The research supported by the National Institutes of Health revealed that squalene synthase inhibitors act as a sort of Kryptonite to Staphylococcus aureus bacteria by removing their natural defense: staphyloxanthin, a carotenoid pigment that gives staph a golden hue. S. aureus bacteria that lack that pigment have inhibited ability to fight off the human immune response, resulting in decreased virulence.

In studies, the squalene sythase inhibitor BPH-652 interfered with the enzyme responsible for producing the staphyloxanthin pigment. The resulting colorless staph bacteria were significantly weakened. Lab mice injected with S. aureus bacteria that also received BPH-652 exhibited a 98% reduction in bacterial counts.

Researchers are testing hundreds of additional compounds to determine if any are more effective in stripping staph bacteria of their color and virulence. The research is still in a very early stage – too early for human trials – but pigment reduction appears to be a promising area for further investigation.

The complete study results were reported in the article “A Cholesterol Biosynthesis Inhibitor Blocks Staphylococcus aureus Virulence” published in Science Express, the online edition of Science magazine.

Consideration of new reporting requirements began earlier this fall following an outbreak of over twenty MRSA infections in Montgomery County students. While none of those cases were fatal, a Maryland special education teacher died from MRSA-related complications earlier this month.

The Commission is currently seeking to develop a system for collecting and distributing data on healthcare-associated MRSA infections, not the community-acquired strain that has been at the center of media attention in recent weeks. However, the Commission is recommending a statewide public information campaign to underscore the importance of handwashing in preventing the spread of MRSA.

The APIC survey served as an informal six-month follow-up to the organization’s MRSA Prevalence Study released in June. The MRSA Prevalence Study indicated that MRSA was “significantly more widespread” than previously thought, with rates measuring eight times higher than earlier estimates.

The follow-up poll sought to gauge the impact of the MRSA Prevalence Study results on infection control measures in hospital settings. 41 percent of respondents said that their facility had not implemented any new prevention measures since June. Explanations indicated that “many infection prevention programs are still inadequately funded and that facilities lack resources, staff, and buy-in from senior management to prevent the transmission of MRSA, ” according to Kathy L. Warye, Chief Executive Officer of APIC.

APIC provides their membership with guidelines for implementing a MRSA transmission prevention program. Recommended components include risk assessment, surveillance, hand hygiene, contact precautions, proper housekeeping, and testing of new admissions and high risk groups. Controlling MRSA also requires the explicit support of hospital administrators, and a transformation of the facility’s culture, APIC guidelines suggest.

The authors of the new study examined hospital discharge data from 1999 to 2005 and estimated that MRSA-related hospitalizations more than doubled, growing from 127,036 to 278,203. The estimated number of hospitalizations involving S. aureus–related infections also increased remarkably from 294,570 to 477,927.

So why is the rate of hospitalizations due to MRSA on the rise? “Contrary to the generally accepted view, community-associated MRSA strains may be spreading into the healthcare system rather than the other way around, ” the study authors suggested.

The study did not find a significant variation among geographic regions, with the rate of staph infections rising as follows:

• Northeast: 5% per year
• Midwest: 7% per year
• South: 7% per year
• West: 8% per year.

The rate of infections caused by the MRSA variety of staph rose 9% per year in the Northeast, 11% per year in the Midwest, and 12% per year in the South. Although the incidence of MRSA-related infections is lowest in the West, the rate of increase in the West was 18% per year during the study period.

Based on study findings, the researchers recommend prioritizing Staphylococcus aureus and more specifically, MRSA, in national disease control efforts. The study results indicate the need for expanded reporting requirements at the national level and increased research funding, as well as further inquiry into the relationship between community-acquired infections and hospital-acquired infections.

George was diagnosed with MRSA on September 23, 2005 following coronary artery bypass surgery performed at Charleston Area Medical Center on September 6, 2005. The malpractice lawsuit claims that MRSA bacteria were introduced into George’s body via an indwelling line, resulting in a lengthy hospital stay, temporary and permanent injuries, and ongoing medical expenses.

Kelly George, the wife of Gerald George, is also a plaintiff in the suit. She is seeking compensatory damages due to the “irreparable loss of comfort, society, convenience and consortium from her husband, ” the West Virginia Record reported.

The hearing was prompted by recent media focus on MRSA following a report by the Centers for Disease Control that indicated MRSA can be blamed for more than 18,000 deaths each year in the United States. Coinciding with the CDC report was news that children in Virginia, New Hampshire, Mississippi, and New York died from MRSA infections in October.

Dr. Julie Gerberding, Director of the CDC, addressed the Committee first. She summarized the CDC’s statistical data on staph infections, and described the role of the CDC in monitoring and preventing community-acquired MRSA.

The Committee heard from several other medical professionals, including Dr. James E. Burns of the Virginia Department of Health who discussed Virginia’s response following the MRSA related death of 17-year-old Ashton Bonds last month. Dr. Elizabeth Bancroft, a Los Angeles County epidemiologist, spoke about the public health implications of community-acquired MRSA and Chicago pediatrician Robert Daum covered emerging issues in the treatment of MRSA in the community. Dr. Eric Gayle, a family medicine specialist, testified about the role of the primary care physician in managing MRSA infections.

Testimony about mitigating the impact of MRSA infections in schools was presented by Steven Walts, Superintendent of the Prince William County school district in Virginia. He described disinfection efforts in schools and outreach to parents.

Transcripts of the November 7, 2007 hearing are available on the Web site of the Committee on Oversight and Government Reform. Additional hearings on antibiotic resistance in hospitals and public health consequences will be held by the Committee this spring.