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MRSA-Antibiotic Resistant Staph Infections: Transmission, Identification, Treatment, Prevention

Background on MRSA

Staphylococcus aureus bacterium, also known as staph, is a fairly common organism in the human population. In fact, approximately 25-30% of all people are carriers of the organism, either on their skin or in their nasal passages, while exhibiting no signs of sickness. These people are considered colonized but not infected. MRSA is a specialized strain of staph. Its full name is Methicillin-resistant Staphylococcus aureus and it was first discovered in hospitals as one of the first bacteria resistant to almost all of the broad-range antibiotics used to try to treat it. Of the 25-30% staph carriers, approximately 1% of those are carriers of the MRSA strain of Staph. Those people are also considered colonized, but not infected.

Staph bacteria are generally considered harmless unless they enter the body via cuts or wounds. In healthy people staph infections often result in skin infections that rarely need medical intervention and that heal on their own. But in people with lowered immune health or when infected with a strain of MRSA the results of an infection can be much more severe and can even be fatal. More people died in 2005 (over 18,500) from MRSA infections in the United States than from AIDS.

Transmission of MRSA

There are two major strains of MRSA. Hospital Acquired (HA) MRSA and Community Acquired (CA) MRSA. HA-MRSA includes all cases where the patient has had a current or recent hospitalization, resides in a long-term care facility, is on dialysis, or has had recent antibiotic use. HA-MRSA accounts for about 85% of all MRSA infections.

CA-MRSA affects a wide range of patients. Younger children are at risk and the bacteria often gains entrance through a cut or scrape. Children can be particularly susceptible to pneumonia. Athletes in contact sports at both the amateur and professional level have been affected, the bacteria is spread through cuts, abrasions and skin-to-skin contact. Anyone who shares towels, uniforms or athletic equipment in a public gym could be at risk of transmission. People with weakened immune systems are at risk of contacting CA-MRSA.

MRSA is usually transmitted by direct skin-to-skin contact or contact with shared items or surfaces that have come into contact with someone else’s infection.

Factors that aid in the transmission of MRSA are referred to as the 5 C’s:

• Crowding
• Frequent Skin-to-Skin Contact
• Compromised Skin
• Contaminated Items and Surfaces
• Lack of Cleanliness

Locations where the 5 C’s are common include schools, dormitories, military barracks, households, correctional facilities and daycare centers.

Identification of MRSA

Staph infections usually start as skin infections. They look like small red bumps that may look like pimples, boils, or spider bites. These can become more painful as the infection worsens. They can become deep pustules which are red, swollen, and painful which may have pus or other drainage. These skin infections commonly occur at sites of visible skin trauma, such as cuts and abrasions, and areas of the body covered by hair such as the back of the neck, groin, buttock, armpit, or the beard area of men.

Doctors can diagnose MRSA with a tissue sample or nasal secretion for drug-resistant bacteria. Tests can be done using culture media or via staph DNA tests.

Treatment of MRSA

While MRSA is considered an antibiotic resistant strain of bacteria it is not currently resistant to all antibiotics. HA-MRSA is generally treated with the antibiotic vancomycin while CA-MRSA can be treated with vancomycin or other antibiotics. There have been some instances of HA-MRSA strains which have been resistant to vancomycin and to reduce the threat of the bacteria becoming more resistant many doctors may chose to treat an abscess with draining rather than antibiotics.

Prevention of MRSA

The best way to prevent transmission of MRSA is through proper hygiene.

People who are in healthcare settings should ask healthcare workers to wash their hands before touching them, every time. Healthcare workers should be sanitizing surfaces and equipment with an EPA registered product appropriate for killing the MRSA bacteria. Patients should also wash their own hands frequently.

To reduce the chances of CA-MRSA there are many preventative measures that can help. Washing hands often and thoroughly for at least 20 seconds can remove bacteria. Do not share personal items such as razors, towels, sheets, clothing, or athletic equipment. Use clothing or a towel as a barrier between your skin and shared equipment such as weight-training benches. Shower immediately after participating in exercise and wash athletic clothing after each wearing. If you have a wound, keep the wound clean, covered, and bandaged with dry, sterile bandages until healed. Pus from wounds can often contain MRSA keeping the wound covered can help keep bacteria from spreading and will help keep your wound from being exposed if it is free from MRSA. If you have a cut or a sore wash exposed towels and bed linens in hot water with bleach and dry in hot dryer.

Some areas and surfaces harbor more bacteria than others. For these surfaces you should consider keeping alcohol pads to wipe down the surface or a sanitizing hand gel containing at least 62% alcohol to clean your hands when surface cleaning isn’t feasible. These would include public restrooms or airplane restrooms, public drinking fountains, shopping cart handles, ATM buttons, playground equipment, remote controls, and mats and machines at health clubs.

Recently outbreaks of CA-MRSA have occurred in schools. Educators may want to consider having wall dispensers of hand sanitizers at classroom entrances so students can quickly sanitize without having to take breaks to the restrooms. Educators and coaches need to emphasize that students should not share equipment or personal items. All shared sports equipment needs to be cleaned using appropriate disinfectants that are effective against MRSA. Equipment needs to be cleaned following the instructions of the disinfectant. Students who have been diagnosed with MRSA do not need to be excluded from school. By following instructions on keeping wounds clean and following proper hygiene there is no need to exclude students from regular activities.

Sources for More Information

Environmental Protection Agency’s List of All Registered Products Effective Against MRSA.

CDC Health Topic MRSA and the Workplace.

CDC Overview on Healthcare Associated MRSA.

CDC Overview on Community Associated MRSA.

CDC Questions and Answers on MRSA in Schools.

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