Hawai'i's year-round warm, moist climate and outdoor lifestyle are two reasons the state has a high rate of infection caused by a drug-resistant "superbug" with potentially deadly consequences, experts say.

The spread of methicillin-resistant Staphylococcus aureus, or MRSA, in medical facilities has long been a concern, but it's getting more attention because of a steady increase in infections acquired outside healthcare settings.

A study released yesterday by the Centers for Disease Control and Prevention said MRSA caused more than 94,000 life-threatening infections and nearly 19,000 deaths in the United States in 2005.

Staph infections are not a reportable illness in Hawai'i, so there is no government data on how many cases or deaths have occurred here. However, the Hawaii Health Information Corp. reported 2,112 MRSA hospitalizations in 2006, a more than twentyfold increase from 1995, when only 97 hospital cases were reported.

The nonprofit information agency also found that Hawai'i had 166 MRSA hospitalizations per 100,000 population, compared with Mainland rates ranging from 89 and 113 hospitalizations per 100,000.

About 30 percent of people carry the bacteria on their skin or in their nasal passage without symptoms. Infections occur when the staph bacteria enter the body through a cut in the skin.

Infectious disease specialist Dr. Alan Tice said only about 5 percent of all staph infections involve antibiotic-resistant strains. MRSA infections can range from mild skin infections such as pimples and boils to more severe infections of the bloodstream and lungs.

Staph infections, including MRSA, occur most frequently in people in hospitals and healthcare facilities such as nursing homes and dialysis centers who have weakened immune systems, and in those who have undergone medical procedures in the previous year. But MRSA infections can occur in otherwise healthy folks who haven't undergone recent hospitalization.

Hawai'i is "a mixing bowl for strains from all over the world," said Tice, a private physician who also works at the University of Hawai'i John A. Burns School of Medicine. The state's favorable climate encourages bacterial growth, and people tend to wear less clothing and footwear that can protect against cuts and scrapes.

Pacific Islanders have higher rates of community-acquired MRSA, said state epidemiologist Dr. Paul Effler with the Department of Health. Suspected factors include genetic traits dealing with immune function, environmental factors such as large families in overcrowded houses, poverty, limited access to healthcare, cultural and language barriers, and lack of prevention and education programs, he said.

Pacific Islanders also have high rates of diabetes and obesity, and people with those conditions are at risk for skin infections that may require multiple and prolonged use of antibiotics, making them more susceptible to infections with antimicrobial-resistant strains, Effler said.

Other groups prone to community-acquired MRSA infections include homeless or elderly people.

With MRSA spreading in the community, athletic locker rooms and other places where people live, work or play in close contact are newfound places of concern for staph infections.

"It has been on our radar," said Ross Oshiro, athletic healthcare trainer coordinator for the Department of Education. "We've seen our share of boils and staph."

He said high school athletic trainers on O'ahu attended a Department of Health presentation on preventing the spread of staph in April, and the two agencies are developing a brochure to educate parents about taking precautions, such as regular cleaning of gym bags and soccer shinguards.

Military barracks are another potential hot zone. In 2003, three Kane'ohe Marines in the same unit and two of their family members were diagnosed with MRSA.

Simple soap and water and good hygiene is the best defense against staph infections, doctors say. The CDC also recommends that avoiding contact with other people's wounds or bandages, and not sharing personal items such as towels and razors.

"It's simple things like washing your hands, don't pick your nose and stay clean. If you do that, that helps a lot," Tice said. He also recommended "calling a doctor earlier than you use to" if cuts, scrapes and scratches develop redness, pain and swelling.

Effler said careful outpatient use of antibiotics can prevent development of antibiotic-resistant organisms. Patients should finish their full course of prescribed antibiotics to knock out the infection, he said.

Reach Christie Wilson at cwilson@honoluluadvertiser.com.