(Methicillin-Resistant Staphylococcus aureus)

Staphylococcus aureus, frequently referred to simply as “staph,” are bacteria normally found on the skin and in the nasal passages of up to 30% of healthy individuals. Staph can lead to infections, the majority of which are mild to moderate in presentation (such as acne pimples, boils, or abscesses). Occasionally, staph infections involve the lungs (pneumonia) or the blood (sepsis), and are severe and even fatal. MRSA causes infections that are resistant to treatment with the beta-lactam antibiotic methcillin, and other similar antibiotics such as oxacillin, penicillin, and amoxicillin. However, there are antibiotics that work very well to treat the MRSA bacteria.

Most MRSA infections occur in hospitals and in patients who have had surgery or other invasive medical procedures, or in patients who have weakened immune systems. These MRSA infections are labeled as hospital-associated (HA-MRSA). MRSA can also affect otherwise healthy people without any known recent healthcare-related issues. This form of MRSA is termed community-associated (CA-MRSA), and it is the emergence of this form that has been receiving the most media attention recently. Much like the hospital setting, community transmission is primarily through direct skin-to-skin contact with a colonized or infected individual, but can also be spread through contact with inanimate objects that these individuals have had contact with. MRSA can occur anywhere, but some settings such as schools/daycare facilities, athletic areas, dormitories, military barracks, nursing homes, and correctional facilities are more likely settings for outbreaks due to the close contact of individuals in such environments. Clusters of infections have been documented in these types of settings.

The Center for Disease Control (CDC) has identified the 5 C’s that facilitate the transmission of MRSA:

  • Crowding
  • Frequent skin-to-skin contact
  • Compromised skin (cuts, abrasions)
  • Contaminated surfaces and other items
  • Lack of cleanliness

MRSA most frequently presents as an acne pimple, boil or abscess, sometimes with draining fluid or pus. These lesions may be red, swollen, warm and tender to the touch. However, MRSA may also present as a flat but tender erosion (loss of epidermis), or as folliculitis (inflamed hair follicles) around the navel. As the appearance of the infected area alone is not sufficient to distinguish MRSA from other bacterial infections, a culture should be obtained from the infection site and sent to the lab. Any new suspect skin infections in an otherwise healthy individual should be referred to a dermatologist for proper evaluation and treatment.

MRSA Treatment

If you have been diagnosed with MRSA, the following should be implemented to irradicate the infection:

  • Oral and/or topical antibiotics
  • Wash body from the neck down with either 2% chlorhexidine wipes or 4% foaming cleanser (found at pharmacies) for 7 days.
  • Swab both nasal passages with Bactroban (Mupirocin) ointment daily for seven days.

MRSA is highly preventable

Good hygiene helps to prevent all staph infections including MRSA:

  • Regularly wash your hands using soap and water or an alcohol based hand sanitizer.
  • Cover breaks in the skin with a clean bandage until healed.
  • Avoid sharing personal items touching the skin such as towels or razors.
  • Regularly clean frequently touched surfaces.

The careful use of antibiotics for MRSA and other skin conditions can minimize the potential for MRSA strains to develop resistance to other antibiotics.

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