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Methicillin-resistant Staphylococcus aureus, or MRSA, is a bacterium that causes infections in different parts of the body. It is tougher to treat than most strains of staphylococcus aureus, or staphylococcus in general.

The reason is that this bacterium is immune to some antibiotics commonly used for treatment of bacterial infections. The symptoms of MRSA depend on where patient is infected. Most often it causes mild infections of the skin, typically pimples or boils. However, it can also cause more serious skin infections, or infect surgical wounds, the bloodstream, the lungs, or the urinary tract. Although most MRSA infections are not serious, some of them can be life-threatening. Many public health experts feel the situation regarding the spread of tough strains of MRSA is alarming. Because it is hard to treat, MRSA has been dubbed a “super bug”.

What causes it?

Garden-variety staphylococcus is a common type of bacteria living on our bodies. Plenty of healthy people carry these bacteria without being exposed to any infection. In fact, 25-30% of us have staphylococcus bacteria in our noses. However, staphylococcus can be a problem if it manages to get inside the body. Most commonly it happens through a cut. Once there, it can cause an infection and potentially huge problems.

Staphylococcus is one of the most common causes of skin infections in the world. Usually, these infections are minor and do not need special treatment. Less often, these bacteria can cause serious problems like infected wounds or pneumonia. Staphylococcus usually responds to antibiotic treatment. However, over the decades, some strains of staphylococcus, such as MRSA, have become resistant to antibiotics that once were able to destroy it.

MRSA was discovered in 1961, and it is now immune to Methicillin, amoxicillin, penicillin, oxacillin, and many other antibiotics. While some antibiotics still work, MRSA is constantly adapting, and researchers developing new antibiotics are having a hard time keeping up.

Who gets MRSA?

The easiest way to spread MRSA is by contact. Therefore, you could get MRSA by touching another person who has it on the skin. On the other hand, you could get it by touching objects that have the bacteria on them as well. MRSA is bacteria that more that 1% of the population colonizes, although most of them are not infected. Infections are most common among people who have weak immune systems. Those living in hospitals, nursing homes, and other heath care centers are most prone to the infection. It can appear around surgical wounds, invasive devices like catheters, or around implanted feeding tubes. Rates of infection in hospitals, especially intensive care units, are rising throughout the whole world. In U.S. hospitals, MRSA causes up to 40-50% of staphylococcus infections.

What are the symptoms of MRSA?

When an infection is on the skin, it usually looks like a boil or abscess. It also might infect a surgical wound, but in either case, the area would look swollen, red, painful, and pus-filled. Many people who actually have staphylococcus skin infections often mistake it for a spider bite. If these bacteria infect the lungs and cause pneumonia, you might experience shortness of breath, fever, or chills. MRSA can cause many other symptoms, since it can infect the urinary tract or the bloodstream where symptoms are typical for that area. Very rarely, staphylococcus infection can result in necrotizing fasciitis, or a flesh-eating bacterial infection. These are serious skin infections which spread very quickly. While frightening, necrotizing fasciitis caused by a staphylococcus infection is rare. There have only been a handful of reported cases.

When to call the doctor

In most cases, MRSA is easily treated, but since a MRSA infection can be serious or even fatal, you should not ignore signs of infection. See your health care provider if you are already being treated for an infection, and watch for signs that your medicine is not working. If you are taking an antibiotic, call your doctor if the infection is no better after three or four days, or if the infection keeps getting worse. If you develop a fever, or if your fever gets worse, you should also contact your doctor. People who are ill or have a compromised immune system have a higher risk of getting MRSA, as is the case for any other infection. If you have a condition that lowers your immunity, call your doctor right away if you think that you might have an MRSA infection. Your health care provider should be able to run lab tests to see if you have MRSA. If you have an infection on the skin, your doctor will take a culture from the infected area, so depending on your symptoms your doctor might test also your blood, urine, or sputum.

What are the treatments for an MRSA infection?

The good news is that MRSA is treatable, although by definition, it is resistant to some antibiotics. However, some other kinds of antibiotics still work. Bactrim® and Vancocin® are often the first drugs used in treatment. Other options are Cleocin®, Levaquin®, Cubicin®, Targocid®, Zyvox®, and Synercid®. Some of these antibiotics are applied intravenously. There is also an emerging antibiotic resistance seen with some of these medications as well, although antibiotics are not always necessary. If you have a skin boil, your doctor may just make an incision and drain it to relieve your symptoms. If you are taking antibiotics, you should follow your health care provider’s instructions precisely. You should never stop taking your medicine, even if you are feeling better. If you do not take all of your medicine, some of the strongest staphylococcus bacteria may survive. These survivors then have the potential to become resistant to the antibiotic, and they are able to re-infect you or infect someone else.

How to prevent MRSA

As we have already heard, a staphylococcus infection is spread easily through direct contact. You can get MRSA if you touch a person who carries the bacteria, or if you touch something that an infected person has touched.  There are also some other situations associated with the spread of MRSA. Close skin-to-skin contact, openings in the skin (suh as cuts or abrasions), and contaminated items and surfaces are important potential causes of MRSA spread. Crowded living conditions, like in hospitals or prisons, and poor hygiene in health care centers, are also contributing factor for a staphylococcus infection. People who carry MRSA are sometimes isolated from other patients to prevent the bacteria from spreading. So, how do we prevent MRSA?

First, it is important to wash hands using soap and water or an alcohol-base hand sanitizer and wash thoroughly. Experts suggest that you wash your hands for as long as it takes you to recite the alphabet in your head.

Try to cover cuts and scrapes with a clean bandage, which should help the wound heal. It will also prevent you from spreading bacteria to other people if you already have been diagnosed with MRSA.

Do not touch other people’s wounds or bandages, and do not share personal items like towels or razors. If you use any shared gym equipment, wipe it down before and after you use it each time. Drying clothes, sheets, and towels in a dryer helps kill bacteria.

How to contain the spread of an existing MRSA infection

You can prevent spreading an MRSA infection to those you live with or others around you by following some basic steps. Try to keep infections, particularly those that continue to produce pus or drain material, covered with clean, dry bandages. Follow your healthcare provider’s instructions on proper care of the wound. Pus from infected wounds can contain MRSA and spread the bacteria to others, so advise your family and other close contacts to wash their hands frequently with soap and warm water, especially if they change your bandages or touch the infected wound, or have otherwise had contact with potentially infectious materials. Avoid sharing personal items that may have had contact with the infected wound and potentially infectious material. Wash linens and clothes that are soiled with hot water and laundry detergent. You also have to tell any healthcare providers who treat you that you have an antibiotic-resistant staphylococcus skin infection. You have to be aware this might be a serious condition, because on rare occasion, MRSA can cause severe illness even when treated quickly, as in the cases of four children who died from MRSA.

Read More: MRSA - Methicillin Resistant Staphylococcus Aureus Fact sheet

Does MRSA attack healthy people and healthy skin?

The answer is yes, because staphylococcus infections are known to affect healthy people and healthy skin. These infections are usually easy to treat, while any activity that promotes breakdown in skin integrity can promote skin infections, including those caused by MRSA. MRSA has been a problem in the healthcare setting for over 20 years. CDC believes that MRSA has been emerging in the community over the last several years. It is difficult to determine whether there is an increase in MRSA disease in the community, or just an increased awareness and recognition of MRSA disease in the world. However, it is clear that some of the recently recognized outbreaks of MRSA are associated with strains that have some unique properties. We might compare this to the traditional hospital-based MRSA strains, suggesting some biologic properties, which may allow the MRSA strains to spread further or cause more disease. However, these hypotheses need testing and confirmation.