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MRSA Tips

What is MRSA?

MRSA stands for Methicillin Resistant Staphylococcus aureus. MRSA is a type of Staphylococcus bacterium that has developed resistance to the antibiotics usually used to treat the infection including methicillin, ampicillin and other penicillins.

How do individuals get MRSA?

Individuals get MRSA the same way they get other strains of S. aureus that are sensitive to methicillin. The primary way individuals “get” MRSA is by contact (direct or indirect) with a person who either has a wound infection, an infection of the respiratory tract, or who is colonized with the bacteria.

Does everyone who is exposed to MRSA become infected?

No. Some individuals who are exposed to MRSA become “colonized” which means that the bacteria are present, growing and multiply without observable signs of disease. MRSA colonization occurs on the skin surface, in the nasal passage, in the sputum or in the urine. Other individuals who are exposed to MRSA never become colonized. MRSA colonization may precede or lead to infection in persons with weakened immune systems. However, persons who get MRSA infections are usually already very ill from other medical conditions.

How are MRSA infections treated?

Effective antibiotics to treat MRSA infection may include Bactrim, vancomycin and teicoplanin. Laboratory tests are usually done to determine which antibiotic will be most effective to treat MRSA infection. Only patients with symptomatic MRSA infection should be treated; MRSA colonization should usually not be treated.

How long will MRSA last?

The length of illness caused by MRSA infection depends upon the severity of the infection, the response to antibiotic therapy, and the individual’s overall health. After infection has been resolved, the individual may remain intermittently or persistently colonized with MRSA and may or may not develop future infection (s).

What precautions should be followed when I go home?

Hand washing is the most important measure. Hands should always be washed after using the toilet, using household hand soap for at least 15 seconds. If you require continued care at home, you, or whomever is caring for you, should wear gloves when handling body fluids (urine, wound drainage, etc.), when providing care, or contacting surfaces contaminated with body fluids. Disposable items soiled by body fluids (dressings, diapers, used gloves, etc) should be placed in the trash. Good cleaning with soap and water followed by a household disinfectant such as bleach is adequate to disinfect surfaces contaminated with MRSA. Laundry can be done in accordance with manufacturer’s directions using standard detergent. Dishes and utensils can be washed

MRSA Basics

General information

• Staphylococcus aureus (Staf-lo-coc-cus aw-ree-us ( staph) is a germ that often lives in the noses and on the skin of healthy people and spreads from person to person on contaminated hands, skin, and objects.
• Most infections caused by staph are skin infections, but staph can also cause more serious infections such as blood and joint infections, and pneumonia.
• Some staph called MRSA (Methicillin-Resistant Staph aureus) cannot be killed by certain antibiotics – called beta lactams – which are commonly used to treat staph.

What to do to Prevent Staph Skin Infections

• Keep your hands clean by washing well with soap and water or using an alcohol hand gel.
• Keep cuts and scrapes clean and covered with a bandage until healed.
• Avoid contact with other people’s wounds or bandages.
• Avoid sharing personal items such as towels or razors.

What to do if You have a Staph Skin Infection

• Cover your wound. Keep wounds that are draining or have pus covered with clean, dry bandages. Follow your healthcare provider’s instructions on proper care of the wound. Pus from infected wounds can contain staph. So keeping the infection covered will help prevent the spread to others. Bandages or tape can be thrown away with the regular trash.
• Wash your hands. You, your family, and others in close contact should wash their hands often with soap and warm water. You can use an alcohol hand gel when soap and water are not available. This is especially important to do after changing the bandage or touching the infected wound.
• Do not share personal items. Avoid sharing personal items such as towels, washcloths, razors, clothing, or uniforms that may have had contact with the infected wound or bandage. Wash soiled sheets, towels, and clothes with water and laundry detergent. Dry clothes in a hot dryer, rather than air-drying. This also helps kill bacteria in clothes.
• Talk to your doctor. Tell any healthcare providers who treat you that you have or had a staph skin infection. If the type of staph infection you have is MRSA, be sure to tell them this as well.

What does a Staph or MRSA Infection Look Like?

• Staph bacteria, including MRSA, can cause skin infections that may look like a pimple or boil and can be red, swollen, painful, or have pus or other drainage. More serious infections may cause pneumonia, bloodstream infections, or surgical wound infections.

What Factors are Associated with Increased Risk for Community-Associated Staph or MRSA Infections?

• Factors that have been associated with the spread of MRSA skin infections 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.

Staph bug thrives in state

In the bay area, half of a study’s samples were drug resistant, showing rapid spread.

By LISA GREENE, Times Staff Writer
Published November 12, 2007

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The drug-resistant bacteria whose deadly spread across the United States has been marked by panicky school closings and grim headlines is gaining ground across Florida.State health investigators have tracked the bug, a form of staphylococcus bacteria known as MRSA, for the first time in a study released this year. They analyzed more than 67,000 cultures of staph infections taken by a large private lab across the state from 2003 to 2005. Almost all came from community doctors, not hospitals.The results were startling: Drug-resistant infections zoomed from 35 percent of all infections in 2003 to 49.7 percent in 2005. The number of cultures tested more than quadrupled, from about 8,300 in 2003 to nearly 36,000 in 2005.In the Tampa Bay area, more than half of the study’s cultures were resistant. Local hospitals also report steady increases in the number of infections they see.

“This nasty little bacteria is thriving,” said Cathy Ricchezza, manager of infection control at St. Joseph’s Hospital.

