Methicillin Resistant Staphylococcus Aureus (MRSA)
Recently there has been a lot of news on the emergence of the super bug Staph, also known as MRSA. MRSA stands for Methicillin Resistant Staphylococcus Aureus. Staphylococcus aureus (Staph) is a bacterium that has been a part of the normal bacteria on human skin for years. It often resides inside the nose, and is more commonly carried in hospital employees and patients. The Center for Disease Control estimates that 25-30% of the population are carriers of Staph. Methicillin is synthetic penicillin or more simply put an antibiotic. Basically MRSA is a specific strand of a Staph infection that is resistant to multiple forms of antibiotics, making it more difficult to treat. This is why MRSA has been referred to as the “Super bug.” MRSA used to be primarily an acquired hospital infection (HA-MRSA), currently community acquired MRSA (CA-MRSA) is making the headlines. One reason community acquired MRSA exists, is healthy individual can harbor the bacteria without any signs or symptoms.
Staphylococcus aureus most commonly causes skin infections such as an abscess, boil, or cellulitis. MRSA is now one of the most ubiquitous bacteria causing these skin lesions. The lesions can recur and spread to other sites on the skin. The good news is that the community acquired MRSA is still susceptible to a few antibiotics. Plus, CA-MRSA rarely manifests as a systemic infection. On the other hand, HA- MRSA can only be treated with just a few intravenous antibiotics, and there have been some cases that are resistant to these drugs also.
Practicing good hygiene is the most effective defense against both forms of MRSA. Examples of ways to minimize your chances of contracting MRSA includes frequent hand washing, avoiding skin to skin contact with someone who has an open wound, covering open wounds until they heal and refraining from sharing personal items such as deodorant, razors, toothbrushes, and towels. Schools, ambulances, and health care facilities must sanitize all surfaces with antibacterial products including bleach and alcohol. Studies have shown that alcohol based sanitizers kill MRSA, but keep in mind MRSA can still survive on clothing and other surfaces. Employees and children with an active MRSA skin infection may go to work and school as long as the infection can be covered with dry bandage unless the healthcare provider decides otherwise.
If your skin is starting to get red or is warm to touch, or if a boil or abscess develops you should see your health care provider for assessment immediately. The provider may culture the lesion to see if it is MRSA, or may initiate treatment right away. Depending on the size and stage of the lesion an incision and drainage may be needed to remove the pus harboring the infection. The primary concern is for infants, the elderly, and those that have chronic illnesses. Topical Bactroban and oral antibiotics may also be prescribed. There is now a nasal form of Bactroban that can be used for 5 days for those individuals believed to carry and harbor the MRSA infection in their nasal passages. A nasal swab can confirm MRSA bacteria colonized inside the nose in those that are asymptomatic; this is estimated to be about 1% of the population.
Staphylococcus aureus and MRSA can be the source of many other disease states. Staph can disseminate through the blood causing a systemic infection. It can exist in the respiratory tract leading to pneumonia, and infect heart valves. Staph can also act as a oxin and cause food poisoning, toxic shock syndrome, and scalded skin syndrome. The more serious Staph infections are a concern for those frequently hospitalized or those with underlying illnesses that result in immune compromise. In fact the Center for Disease Control and Prevention (CDC) estimates that 85% of invasive MRSA occur in the healthcare setting; compared to 14% that occurred in the general population. The rates of critical MRSA will vary in different parts of the world; still the CDC reports that rates are universally higher in those over 65 years of age.
Keep in mind that community acquired MRSA tends to be higher among athletes, military personnel, and schools because of close contact this is why practicing personal hygiene is so important for prevention. Having said all this, if you suspect a skin infection, should get into your local healthcare facility right away for further evaluation and treatment.