Aug 3 2004
Staph bacteria are not uncommon in health care settings. In fact, they account for a large number of hospital-related infections each year.
Methicillin resistant Staphylococcus aureus (MRSA) is one of these types of bacteria which is now found among athletes, military recruits and others in the general population. What is particularly concerning to medical experts is that MRSA is resistant to many common antibiotics.
An MRSA infection causes skin and soft tissue lesions and, when left untreated, can invade deeper structures such as bone and muscle, or even the blood stream – and can be quite serious.
Suzanne Bradley, M.D., an infectious disease specialist at the VA Ann Arbor Healthcare System and University of Michigan Health System, advises the public on what to look for in an MRSA infection, and when a rash may be more than a rash.
“There are many different kinds of staph infections, and even MRSA encompasses a wide number of bacteria. Some are resistant to many antibiotics while others are resistant to only a few,” Bradley says. “Fortunately, the MRSA bacteria acquired in the community is only resistant to a few, including penicillins and cephalosporins.”
Bradley notes that hospitals have been dealing with MRSA at least since the 1980s, but it wasn’t until the mid-1990s that doctors began diagnosing serious MRSA infections in people that never had any contact with a health care system, including healthy children, athletes and military recruits.
“We’ve seen outbreaks in athletes, collegiate athletes and professional football players. Since staph is acquired primarily by direct human contact, anyone with a break in their skin who has a lot of contact with others is potentially at risk,” says Bradley.
She says this is not a subtle infection. Staph infections begin abruptly. Someone with MRSA may develop a large area of redness on the skin, swelling and pain. A pustule or abscess might develop, or boils and carbuncles (red, lumpy sores filled with pus). Some patients have pneumonia-like symptoms or, less frequently, symptoms of toxic shock.
Generally, when a doctor in the office or hospital sees someone with these symptoms, they will likely know that Staph aureus is causing the infection. The doctor will typically prescribe one of the more common antibiotics which, unfortunately, have no effect on MRSA.
“So, in the typical scenario, we’ve lost time in potentially getting an effective antibiotic to treat the MRSA patient,” says Bradley.
If left untreated or not treated aggressively, MRSA can progress to a deeper infection, involvement of the bloodstream, and to the spread of infection to other organs. A patient who is not responding to antibiotics will actually be getting worse after two or three days, experiencing more pain with spreading inflammation.
Bradley warns that anyone in this situation should call the doctor.
“You may need another antibiotic, you may need surgical drainage of an abscess or resection of the tissue. But it’s important to get in touch with your doctor,” she says.
The good news is that there are more antibiotic choices for MRSA. Vancomycin, clindamycin and sulfa drugs are available and effective in treating most of these infections.
Anyone with a break in their skin can be infected, so what’s the best way to prevent MRSA?
- Cover the skin break, cut or wound with a bandage so the staph bacteria can’t get in.
- If you have an open wound, wash it daily with soap and water.
- If you are engaged in contact sports or other close contact with people in a way that might introduce infection to the wound, make sure you shower and wash those areas that have been in contact with others.
- Don’t share towels, razors or other implements that might transmit the bacteria to your skin.
- Wash your hands frequently.
- Avoid others with a known staph infection, and tell others if you have one.
- Wash and dry all clothing, towels and bed linens in hot water if they come in contact with staph bacteria.
The Center for Disease Control is concerned about MRSA in communities and is working with multiple partners on prevention strategies, including determining who is at risk, development of surveillance and tracking systems in the community and improved detection.