The hospital superbug MRSA has now reared its head in the community possibly as a consequence of the abuse and misuse of antibiotic creams, according to fresh research.
The bacterium responsible for difficult-to-treat infections in hospitals due to antibiotic resistance has been found in the nostrils of 8.2 per cent of the 450 healthy individuals who took part in the research.
“We have suspected MRSA was present in the community but we could not confirm it before this study,” National Antibiotic Committee chairman Michael Borg said.
The results of this study, according to Dr Borg, show the MRSA landscape now includes the community, especially since the majority of the carriers identified in the study have never been to hospital.
The figures emerge from research by Jeanesse Scerri as part of her Medical Laboratory Sciences degree, which is being supervised by Dr Borg.
“These results show one of the highest recording MRSA carriage rates in the community anywhere in the world,” he said.
He stressed that being a carrier on its own posed no risk to the individual. However, if this person was hospitalised, he then could transmit MRSA – which preys on weak immune systems – to vulnerable patients.
In addition, MRSA carriers increase the risk of infections developing after operations and other interventions. In hospital, patients are in close proximity of one other and linked through the hands of doctors and nurses who treat and examine them.
The study also identified another worrying situation – 75 per cent of the MRSA strains isolated were composed of a variant which has only been reported in Malta. This strain is different in its constitution from all other types of MRSA reported elsewhere in the world.
“This strain is resistant to the penicillin antibiotics in the same way as other MRSA bacteria, but it also carries a resistant gene for another antibiotic – fucidic acid,” Dr Borg said.
He is convinced this is not a coincidence as Malta has one of the highest levels of use per capita in Europe for fucidic acid, a component of some antibiotic creams.
“It is more than likely that overuse and misuse of skin creams containing fucidic acid could be the main cause for the development of this new MRSA strain,” he said.
Dr Borg said that unfortunately, while many appreciated the problems associated with the unnecessary use of antibiotic tablets and syrups, there was not a similar level of awareness on the risk of using antibiotic creams and ointments unnecessarily.
“We have heard about these creams being prescribed or dispensed for a variety of inappropriate conditions including heat rash, mosquito bites, allergies and small boils, all of which are incorrect indications for these topical antibiotics,” he said.
“It is also not uncommon for antibiotic creams to be used haphazardly, for just a day or two and then stopped. This predisposes for the development of resistance even more than oral antibiotics, since the concentration in the body would be lower and therefore bacteria on the skin can become resistant much more easily.
“It is important our doctors cut down on the current levels of prescribing antibiotic creams and make sure this is done for specific indications where medical evidence shows they work,” he advised.
It was also vital for pharmacists not to dispense these products over the counter without prescription.
“Above all it is essential patients do not borrow or share antibiotic creams as all these practices will ultimately backfire on them and they risk becoming carriers of resistant bacteria such as MRSA,” he warned.