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Battling a Superbug

A teen athlete struggles to defeat killer germs

Fourteen-year-old C. J. Jackson never imagined that a red irritated spot on his leg could turn into a life-threatening disease. But two months after he first discovered what looked like a bug bite on his right knee, he was fighting for his life in a Georgia hospital. His body temperature soared to 42 degrees Celcius (107 degrees Fahrenheit ), and he had severe sepsis- an often-fatal condition in which disease-causing microorganisms have overwhelmed a person's blood.

Although C. J. and his doctor didn't know it at the time, the red spot on his knee was the first sign that his body was infected with a dangerous type of the microorganism Staphylococcus aureus. Skin infections of this bacterium are relatively common and can usually be cured with antibiotics. But the strain of staph that had infected C. J. was different. Called methicillin-resistant Staphylococcus aureus (MRSA), this strain of staph has built-in defenses against many of the antibiotic medicines that exist today. As a result, MRSA (commonly pronounced MUR-suh) infections are difficult to treat.

The bacteria often spread from a person's skin to other parts of the body. “Once it gets in the bloodstream, the infection can be very severe and even fatal,” says Dr. Robert Daum, an infectious- disease specialist at the University of Chicago.

Fortunately, C. J. survived his bout with MRSA. Now, he is joining scientists in trying to spread awareness of the disease. There's good news in C. J.'s message: By following simple steps, most MRSA infections can be avoided or stamped out before they become deadly.

EMERGING THREAT

Just 10 years ago, MRSA infections were rarely seen in healthy people like C. J. But doctors have recently been reporting more and more outbreaks around the country. “MRSA is now the most common cause of skin infections in the United States,” says Jeffrey Hageman, an epidemiologist who studies the spread of diseases for the U.S. Centers for Disease Control and Prevention (CDC).

Studies are also showing that C. J. is part of a population that is particularly at risk: athletes. In sports like football and wrestling, athletes are in close contact with each other, making it easy for MRSA to spread from one person to another.

POWERFUL DEFENSE

Like the bodies of all people, those of athletes are covered with bacteria. “There are billions of bacteria living on each of us,” says Daum. And about one in three people harbor one or more strains of staph bacteria on their bodies.

A much smaller percentage of people-about 0.8 percent-carry the MRSA strain of staph. MRSA bacteria have a specific gene, or a segment of DNA, called mecA. This gene arms the bacteria with weapons that fight against the most commonly prescribed antibiotics, such as penicillin and cephalosporins.

STOP THE SPREAD

MRSA bacteria can reside directly on the skin. So an athlete who is carrying MRSA bacteria on his or her skin can easily pass it to other players through skin to skin contact.

C. J., who plays football and baseball, doesn't know if he got the MRSA bacteria from contact with another player. But to be safe, he now follows simple steps to avoid another infection. He doesn't share towels or even bars of soap-which may harbor the bacteria. “Good sports hygiene is the most important thing,” he says. “It's important to always take a shower after playing.” That will wash off any bacteria that may have been picked up during practice or a game.

WHEN MICROBES ATTACK

Even if people get MRSA bacteria on their skin-it doesn't necessarily warrant a trip to the doctor. The skin provides good protection against any harmful effects of the bacteria. But when there is a break in that barrier-such as a cut or a scrape-the bacteria may infect the wound and start to destroy tissue.

“Areas where infections often occur are abrasions from playing football or slide tackling in soccer, or mat burns in wrestling,” says Hageman. Now C. J. is careful to keep his cuts and scrapes covered with a clean bandage so that bacteria can't enter the wound.

If bacteria do enter the skin, the first sign of infection is usually an irritated or pus-filled spot that may resemble a bug bite. If a MRSA infection is caught at this stage, it can usually be cured by removing the infected skin or by taking certain antibiotics that are effective at killing off the bacteria.

But if the infection is left untreated or treated with antibiotics that are ineffective, the bacteria can continue to spread through the body. In C. J.'s case, the bacteria invaded his bloodstream and entered his bones-a condition called osteomyelitis. “It was eating into my bones from the inside out,” he says.

To rid his body of the bacteria, C. J. had to take strong antibiotics for nine months. And because his bones were injured from the infection, he needed physical rehabilitation to build up strength to even walk again.

SPREADING THE WORD

To help teens avoid an experience like his, C. J. and his mother have been sending materials to local schools about MRSA and how to avoid it. At the same time, scientists like Daum and Hageman are informing the health-care community to watch out for MRSA. “It's something we didn't think about five years ago,” says Hageman.

—Britt Norlander