MRSA: overview and more

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Although there are many strains of the bacteria Staphylococcus aureus or Staphylococcus aureus, methicillin-resistant Staphylococcus aureus ( MRSA ) is especially notable because it is resistant to many standard antibiotics and can cause serious infections. Staph usually live on the skin and sometimes in the nasal passages. If a hole appears in the skin, bacteria can enter the body and cause an infection. Although it is well known that MRSA infections occur in people in care settings such as hospitals, anyone can get MRSA.

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Types and symptoms of MRSA

A person can become infected with MRSA in two ways: they can be a carrier or have an active infection.

  • A carrier means that the person has no symptoms, but the MRSA bacteria live in their nose or skin. This is also called colonization.
  • An active infection means that MRSA bacteria entered the body through a hole (usually a cut, scrape, or wound) and that person is now showing symptoms.

There are also two types of MRSA infections, depending on where the MRSA was acquired. These two types are:

  • Community-acquired MRSA infections (CA-MRSA)
  • Hospital acquired MRSA infections (HA-MRSA)

Community-based MRSA infections

Community-acquired MRSA infections occur in healthy people who do not have contact with healthcare facilities, such as a hospital, dialysis facility, or long-term care facility. Generally, CA-MRSA infections are skin infections such as folliculitis , boils , carbuncles , and cellulitis .

Symptoms of a MRSA skin infection are sometimes mistaken for a spider bite and include one or more of the following:

  • Swelling
  • Skin heat
  • Redness of the skin
  • Tenderness in or around the infected area
  • Thick, yellowish drainage (pus) from the center of the infected area, especially if there is a large red bump.
  • Hot
Methicillin-resistant Staphylococcus aureus. Jody Jacobson / Getty Images

Hospital MRSA infections

Hospital MRSA infections refer to an infection that occurs more than 48 hours after hospitalization or an infection that occurs outside of the hospital within 12 months of contact with a medical facility.

Nosocomial MRSA infections are usually more serious and invasive than CA-MRSA infections and are often the result of surgical wounds. A skin or wound infection with HA-MRSA is usually:

  • Red and swollen
  • Painful

Also can:

  • Drains pus and looks like an abscess or boil
  • Fever, chills, muscle aches / fatigue
Methicillin-resistant Staphylococcus aureus. Jody Jacobson / Getty Images

Nosocomial MRSA infections can also occur in the bloodstream and cause sepsis . It is a phenomenon in which the body triggers a strong inflammatory response to an infection, causing numerous symptoms and signs, such as:

  • Hot
  • Perspiration
  • Rapid heartbeat and rapid breathing.
  • Confusion
  • Organ failure due to impaired blood flow ( septic shock )

Once in the bloodstream, MRSA can enter and infect various tissues or organs, such as a heart valve ( endocarditis ), a bone ( osteomyelitis ), a joint ( septic joint ), or lungs ( pneumonia ).

After infection, symptoms develop that are characteristic only of this tissue or organ. For example, in the case of pneumonia caused by MRSA, the person may experience fever, chills, muscle pain, shortness of breath, chest pain, and cough.

Causes

MRSA is a bacteria that has been exposed to antibiotics over time and then has mutated to become a powerful and super resistant microbe . However, although many people are colonized by Staphylococcus aureus (about 33% of the population), only about 1% are colonized by MRSA.

The truth is that anyone can become a carrier of MRSA and then become infected, although your risk increases if you spend a lot of time in crowded areas and / or use shared equipment or supplies .

Some of these locations include:

If one person in the household has an MSRA, it usually spreads to other members of the household.

In addition to environmental factors, there are other factors that increase the risk of MRSA. Some of these include:

  • Previous use of antibiotics
  • Weak immune system
  • Sharing needles or razors
  • History of injection drug use

Inside the hospital, there are additional risk factors for getting hospital-acquired MRSA, such as:

  • Open wound, catheter, or breathing tube
  • Long hospital stay
  • Long-term care facility accommodation
  • Recent surgery
  • Receive dialysis

Diagnostics

The last way to diagnose a MRSA wound or skin infection is with a bacterial culture of pus from the infected area. Culture results are usually available within 24 to 72 hours.

Blood cultures are used to diagnose MRSA bloodstream infections. If an infection of the lungs, bones, joints, or heart valve is suspected, imaging tests will be ordered. For example, a chest x-ray or computed tomography (CT) scan can diagnose pneumonia, and an echocardiogram can diagnose endocarditis.

Finally, to diagnose potential MRSA carriers (most often only done in hospitals or other healthcare settings), swabs can be taken from each patient's nostrils and sent to a lab for analysis.

Watch out

The main treatment for MRSA infection is antibiotics. But since the bacteria have overtaken many of these drugs, some potent types are being considered, and several types may need to be tried to successfully eradicate the infection.

Antibiotics commonly used to treat MRSA infections include:

  • Septra or Bactrim (trimethoprim-sulfamethoxazole)
  • Cleocin HCl (clindamycin)
  • Zyvox (linezolid)
  • Sumycin (tetracycline)
  • Dynacin or minocin (minocycline)
  • Vibramycin or Dorix (doxycycline)
  • Vancocina (vancomycin)

The choice of antibiotic will depend on the severity of your disease, as well as local resistance patterns and available culture data.

It is important to take the antibiotic as directed by your doctor. Be sure to contact your doctor right away if you experience any side effects from the medication or if your infection does not improve or if it worsens.

For more serious infections, drainage and one or more antibiotics are used. If your illness is severe, you may need hospitalization and intravenous (IV) antibiotics such as vancomycin. You may also need other hospital treatments, such as:

  • Intravenous fluid administration
  • Dialysis (if your kidneys are not working as a result of MRSA infection)
  • Ventilator placement (to make breathing easier if your lungs are not working as a result of infection)

Decolonization

For patients in the hospital who are carriers of MRSA, a decolonization treatment plan can be initiated upon discharge from the hospital. The main goals of decolonization are to prevent future MRSA transmission and infection.

This treatment can be administered for five days, twice a month for six months and consists of the following three therapies:

  • Chlorhexidine 4% washable for daily bath or shower
  • 0.12% chlorhexidine mouthwash twice daily
  • 2% nasal mupirocin twice daily

For people within the community, decolonization may be recommended for those who continue to contract MRSA despite optimizing their hygiene practices and / or continuing to transmit MRSA to family members.

However, keep in mind that decolonization, especially within the community, is still evolving, with no established guidelines.

Protect your skin

It is important not to squeeze, squeeze, or try to remove the abscess or pimple on your own, as this can make the infection worse.

Prophylaxis

Personal hygiene measures are essential to prevent MRSA infections.

Follow these guidelines:

  • Cover cuts, abrasions, and wounds with a bandage until they heal.
  • Do not touch the cuts, scrapes or wounds of another person.
  • Don't share personal items like towels, razors, washcloths, clothing, deodorant, or makeup.
  • Wash your hands frequently and for at least 20 seconds with soap and water (if not, use an alcohol-based hand sanitizer ).
  • Cleanse your body regularly, especially after exercise.
  • Make sure your healthcare professional washes their hands with soap and water before examining you.
  • Clean the equipment with an alcohol solution before and after use.

Get the word of drug information

MRSA is a bacterium that healthcare professionals remain concerned about given the serious infections it can cause and its resistance to many traditional antibiotics. To protect yourself from MRSA, be proactive about hand and body hygiene and be sure to see your doctor right away if you suspect you have an MRSA infection. Timely care is the key to eliminating this superbug.

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