While staph has long been one of the most common causes of skin infections, MRSA worries health officials because some antibiotics won’t kill it. Once rare outside hospitals, it now has spread into the community, and a new, more aggressive strain can kill patients rapidly.

MRSA made news this fall with the deaths of a Virginia teenager and a New York City 12-year-old. A study saying that nearly 95,000 people got serious infections in 2005 added to the scare.

“We are fighting a bug that’s out there, and it’s a difficult one to fight,” said Roger Sanderson, a state health epidemiologist and co-author of the survey published this summer.

Four years ago, Dr. Juan Dumois, infectious disease chairman at All Children’s Hospital in St. Petersburg, was among the first local doctors to notice unusual MRSA infections. Patients hadn’t been in hospitals or had health problems that made them more vulnerable.

Back then, patients would tell Dumois that their infection was first diagnosed as a spider bite.

That doesn’t happen anymore. Instead, Dumois got a call a few weeks ago from a patient’s father, upset after seeing MRSA on TV.

“He was upset that he had not been told that his child could die,” Dumois said.

That child’s infection was minor. But Dumois has treated more serious cases. A few children have died. Others have spent weeks in intensive care, getting IV antibiotics. Some have had to get pus drained from inside their chests or rely on a machine to help them breathe.

“We usually can’t predict who’s going to get sicker,” he said. “That’s the scary thing.”

Even relatively minor infections can be painful and persistent. In July, New Port Richey resident Mark Kowalick noticed what he thought was a spider bite on his knee. Within a few days, the pain and swelling were so bad that he couldn’t walk.

A few months ago, it happened again, this time on his finger. Last month, it was his face.

Kowalick still doesn’t know where it came from.

“I’m not shy,” he said. “I tell people, you can get it anywhere.”

Kowalick washes his hands often, uses disinfectants, and does his laundry separately to avoid spreading the bug.

More patients like Kowalick are showing up in Tampa Bay emergency rooms. Although they count their numbers differently, most of the area’s biggest hospitals report increases in their total number of MRSA cases.

Tampa General saw a 20 percent increase last year in the number of MRSA patients coming there. St. Joseph’s averaged 150 patients coming in with MRSA per month in 2005, but sees about 300 a month now. The All Children’s lab did 170 positive MRSA cultures in 2003, but 600 last year.

Still, health officials say some fears are overblown.

“There’s a significant amount of hysteria,” said Dr. John Greene, chief of infectious disease at H. Lee Moffitt Cancer Center and Research Institute.

People should have “a respect for the bug but not an overreaction,” Greene said.

For example, the increased number of cultures in the Florida survey probably isn’t just because of more infections, but also because doctors are asking for more tests, Sanderson said.

The vast majority of MRSA infections are still relatively minor skin infections that can be successfully treated with other drugs. Even just lancing and draining the infections is often enough to get rid of them.

Most health officials say that daily hygiene is the most effective prevention, rather than such dramatic measures as closing schools, or the full-scale weekend cleaning done at a Hernando school after a report that one student might be infected.

As the traditional breeding ground for drug-resistant germs, hospitals are taking new steps to try to stop their spread. Several hospitals are testing high-risk patients and isolating those who test positive. They’re treating patients who carry the germ before certain surgeries to cut down on postsurgical infections.

All Children’s tests every baby coming into its neonatal unit. This week, Bayfront Medical Center started testing all patients entering its neuro-intensive care unit. St. Joseph’s keeps a database of past MRSA patients. Moffitt nurses wear buttons: “Ask me if I’ve washed my hands.”

full story

MRSA and prevention

“MRSA” What is it and helping prevent it?

Methicillin-resistant Staphylococcus Aureus is the technical name and while no one thing can prevent it, common sense and an understanding of the bacteria can help.

Staphylococcus Aureus, commonly called staph, are bacteria commonly carried on the skin or in the nose of healthy people. Staph may live in people’s noses or on their skin and most of the time do not cause a problem. The bacteria can enter the body through a break in the skin and cause an infection. Staph bacteria are one of the most common causes of skin infections. Staph can cause serious infections such as post op infections, pneumonia and sepsis. The wide spread overuse of antibiotics has led to some staph bacteria becoming resistant to antibiotics. MRSA is a type of staph that is resistant to antibiotics including methicillin. Staph or MRSA infections in the community are usually manifested as skin infections and occur in otherwise healthy people. These may appear as pimples, pustules or boils which are red, swollen, painful, or draining.

Protect yourself by:

• Good Hygiene
• Covering any open wound
• Not sharing personal items
• Clean environment—Clean surfaces that are frequently touched or come in direct contact with peoples skin. Bleach solution 1:100 (new solution daily) may be used to help.

Treatment: Most MRSA skin infections can be effectively treated by drainage of pus with or without antibiotics. If given an antibiotic be sure to take all of them. Unless directed by a physician, students with MRSA should not be excluded from school. Students with active infections should be excluded from activities where skin to skin contact is likely to occur (e.g. sports) until their infections are healed.

Preventing Spread.

• All open wounds should be covered.
• Good hygiene. Hand washing or hand sanitizer.
• Do not share personal items. (towels, washcloths, razors, clippers, clothing, uniforms)

Some common recommendations are:

1. Good Hand washing
2. All wounds/sores should be covered
3. Any wound that appears infected or draining should be referred to a health care provider for evaluation.

The most important health lesson to all and especially children, is good hand hygiene.

Let us know if you have any tips that can be shared and if you suspect that you may have an infection see your health care provider immediately.

Copyright © 2008 MRSA Diagnosis

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