Center for Disease Control A scanning electron micrograph image of a grouping of methicillin resistant Staphylococcus aureus (MRSA) bacteria. These S. aureus bacteria are methicillin-resistant, and are from one of the first isolates in the U.S. that showed increased resistance to vancomycin as well. Click photo for larger image.

Skin infections caused by a drug-resistant strain of bacteria are becoming more common in the region, particularly among students who play contact sports.

Sixteen football players from four school districts have had skin infections caused by methicillin-resistant Staphylococcus aureus, better known as MRSA, since the start of the academic year, according to the Allegheny County Health Department.

"This is a much more common occurrence than people ever thought," said county Health Director Dr. Bruce Dixon. "The community generally ought to be a little more aware that it's occurring."

Experts from the county and state health departments, the U.S. Centers for Disease Control and Prevention and Children's Hospital will try to rectify that this afternoon. They will conduct a seminar on infections for health-care workers and staff at schools, day-care centers and correctional facilities at the joint conference of the Pennsylvania Public Health Association and the Public Health Institute at the Hilton Pittsburgh, Downtown.

The goal is to increase awareness of community-acquired MRSA to improve diagnosis and treatment.

"Many people . . . are misdiagnosed with things like insect bites until somebody smart enough figures out this is actually an infection of their hair follicles with MRSA," Dr. Dixon said.

Experts had thought of MRSA as a problem solely for hospitals, said CDC epidemiologist Jeffrey Hageman. But in the past five years, it has emerged in community settings, first in prisons and among athletes, and now increasingly in the general population.

"It's kind of reaching a whole new audience -- people who don't traditionally see these infections, like athletic trainers," he said. "Also, we didn't see these in the past occur in otherwise healthy people."

The skin infections are generally mild and only in rare instances have progressed to more serious conditions, such as pneumonia or a bloodstream infection, Mr. Hageman said. But if physicians don't recognize that the infections are caused by a resistant strain, they may prescribe antibiotics that are ineffective, allowing the infection to persist.

Hospital MRSA strains tend to affect sicker people, are resistant to more drugs and are harder to treat.

Skin infections with staph bacteria that are susceptible to methicillin antibiotics look just the same as those caused by the resistant germ, said Dr. Marian Michaels, an infectious disease specialist at Children's Hospital.

Doctors now need to consider culturing lesions for MRSA so that they can identify and prescribe an effective antibiotic immediately, she said. The bacterial strain is resistant to certain penicillins and other drugs typically used as a first-line treatment of a staph infection, but it is vulnerable to other antibiotics.

Indiscriminate use of those drugs could create more resistance.

"My own suspicion is that at some point, if those get used frequently, we will lose that susceptibility as well," Dr. Michaels said.

Sometimes, an MRSA-infected abcess or boil will clear up with simple lancing and drainage of the lesion, said Mr. Hageman.

He noted that identifying the MRSA strains circulating in a community will help physicians pick an appropriate therapy.

"What people are doing in Los Angeles doesn't necessarily apply to what people are seeing in New York," he explained. "That's why there's a need for local data."

Now, community strains are beginning to appear in hospitals, which could generate still more resistant germs and makes monitoring all the more important, Mr. Hageman said.

On several occasions in the region, MRSA infections have occurred among high school football players, who may get scrapes and cuts during practice and games.

Injuries like that should be kept clean and covered because MRSA could spread between individuals during contact sports. Towels, washcloths, shaving equipment and other items that could harbor the germ should not be shared.

"It boils down to common sense," and good hygiene, such as regular handwashing, Mr. Hageman said.

Getting a flu shot is also a good idea, Dr. Dixon said. The combination of influenza and a staph infection can be deadly, and it is thought to have caused the deaths of two Allegheny County Jail inmates in the spring.

Dr. Dixon said the county health department will be asking school district officials to voluntarily report MRSA infections among their students to better track the problem and develop strategies to prevent it.

For more information about the educational session or to register, call Catherine Polachek at 570-826-2062.