or

has a weakened immune system, it can cause serious illness, even death.

Hospitals are increasingly vigilant about taking precautions to prevent MRSA

from causing central-line infections, which occur when the microorganisms get

into the blood stream as intravenous catheters are inserted.

According to the Centers for Disease Control and Prevention, nearly 30% of the

U.S. population was estimated to harbor Staph aureus and 1.5% harbored the

drug-resistant strain known as MRSA, as of 2004. Of 94,000 people who had

serious MRSA infections in 2005, the CDC reported, 19,000, or 20%, died.

Of these serious infections, about 86% were acquired in a hospital or other

health care facility.

" MRSA is very prevalent in this area, " Mr. Tierno said, referring to New York

City and neighboring communities.

Some people who come into the hospital have already been " colonized " with a

different type of MRSA, one they picked up in the outside community—though they

show no signs of illness.

When someone does come down with an infection caused by the community-acquired

MRSA strain, it can be treated with some antibiotics if caught in time. But

because that strain of the bacteria releases a toxin, the infection can quickly

rage out of control. " It can cause toxic shock, " said Mr. Tierno, the syndrome

that sometimes leads to emergency amputations and even death.

Hospital-acquired MRSA infections are less toxic but hard to cure because the

organism has evolved to be immune to more antibiotics than has the community

strain, Mr. Tierno said.

Most hospitals now have departments that focus on preventing such infections.

The CDC says that hospital vigilance has helped bring down the number of

infections, but they remain a big problem.

Dr. Belinda Ostrowsky serves Montefiore Medical Center in the Bronx as its

director of the antimicrobial stewardship program. She said the possibility of a

link between bedbugs and MRSA was intriguing but unproven. " Theoretically, any

breaks in the skin could lead to an infection, " she said, " but I haven't seen

any specific cases or studies. "

Cornell's Ms. Gangloff-Kaufmann says she would welcome that research

opportunity, " I'd love to do a study, I'd give anything for that chance. "

http://www.crainsnewyork.com/article/20101105/FREE/101109903