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What's All the Buzz About MRSA?

News in recent months has been filled with reports on the spread of MSRA, the nasty little “superbug” that once confined itself to hospitals but is now showing up in schools and locker rooms across the country. MRSA, often said as a single word, “mersa,” is one of the first germs to outwit all but the most powerful antibiotic drugs. But, what is it? Where did it come from? And, how do we prevent it?

What is MRSA?
MRSA, short for methicilllin-resistant staphylococcus aureus, is an infection caused by staphylococcus aureus bacteria — often called “staph.” Decades ago, a strain of staph emerged in hospitals that was resistant to the broad-spectrum antibiotics commonly used to treat it.

Staph bacteria are normally found on the skin or in the nose of about one-third of the population. If you have staph on your skin or in your nose but aren't sick, you are considered “colonized” but not infected with MRSA. Healthy people can be colonized with MRSA and have no ill effects, however, they can pass the germ to others.

The bacteria are generally harmless unless they enter the body through a cut or other wound, and even then they often cause only minor skin problems in healthy people. But in older adults and people who are ill or have weakened immune systems, ordinary staph infections result in MRSA or community-associated MRSA (CA-MRSA), which can be fatal when not treated properly. Even if not deadly, MRSA can still cause many serious skin and soft tissue infections, as well as a serious form of pneumonia.

Signs and Symptoms
MRSA skin infections, which are transmitted primarily by skin-to-skin contact and contact with surfaces that have come into contact with someone else’s infection, generally start as small red bumps that resemble pimples, boils or spider bites. These can quickly turn into deep, painful abscesses that require surgical draining.

Sometimes the bacteria remain confined to the skin. But they can also burrow deep into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.

What Causes MRSA?
Leading causes of antibiotic resistance include unnecessary antibiotic use in humans, antibiotics in food and water and germ mutation.

What Are the Risk Factors?
Because hospital and community strains of MRSA generally occur in different settings, the risk factors for the two strains differ.

Hospital-Acquired MRSA

• Current or recent hospitalization
• Residing in a long-term care facility
• Use of invasive devices, such as dialysis, catheterization, or feeding tubes

CA-MRSA

• Young age
• Participating in contact sports
• Use of invasive devices, such as dialysis, catheterization, or feeding tubes
• Weakened immune system
• Living in crowded or unsanitary conditions
• Recent hospitalizations or antibiotic use
• Association with healthcare workers

Treatment
Vancomycin is one of the few antibiotics still effective against hospital strains of MRSA infection, although the drug is no longer effective in every case. Several drugs continue to work against CA-MRSA, but CA-MRSA is a rapidly evolving bacterium, and it may be a matter of time before it, too, becomes resistant to most antibiotics. Some hospitals are already seeing outbreaks of vancomycin-resistant MRSA. To help reduce that threat, doctors may drain an abscess caused by MRSA rather than treat the infection with drugs.

Prevention
Still, the best way to prevent the spread of germs is for healthcare workers to wash their hands frequently, to properly disinfect hospital surfaces and to take other precautions, such as wearing a mask when working with people with weakened immune systems. In the hospital, people who are infected or colonized with MRSA are placed in isolation to prevent it from spreading to other patients and healthcare workers. Visitors and healthcare workers caring for isolated patients may be required to wear protective garments and must follow strict hand-washing procedures.

When to Seek Medical Advice
Keep an eye on minor skin problems — pimples, insect bites, cuts and scrapes — especially in children. If wounds become infected, see your doctor. Ask to have any skin infection tested for MRSA before starting antibiotic therapy. Drugs that treat ordinary staph aren’t effective against MRSA, and their use could lead to serious illness and more resistant bacteria.

Protecting Yourself From MRSA in the Hospital

• Ask all hospital staff to wash their hands before touching you — every time.
• Wash your own hands frequently.
• Ask to be bathed with disposable cloths treated with a disinfectant rather than with soap and water.
• Make sure that intravenous tubes and catheters are inserted and removed under sterile conditions; some hospitals have dramatically reduced MRSA blood infections simply by sterilizing patients' skin before using catheters.

Protecting Yourself From MRSA in Your Community

• Keep personal items personal. Avoid sharing items such as towels, sheets, razors, clothing and athletic equipment. MRSA spreads on contaminated objects as well as through direct contact.
• Keep wounds covered. Keep cuts and abrasions clean and covered with sterile, dry bandages until they heal. The pus from infected sores often contains MRSA, and keeping wounds covered will help keep the bacteria from spreading.
• Sanitize linens. If you have a cut or sore, wash towels and
  bed linens in hot water with added bleach and dry them in a hot dryer. Wash gym and athletic clothes after each wearing.
• Wash your hands. In or out of the hospital, scrub your hands briskly for at least 15 seconds, then dry them with a disposable towel, using another towel to turn off the faucet. Carry a small bottle of hand sanitizer with at least 62 percent alcohol to use when you don't have access to soap and water.
• Get tested. If you have a skin infection that requires treatment, ask your doctor if you should be tested for MRSA. Many doctors prescribe drugs that aren't effective against antibiotic-resistant staph, which delays treatment and creates more resistant germs.