MRSA: Skin Deep

Robert C. Robinson III, MD 

By now we’ve all heard of it.  It’s the super bug that is claiming life and limb at unprecedented rates.  If you’ve been watching the news at all over the past few years then you know exactly what I’m referring to.  The super bug is none other than MRSA (methicillin resistant Staphylococcus Aureus) and it’s becoming more prevalent throughout the community.

 

Previously recognized as an infection that predominately affects individuals in the healthcare setting, more cases of community acquired MRSA (CA-MRSA) are cropping up and it is something that you and your loved ones need to be aware of.

 

What is MRSA?

MRSA, as it’s name implies, is a strain of Staphylococcus Aureus that is resistant to certain types of antibiotics, namely the penicillin class.  Staphylococcus is a bacterium that is very prevalent in the community and until recently was one that was relatively easily treated if it caused infection.  Historically, Staphylococcus (commonly referred to as Staph) has been a bacterium that is susceptible to the most basic of antibiotics.  As antibiotic use has become more widespread, bacteria have evolved and developed resistance to certain classes of antibiotics.  This is precisely the case with MRSA. It is important to use antibiotics sparingly and only as prescribed by a doctor to prevent the rise in resistance that we are seeing.

 

 

How is MRSA spread?

Staphylococcus lives on the skin of 25-30% of individuals, however less than 2% are colonized with the virulent MRSA strain.  MRSA infection is usually spread by coming in contact with an infected person’s skin or personal items (i.e. towels, razors, bandages).  Infection is most likely to be spread in places where people are in close contact with others, such as locker rooms, communal showers or in a common dwelling. Factors shown to have an association with spread of MRSA skin infection include: close skin to skin contact, openings in the skin such as cuts or abrasions, contaminated items and surfaces, crowded living conditions, and poor hygiene.

 

Who is at risk for MRSA?

A potential risk is present for just about anyone who is in close contact with an individual who has been diagnosed as having a MRSA skin infection.  But statistics show that those who are at an increased risk as compared to the general population include:

 

• Patients in healthcare settings
• Visitors of infected patients
• Athletes (due to use of communal showers, towels etc.)
• Students living in dormitories (same reason as above)
• Individuals living in military barracks
• Prisoners in correctional facilities
• Employees and students in daycare centers

(These risks are likely related to the increased likelihood of skin-to-skin contact or contact with personal items in the above situations.)

 

In addition, it was noted in a study published by the CDC in 2007, that people over age 65 were four times more likely than the general population to develop a MRSA infection.  Incidence rates among blacks are reportedly twice that of the general population.

 

What are the Symptoms of a MRSA infection?

Any skin infection can potentially be a MRSA infection.   Most community acquired MRSA infections appear as pustules or boils that are often swollen, red, painful or have pus or other drainage.  The characteristic history is that an individual notices a “pimple”, or what they believe is a “spider bite” on their skin.  The bump becomes progressively more red, swollen and painful and may start to drain or “leak” pus.  Oftentimes individuals delay seeking medical attention because of the benign appearance of the initial lesion, however as this progresses it becomes difficult if not impossible to ignore.   Most MRSA infections occur at areas of visible skin trauma such as cuts or abrasions, and areas of the body covered by hair (e.g. bearded area of men, groin, armpit, back of neck).

 

How is MRSA treated?

As you may have guessed MRSA infection is treated with antibiotics.  As pointed out earlier, MRSA is resistant to certain types of antibiotics so it is important that you consult your healthcare provider to obtain the best treatment for your MRSA infection.  Once you have been issued a prescription be sure to take all of your prescribed antibiotics as directed to increase your chances of successfully treating the infection.  Just as important as taking your antibiotics is decontaminating yourself, personal hygiene products, family members and those in close personal contact with you.  This often requires the use of an antibacterial “scrub” which may be prescribed by your personal healthcare provider.

 

How is MRSA Prevented?

MRSA infection can be prevented and in fact is a highly preventable condition.  Take the following steps to ensure that you are not exposing yourself to MRSA infection:

 

• Practice good hand hygiene – Keep your hands clean by washing thoroughly with soap and water or using an alcohol-based hand sanitizer
• Cover up – Keep cuts, abrasions, and scratches clean and covered with a bandage until the skin has healed
• Keep it to yourself – Don’t share personal items such as razors or towels
• Wash it off- Always shower after using public equipment which may have been exposed to the Staph bacteria (i.e. health club equipment)