MRSA Overview

ExitCare ImageMRSA stands for methicillin-resistant Staphylococcus aureus. It is a type of bacteria that is resistant to some common antibiotics. It can cause infections in the skin and many other places in the body. Staphylococcus aureus, often called "staph," is a bacteria that normally lives on the skin or in the nose. Staph on the surface of the skin or in the nose does not cause problems. However, if the staph enters the body through a cut, wound, or break in the skin, an infection can happen.

Up until recently, infections with the MRSA type of staph mainly occurred in hospitals and other healthcare settings. There are now increasing problems with MRSA infections in the community as well. Infections with MRSA may be very serious or even life-threatening. Most MRSA infections are acquired in one of two ways:

  • Healthcare-associated MRSA (HA-MRSA)

  • This can be acquired by people in any healthcare setting. MRSA can be a big problem for hospitalized people, people in nursing homes, people in rehabilitation facilities, people with weakened immune systems, dialysis patients, and those who have had surgery.

  • Community-associated MRSA (CA-MRSA)

  • Community spread of MRSA is becoming more common. It is known to spread in crowded settings, in jails and prisons, and in situations where there is close skin-to-skin contact, such as during sporting events or in locker rooms. MRSA can be spread through shared items, such as children's toys, razors, towels, or sports equipment.

CAUSES

All staph, including MRSA, are normally harmless unless they enter the body through a scratch, cut, or wound, such as with surgery. All staph, including MRSA, can be spread from person-to-person by touching contaminated objects or through direct contact.

SPECIAL GROUPS

MRSA can present problems for special groups of people. Some of these groups include:

  • Breastfeeding women.

  • The most common problem is MRSA infection of the breast (mastitis). There is evidence that MRSA can be passed to an infant from infected breast milk. Your caregiver may recommend that you stop breastfeeding until the mastitis is under control.

  • If you are breastfeeding and have a MRSA infection in a place other than the breast, you may usually continue breastfeeding while under treatment. If taking antibiotics, ask your caregiver if it is safe to continue breastfeeding while taking your prescribed medicines.

  • Neonates (babies from birth to 1 month old) and infants (babies from 1 month to 1 year old).

  • There is evidence that MRSA can be passed to a newborn at birth if the mother has MRSA on the skin, in or around the birth canal, or an infection in the uterus, cervix, or vagina. MRSA infection can have the same appearance as a normal newborn or infant rash or several other skin infections. This can make it hard to diagnose MRSA.

  • Immune compromised people.

  • If you have an immune system problem, you may have a higher chance of developing a MRSA infection.

  • People after any type of surgery.

  • Staph in general, including MRSA, is the most common cause of infections occurring at the site of recent surgery.

  • People on long-term steroid medicines.

  • These kinds of medicines can lower your resistance to infection. This can increase your chance of getting MRSA.

  • People who have had frequent hospitalizations, live in nursing homes or other residential care facilities, have venous or urinary catheters, or have taken multiple courses of antibiotic therapy for any reason.

DIAGNOSIS

Diagnosis of MRSA is done by cultures of fluid samples that may come from:

  • Swabs taken from cuts or wounds in infected areas.

  • Nasal swabs.

  • Saliva or deep cough specimens from the lungs (sputum).

  • Urine.

  • Blood.

Many people are "colonized" with MRSA but have no signs of infection. This means that people carry the MRSA germ on their skin or in their nose and may never develop MRSA infection.

TREATMENT

Treatment varies and is based on how serious, how deep, or how extensive the infection is. For example:

  • Some skin infections, such as a small boil or abscess, may be treated by draining yellowish-white fluid (pus) from the site of the infection.

  • Deeper or more widespread soft tissue infections are usually treated with surgery to drain pus and with antibiotic medicine given by vein or by mouth. This may be recommended even if you are pregnant.

  • Serious infections may require a hospital stay.

If antibiotics are given, they may be needed for several weeks.

PREVENTION

Because many people are colonized with staph, including MRSA, preventing the spread of the bacteria from person-to-person is most important. The best way to prevent the spread of bacteria and other germs is through proper hand washing or by using alcohol-based hand disinfectants. The following are other ways to help prevent MRSA infection within the hospital and community settings.

  • Healthcare settings:

  • Strict hand washing or hand disinfection procedures need to be followed before and after touching every patient.

  • Patients infected with MRSA are placed in isolation to prevent the spread of the bacteria.

  • Healthcare workers need to wear disposable gowns and gloves when touching or caring for patients infected with MRSA. Visitors may also be asked to wear a gown and gloves.

  • Hospital surfaces need to be disinfected frequently.

  • Community settings:

  • Wash your hands frequently with soap and water for at least 15 seconds. Otherwise, use alcohol-based hand disinfectants when soap and water is not available.

  • Make sure people who live with you wash their hands often, too.

  • Do not share personal items. For example, avoid sharing razors and other personal hygiene items, towels, clothing, and athletic equipment.

  • Wash and dry your clothes and bedding at the warmest temperatures recommended on the labels.

  • Keep wounds covered. Pus from infected sores may contain MRSA and other bacteria. Keep cuts and abrasions clean and covered with germ-free (sterile), dry bandages until they are healed.

  • If you have a wound that appears infected, ask your caregiver if a culture for MRSA and other bacteria should be done.

  • If you are breastfeeding, talk to your caregiver about MRSA. You may be asked to temporarily stop breastfeeding.

HOME CARE INSTRUCTIONS

  • Take your antibiotics as directed. Finish them even if you start to feel better.

  • Avoid close contact with those around you as much as possible. Do not use towels, razors, toothbrushes, bedding, or other items that will be used by others.

  • To fight the infection, follow your caregiver's instructions for wound care. Wash your hands before and after changing your bandages.

  • If you have an intravascular device, such as a catheter, make sure you know how to care for it.

  • Be sure to tell any healthcare providers that you have MRSA so they are aware of your infection.

SEEK IMMEDIATE MEDICAL CARE IF:

  • The infection appears to be getting worse. Signs include:

  • Increased warmth, redness, or tenderness around the wound site.

  • A red line that extends from the infection site.

  • A dark color in the area around the infection.

  • Wound drainage that is tan, yellow, or green.

  • A bad smell coming from the wound.

  • You feel sick to your stomach (nauseous) and throw up (vomit) or cannot keep medicine down.

  • You have a fever.

  • Your baby is older than 3 months with a rectal temperature of 102° F (38.9° C) or higher.

  • Your baby is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.

  • You have difficulty breathing.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.