Drug-resistant staph infection spreading among L.A. gay men

By Advocate.com Editors

Originally published on Advocate.com January 28 2003 1:00 AM ET

Staph infections that are resistant to commonly used antibiotic treatments are appearing with increasing frequency among gay men in Los Angeles County, marking the first time that the infections have cropped up in any of the nation's gay communities, the Los Angeles Times reports. The large, painful skin infections first turned up early last fall among local gay men and have been reported with increasing frequency since then. They are caused by a drug-resistant strain of Staphylococcus aureus, most commonly known as staph, that is likely spread through skin-to-skin contact. The infections have been reported in both HIV-positive and HIV-negative gay men.

Doctors treating the infection warn that it could be contracted at health clubs, steam rooms, and other warm, moist environments. So far, the outbreak seems confined primarily to gay men, but health care officials can't predict how many people it may eventually affect because so little is known about the extent of the outbreak. "The concern is this organism could spread to and cause disease in the community at large," said Peter Ruane, an infectious disease specialist in Los Angeles. "It seems to be able to attack normal skin in healthy people."

Treatment typically involves draining the sores on the skin and then treating patients with antibiotics. However, the standard drugs used to treat staph infections are inadequate against the strain of bacteria causing the outbreak, and stronger, newer drugs should be used in their place. In some cases, patients have had to be hospitalized to receive intravenous antibiotics. "Primary care doctors and ER doctors need to know about this so that when they encounter these infections they can prescribe a drug that's active against resistant staph," Ruane said.

County health officials, with support from the Centers for Disease Control and Prevention, have begun an investigation into the staph outbreak. The Los Angeles County outbreak marks the first time drug-resistant staph has been reported in large numbers among otherwise healthy gay men, although the infections are seen more often in gay men with AIDS. Doctors worry that the infection has the potential to spread rapidly between men who have sex with men because many gay men have multiple sex partners, attend circuit parties, or visit bathhouses and sex clubs, all of which put them at a higher risk of becoming infected.

Similar drug-resistant staph outbreaks, sometimes with fatalities, have been previously reported among intravenous-drug abusers, athletes, prisoners, Native Americans, and Eskimos, whose close living conditions make them likely to share personal items such as towels, which can carry the bacteria.