Methicillin-Resistant Staphylococcus Aureus (MRSA)

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that causes infections in different parts of the body. It's tougher to treat than most strains of staphylococcus aureus -- or staph -- because it's resistant to some commonly used antibiotics.

The symptoms of MRSA depend on where you're infected. Most often, it causes mild infections on the skin, like sores or boils. But it can also cause more serious skin infections or infect surgical wounds, the bloodstream, the lungs, or the urinary tract.

Though most MRSA infections aren't serious, some can be life-threatening. Many public health experts are alarmed by the spread of tough strains of MRSA. Because it's hard to treat, MRSA is sometimes called a "super bug."

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Garden-variety staph are common bacteria that can live in our bodies. Plenty of healthy people carry staph without being infected by it. In fact, one third of everybody has staph bacteria in their noses.

But staph can be a problem if it manages to get into the body, often through a cut. Once there, it can cause an infection. Staph is one of the most common causes of skin infections in the U.S. Usually, these are minor and don't need special treatment. Less often, staph can cause serious problems like infected wounds or pneumonia.

Staph can usually be treated with antibiotics. But over the decades, some strains of staph -- like MRSA -- have become resistant to antibiotics that once destroyed it. MRSA was first discovered in 1961. It's now resistant to methicillin, amoxicillin, penicillin, oxacillin, and many other common antibiotics.

While some antibiotics still work, MRSA is constantly adapting. Researchers developing new antibiotics are having a tough time keeping up.

Risk factors vary depending on the type of MRSA infection.

You’re at an increased risk for HA-MRSA if you:

  • were hospitalized within the past three months
  • regularly undergo hemodialysis
  • have a weakened immune system due to another medical condition
  • live in a nursing home

You’re at an increased risk for CA-MRSA if you:

  • share exercise equipment, towels, or razors with other people
  • participate in contact sports
  • work at a day care facility
  • live in crowded or unsanitary conditions

Symptoms of HA-MRSA

HA-MRSA is generally more likely to cause serious complications, such as pneumonia, urinary tract infections, and sepsis. It’s important to see your doctor right away if you notice any of the following symptoms:

  • rash
  • headaches
  • muscle aches
  • chills
  • fever
  • fatigue
  • cough
  • shortness of breath
  • chest pain

Symptoms of CA-MRSA

CA-MRSA usually causes skin infections. Areas that have increased body hair, such as the armpits or back of the neck, are more likely to be infected. Areas that have been cut, scratched, or rubbed are also vulnerable to infection because your biggest barrier to germs — your skin — has been damaged.

The infection usually causes a swollen, painful bump to form on the skin. The bump may resemble a spider bite or pimple. It often has a yellow or white center and a central head. This may often be surrounded by an area of redness and warmth, known as cellulitis. Pus and other fluids may drain from the affected area. Some people also experience a fever.

Diagnosis begins with a medical history assessment and physical examination. Samples will also be taken from the site of infection. The types of samples obtained to help diagnose MRSA include the following:

Wound cultures

Wound samples are obtained with a sterile cotton swab and placed in a container. They’re then taken to a laboratory to be analyzed for the presence of staph bacteria.

Sputum cultures

Sputum is the substance that comes up from the respiratory tract during coughing. A sputum culture analyzes the sputum for the presence of bacteria, cell fragments, blood, or pus.

People who can cough can provide a sputum sample easily. Those who are unable to cough or who are on ventilators may need to undergo a respiratory lavage or bronchoscopy to obtain a sputum sample. Respiratory lavage and bronchoscopy involve the use of a bronchoscope, which is a thin tube with a camera attached. Under controlled conditions, the doctor inserts the bronchoscope through your mouth and into your lungs. The bronchoscope allows the doctor to see the lungs clearly and to collect a sample of fluid for testing.

Urine cultures

In most cases, a sample for a urine culture is obtained from a “midstream clean catch” urine specimen. To do this, urine is collected in a sterile cup during urination. The cup is then given to the doctor, who sends it to a lab for analysis. Sometimes, urine has to be collected directly from the bladder. To do this, the healthcare provider inserts a sterile tube called a catheter into the bladder. Urine then drains from the bladder into a sterile container.

Blood cultures

A blood culture requires the removal of a small sample of blood. Blood is then placed on a dish in a laboratory and allowed to grow bacteria that may be present within it. Results from blood cultures typically take about 48 hours. A positive test result can indicate sepsis, a type of blood infection. Bacteria can enter the blood from infections located in other parts of your body, such as the lungs, bones, and urinary tract.

HA-MRSA and CA-MRSA infections are typically treated differently.

HA-MRSA

HA-MRSA infections have the capability of producing severe and life-threatening infections. These infections usually require antibiotics through an IV, sometimes for long periods of time depending on the severity of your infection.

CA-MRSA

CA-MRSA infections will usually improve with oral antibiotics alone. If you have a large enough skin infection, your doctor may decide to perform an incision and drainage. This procedure is typically performed in an office setting under local anesthesia and involves using a scalpel to cut open the area of infection and drain it completely. You may not need antibiotics if this is performed.

Take the following measures to reduce your risk of getting and spreading CA-MRSA:

  • Wash your hands on a regular basis. This is the first line of defense against spreading MRSA. Scrub your hands for at least 15 seconds before drying them with a towel. Use another towel to turn off the faucet. Carry hand sanitizer that contains 60 percent alcohol. Use it to keep your hands clean when you don’t have access to soap and water.
  • Keep your wounds covered at all times. Covering wounds can prevent pus or other fluids containing staph bacteria from contaminating surfaces that other people may touch.
  • Don’t share personal items. This includes towels, sheets, razors, and athletic equipment.
  • Sanitize your linens. If you have cuts or broken skin, wash bed linens and towels in hot water with extra bleach. You should also wash your gym and athletic clothes after each use. Dry everything in the dryer at high heat.

People with HA-MRSA are typically placed in isolation temporarily until their infection improves. Isolation prevents the spread of this type of MRSA infection. Hospital personnel caring for people with MRSA have to follow strict handwashing procedures. To further reduce their risk for MRSA, hospital staff and visitors should wear protective garments and gloves to prevent contact with contaminated surfaces. Linens and contaminated surfaces should always be properly disinfected.

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