Residents of an impoverished area of Vancouver were infested with bed bugs carrying antibiotic-resistant bacteria, said researchers today Wednesday May 11th, 2011, and warn doctors to watch out for the potential problem.
A letter in todays issue of the U.S. Centers for Disease Control and Prevention’s journal Emerging Infectious Diseases reported that two types of drug-resistant bacteria were isolated from bedbugs found on three patients.
The resistant bacteria were methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE), a less dangerous form of antibiotic-resistant bacteria.
Christopher Lowe of the University of Toronto and medical microbiologist Marc Romney of Vancouver’s St. Paul’s Hospital suggest bed bugs carrying MRSA could transmit the bacteria during a blood meal. Included is a citation to the full article which is being released in June, here:
“Because of the insect’s ability to compromise the skin integrity of its host, and the propensity for S. aureus to invade damaged skin, bedbugs may serve to amplify MRSA infections in impoverished urban communities,” Lowe and Romney write. The three patients lived in Vancouver’s Downtown Eastside, which has high rates of homelessness, poverty, HIV/AIDS and injection drug use.
Similar to other cities worldwide, Vancouver has seen an alarming increase in bedbugs, particularly in Downtown Eastside, where 31 per cent of residents have reported infestations, the researchers said.
Likewise, MRSA is also a substantial problem in the neighbourhood, with nearly 55 per cent of skin and soft tissue infections in patients treated at St. Paul’s emergency department showing MRSA, the authors said.
In drug injection users with wound infections, an earlier study showed 43 per cent were colonized or infected with a community-acquired MRSA strain found outside of hospitals.
The study was small with just five bedbugs and very preliminary, but “it’s an intriguing finding” that needs to be further researched, said Romney.
Both resistant strains are often seen in hospitals, and experts have been far more concerned about nurses and other health-care workers spreading the bacteria than insects.
Given the high prevalence of MRSA in hotels and rooming houses in Downtown Eastside, the insects may act as “a hidden environmental reservoir for MRSA and may promote the spread of MRSA in impoverished and overcrowded communities,” the authors said.
So: This could be sticky but is it currently significant?
The authors point out that several research groups have tried in the past to link bedbugs and disease transmission (hepatitis) and failed. They certainly have not proven transmission in this case. But they also say that there is a density of these two organisms in the area where the men live that make it more likely that bedbugs could be involved in diseases pingponging through the neighborhood. First, there’s the high density of bedbug presence, in 31 percent of Downtown Eastside residents. Second, there’s the high prevalence of MRSA, in 58 percent of the skin infections in the St. Paul’s ER. And third, there’s the previously recorded and persistent presence of VRE in in-patients at St. Paul’s.
The US CDC believes that crowding, poor hygiene and skin disruption increase the likelihood of MRSA infection; crowding and poor hygiene are common in homelessness and shelter living, and bedbugs by definition disrupt the skin’s barrier by their bites. Meanwhile, in the ill and hospitalized, VRE frequently causes infections in disrupted skin, such as a surgical incision or a diabetic ulcer.
The authors have commented:
“…These insects may act as a hidden environmental reservoir for MRSA and may promote the spread of MRSA in impoverished and overcrowded communities. Bedbugs carrying MRSA and/or VRE may have the potential to act as vectors for transmission.”
To be clear: The victims here are also the ones who are likely to be most at risk. What this paper says, first of all, is that the substandard living conditions of being poor and homeless make those who are poor and homeless more likely to be vulnerable to yet more dangerous and difficult diseases. As with so many other health disparities in North American society, this is a social justice issue.
But if I am candid, it is also a reminder to the more-privileged rest of us that bedbugs have spread explosively, especially in poor communities, in a manner that is not completely understood, and that they pose a disease-transmission risk that is not yet well-defined.
We can assure you there will be more bed bugs to come and in the mean time I am going to check my box spring…