From the MASSAGE Magazine article titled, “What Massage Therapists Need to Know About Staph Infections,” by Chris Cunningham, in the November 2008 issue. Article summary: CA-MRSA is the newest strain of bacteria that causes staph infection, and it can spread in nonhospital settings—such as your massage practice—among people who are otherwise healthy.

A national analysis of physician office and emergency department records shows that the types of skin infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) doubled in the eight-year study period, with the highest rates seen among children and in urban emergency rooms.

The study, conducted at the University of California, San Francisco, examined annual data from the National Center for Health Statistics of patient visits for skin and soft-tissue infections from 1997 to 2005.

During that time period, according to a university press release, office and emergency room visits for all skin infections rose from 8.6 million nationwide to 14.2 million, according to Adam Hersh, M.D., Ph.D., lead author on the paper and a fellow in the divisions of general pediatrics and of pediatric infectious diseases at UCSF.

The vast majority of that increase was attributable to visits for abscesses or cellulitis, which Hersh called the hallmark signs of infections from the variety of staph bacteria known as MRSA, or methicillin-resistant Staphylococcus aureus.

Those infections rose from 4.6 million to 9.6 million during the study period.

“This shows that community-acquired MRSA infections are occurring nationwide and affect all subsets of the population,” Hersh said. “But there clearly are some subsets that are disproportionately affected, such as children.”

The increase was predominantly seen among children and among patients who visit emergency rooms in urban areas at so-called safety net hospitals. Those are hospitals in which at least half of the patients receive Medicaid or are uninsured.

From 1997 to 2005, the number of visits for abscesses or cellulitis nearly quadrupled in safety-net emergency departments, from 1.3 people per 1,000 total population to 4.9. Among children, the incidence nearly tripled from 10.1 patients per 1,000 children to 27.6. By contrast, incident rates among patients older than 45 rose less than 50 percent, from 27.9 to 41.3 patients per 1,000 adults in that age group.

By comparison, the number of patients who sought medical care for any skin infection rose from a rate of 32.1 to 48.1 visits per 1,000 people during the same period.

Previous studies at UCSF and other urban medical centers have indicated that MRSA had begun to spread outside hospital settings in the late 1990s, but until now, no one had been able to verify those suspicions with hard data or to indicate the extent of MRSA nationwide, Hersh said. There also was no way of assessing whether the rise was due to population shifts or to people visiting emergency rooms instead of family physicians.

 

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