Infection rate in city levels off; some areas up

The Baltimore Sun

The overall rate of infections caused by antibiotic-resistant bacteria has leveled off in Baltimore, but some types of infections remain much higher than in surrounding jurisdictions and statewide, according to data released yesterday by the city Health Department.

While rates have declined in hospitals and among intravenous drug users, infections reported at dialysis centers and long-term care facilities have had only modest decreases. Meanwhile, rates among people with HIV are up.

City officials pledged to devise better strategies for combating infections caused by invasive methicillin-resistant Staphylococcus aureus, commonly known as MRSA.

"For the first time, we have the overall picture of how these infections are playing out in Baltimore," said Dr. Joshua M. Sharfstein, the city health commissioner. "This gives us a mechanism to understand and respond to this problem."

MRSA can live harmlessly in the body but can attack wounds and cause life-threatening infections, including pneumonia. Over the years, it has evolved into a superbug that resists most antibiotics; experts have blamed overuse of antibiotics.

For years, most MRSA infections were found among hospital patients, older adults and people with weakened immune systems. Recently, MRSA has increased among healthy people in other settings.

A national study in 2007 found that Baltimore's MRSA rate was the highest of nine sites studied. Alarmed, city officials pursued additional studies, released yesterday.

The first was an analysis of Centers for Disease Control and Prevention data from 2004 to 2007. Figures showed fluctuating MRSA rates, leveling off in 2007. The study did not discuss why infections are rising among people with HIV. The second study, done for the city by the RAND Corp., examined hospitalization rates for skin infections often caused by MRSA. From 2000 to 2006, the number of people hospitalized increased 74 percent, among all ages and regardless of insurance coverage. While the figures leveled off from 2005 to 2007, Baltimore's rates were nearly twice as high as Washington and statewide.

"Barely a week goes by where I don't see one or two preschool-aged children who have drainable skin infections," said Dr. Michael Barone, a pediatrician at St. Agnes and Johns Hopkins hospitals.

Sharfstein said the department plans to share the data with HIV clinics and dialysis centers to come up with strategies for eliminating infections.

He stressed that everyone should take precautions such as thorough hand washing, good skin care and not sharing personal items such as towels and razors.

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