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MIDDLETOWN — Scott Wills had never heard of the dangerous superbug that left him in excruciating pain until he contracted the infection through a cut on his foot at a gym.

"I didn't know anything about MRSA,'' said Wills, 39, of Middletown. "When they diagnosed me with gout I believed them. ... If I had been diagnosed (with MRSA) two or three days later I could have lost my leg or died."

Methicillin-resistant Staphylococcus aureus, or MRSA, is a bacterial infection resistant to commonly used antibiotics such as methicillin and penicillin.

The virulent, spread through direct skin-to-skin contact, is common in hospitals, but is becoming more frequently found outside of hospitals and is more lethal than many think.

Based on statistics from a 2007 study by the American Medical Association, MRSA is responsible for more than 94,000 serious infections and 19,000 deaths annually, killing more people than the AIDS virus.

Last year in Ohio, 20 outbreaks of MRSA infected 88 people. The previous year, 28 outbreaks of the bacterium infected 146 people, including seven in Butler County, according to Ohio Department of Health statistics.

But those numbers don't tell the full story. The actual number of individuals who have been infected with MRSA is far greater, said Kristopher Weiss, Ohio Department of Health spokesman.

It's unknown just how many more because Ohio and most other states don't track individual cases of the disease.

Only "outbreaks" of two or more confirmed cases by a lab or epidemiologist linked to the same area are tracked, Weiss said.

The rationale, health officials say, is tracking individual cases won't stop the spread. But prevention efforts, through stressing hand washing and good hygiene practices, can help.

Dr. Rohini Sachdeva, an internist at The Fort Hamilton Hospital, agrees.

"It's everywhere," Sachdeva said.

About 1 percent of healthy people carry MRSA on their skin, but are not infected. However, the bacteria can infect others who have an open wound.

Sachdeva said those most susceptible are the elderly and people in hospitals, nursing homes, prisons and gyms.

"It's out there and it's increasing, but should you panic? Not really," Sachdeva said.

"Good hand washing and good hygiene is the key. If you consistently use good hygiene it can be prevented."

For more information MRSA prevention, visit the Ohio Department of Health, http://www.odh.ohio.gov/alerts/mrsa1.aspx.

What is Staphylococcus aureus (staph)?

Staphylococcus aureus, often referred to simply as "staph," are bacteria commonly carried on the skin or in the nose of healthy people. Approximately 25 percent to 30 percent of the population is colonized (when bacteria are present, but not causing an infection) in the nose with staph bacteria. Sometimes, staph can cause an infection. Staph bacteria are one of the most common causes of skin infections in the United States. Most of these skin infections are minor (such as pimples and boils) and can be treated without antibiotics (also known as antimicrobials or antibacterials). However, staph bacteria also can cause serious infections (such as surgical wound infections, bloodstream infections, and pneumonia).

What is MRSA (methicillin-resistant Staphylococcus aureus)?

Some staph bacteria are resistant to antibiotics. MRSA is a type of staph that is resistant to antibiotics called beta-lactams. Beta-lactam antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin. While 25 percent to 30 percent of the population is colonized with staph, approximately 1 percent is colonized with MRSA.

Who gets staph or MRSA infections?

Staph infections, including MRSA, occur most frequently among persons in hospitals and health care facilities (such as nursing homes and dialysis centers) who have weakened immune systems. These health care-associated staph infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia.

What is community-associated MRSA (CA-MRSA)?

Staph and MRSA can also cause illness in persons outside of hospitals and health care facilities. MRSA infections that are acquired by persons who have not been recently (within the past year) hospitalized or had a medical procedure (such as dialysis, surgery, catheters) are know as CA-MRSA infections. Staph or MRSA infections in the community are usually manifested as skin infections, such as pimples and boils, and occur in otherwise healthy people.

What does a staph or MRSA infection look like?

Staph bacteria, including MRSA, can cause skin infections that may look like a pimple or boil and can be red, swollen, painful, or have pus or other drainage. More serious infections may cause pneumonia, bloodstream infections, or surgical wound infections.

Can I get a staph or MRSA infection at my health club?

In the outbreaks of MRSA, the environment has not played a significant role in the transmission of MRSA. MRSA is transmitted most frequently by direct skin-to-skin contact. You can protect yourself from infections by practicing good hygiene (e.g., keeping your hands clean by washing with soap and water or using an alcohol-based hand rub and showering after working out); covering any open skin area such as abrasions or cuts with a clean dry bandage; avoiding sharing personal items such as towels or razors; using a barrier (e.g., clothing or a towel) between your skin and shared equipment; and wiping surfaces of equipment before and after use.

What should I do if I think I have a staph or MRSA infection?

See your health care provider.

Are staph and MRSA infections treatable?

Yes. Most staph and MRSA infections are treatable with antibiotics. If you are given an antibiotic, take all of the doses, even if the infection is getting better, unless your doctor tells you to stop taking it. Do not share antibiotics with other people or save unfinished antibiotics to use at another time.

However, many staph skin infections may be treated by draining the abscess or boil and may not require antibiotics. Drainage of skin boils or abscesses should only be done by a health care provider.

If after visiting your health care provider the infection is not getting better after a few days, contact them again. If other people you know or live with get the same infection tell them to go to their health care provider.

Source - Centers for Disease Control, www.cdc.gov.