The Bayonet

Tuesday, Jul. 29, 2014

MRSA a communitywide problem, study finds

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A team of scientists from Martin Army Community Hospital conducted a study about skin infections with more than 30,000 trainees of the 198th and 192nd Infantry Training Brigades.

The study focused on methicillin-resistant Staphylococcus aureus bacteria and took place from May 2010 to January 2012 and was recently published in the Clinical Infectious Diseases journal.

The partners with the study included the Infectious Disease Clinical Research Program group from Uniformed Services University and Centers for Disease Control and Prevention, who provided a lot of the funding.

MRSA, a staph infection that can't be killed by commonly used antibiotics, is the cause of nearly half of the skin and soft tissue infections in Soldiers, said Maj. Jeffrey Lanier, assistant program director for the Family Medicine Residency program at MACH and site investigator for the study. Certain groups, such as athletes, prison inmates and Soldiers, are at very high risk for these infections.

"The common thread is people who spend a lot of time in close contact or have a lot of direct skin-to-skin contact," he said.

DISCOVERY In 2008, Jim Patrick, then an infection control nurse at MACH who is now deceased, noticed a significant amount of skin cultures testing positive for MRSA, Lanier said.

This alerted USU who sent Lt. Col. Michael Ellis, Ph.D, principal investigator of the study to Fort Benning.

Fort Benning is the highest in the Army for the total number of skin infections and is No. 2 in the Department of Defense right behind the Marine Corps Base Camp Lejeune, Lanier said. The study conducted at Fort Benning was based off of a study at Camp Lejeune.

"The study was meant to tease out the various things that were successful at Camp Lejeune in reducing skin infections," Lanier said.

MRSA STUDY AND RESULTS Six battalions out of the two Infantry brigades were chosen and each received different interventions, Lanier said.

Two battalions only received pamphlets to educate them about skin infections. Two other battalions were coached by drill sergeants, received first aid kits, told to visit sick call with any concerns and were instructed to take a weekly 10-minute shower.

Lanier said the last two battalions received everything the middle group did except they were instructed to use chlorhexidine, an antiseptic soap surgeons use before they perform surgery.

What they found was the two groups getting intervention had higher rates of infection than the ones who weren't, he said.

"(It) may seem like a surprising finding," Lanier said. "But we think that was probably due to the fact that they were more educated and were more likely to ... seek care earlier on. We think the trainees that were enrolled in group one ... may have gone to the emergency room to get their care. If they went to the ER, we wouldn't have their data."

Though the measures taken in the study didn't result in major prevention change, the main strain of MRSA, USA 300, was identified, Lanier said.

"This study has allowed us to educate the trainees about MRSA, ways to prevent to it and to stop the spread of MRSA among trainees," said Natasha Law, lead research coordinator. "We have learned that some trainees never heard of MRSA until they came to Fort Benning."

The ultimate goal is to develop a vaccine, he said.

PREVENTION Years ago, a red inflamed blister on the skin was thought to be a spider bite, Lanier said. Now people are starting to realize it could be MRSA.

Recognition is the key, he said. Any skin infection with pus should be taken seriously and should be checked out. It can also spread to spouses and children, and from there it can get into the school system.

Lanier said prevention measures consist of: washing hands before and after meals, after each restroom visit, bathe regularly, cover any infected area and visit the hospital.

For more information on skin and MRSA infections, visit

More MRSA information

• Most MRSA occurs within the community and not just in hospitals.

• There is a misconception that if you have MRSA, you have poor hygiene, but it's not true.

• Once exposed to MRSA, you are at risk for other infections.

• If you don't have time to schedule an appointment, be sure to ask your primary care doctor at MACH about the secure messaging system where a picture can be taken of your skin infection and sent to be reviewed. SOURCE: MACH

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