STOKO® TECH-ALERT No. 0108 Understanding and Dealing With MRSA The Basics — What Is It And Where It Is Found? Transmission and Vulnerability
Disturbing, frightening and seemingly relentless,
MRSA is transmitted primarily from the colonized
MRSA (Methicillin-resistant Staphylococcus aureus)
hand of a patient or healthcare worker who did
has haunted the consciousness of the nation. Like a
not properly wash their hands. Swollen, red and
modern-day plague, MRSA, a type of bacterial “staph”
pus-filled areas from surgical incisions or skin irritations
infection resistant to commonly used antibiotics, has
characterize the skin of infected individuals. It can
prompted the concern of health officials, business
also reside in hair-covered regions such as the back
owners and the general public due to its increasing
of the neck or the groin, and is frequently mistaken for
spread, adaptability and virtual defiance of conventional
CA-MRSA, on the other hand, is usually transmitted
Staph bacteria is so ubiquitous that many of us
via skin cuts and abrasions in environments where
unknowingly carry it “colonized” on our bodies —
there is predominantly close-quarter human contact
it resides on the skin or in the nasal passages of
— everywhere from airports to military bases,
nearly 30 percent of the population. This common
gymnasiums, locker rooms, pool areas, ball fields,
bacteria can mutate into a viable threat in hospitals
day care centers and penitentiaries. A common
and other healthcare environments when staph
risk factor is the sharing of towels, razors and other
takes advantage of insect bites, skin abrasions,
personal hygiene products. According to the CDC,
cuts and surgical incision avenues into the body
individuals over age 65 are especially vulnerable to
to cause pneumonia, wound, bloodstream or
MRSA and CA-MRSA, and culturally, records show
urinary tract infections in patients with weakened
that black people appear to experience infections at
First discovered in 1961, these MRSA infections
Regrettably, MRSA is gaining strength outside of
are fiercely resistant to usually reliable beta-
healthcare settings and had found its way into the
lactams antibiotics such as methicillin, oxacillin,
community. One only has to consult the mainstream
penicillin and amoxicillin. In rare cases, mild
media to discover CA-MRSA outbreaks among
skin infections featuring boils or pimples can transform
competitive sports teams from the high school to
into necrotizing fasciitis (“flesh eating”) bacterial
the professional level. The infection has affected
infections that can spread with horrifying speed and
professional sports players and has contributed to
the deaths of high school and college athletes across the country. In addition to the risk factor of
Currently, the majority of MRSA cases are in healthcare
close contact associated with sports, the sharing
settings. According to an October 2007 study
of equipment or clothing may also be a contributor.
published in “The Journal of the American Medical Association” (JAMA), approximately 85% of invasive MRSA infections occur in these environments,
What If You Think You Have It?
while 14% are categorized as community-associated
The bottom line is that if you have a skin cut, abrasion
(CA-MRSA) infections, or in those individuals lacking
or something that looks like a spider bite or even
the risk factors associated with healthcare environ-
a pimple that is not responding to conventional first
ments. As outlined in a Centers for Disease Control
aid methods or over-the-counter medications, you
and Prevention (CDC) report, more individuals died
should consult your physician immediately. Even
though MRSA and CA-MRSA are frequently resistant
to antibiotics, your physician can devise a treatment
• Avoid contact with the wounds and bandages of
strategy utilizing a variety of medications that can be
• Shower immediately after exercise, athletic
If you are already under a physician’s care for
an infection, pay particular attention to the effectiveness of the medication. If you notice that
• Do not share or tolerate the sharing of personal
the infection is getting worse, or if you start running
items such as towels, razors, bar soap or
a fever or have trouble breathing, contact your
physician immediately. If you have a condition
• Do not share or tolerate the sharing of athletic
that lowers your immunity, you are at a higher risk
of MRSA and CA-MRSA infection. If you think that you might have an infection, contact your
• Immediately wash soiled towels, sheets and
clothes with laundry detergent and dry them on the hot dryer setting to kill bacteria
It’s also important to keep in mind that you should avoid asking your physician for antibiotic
• Wipe equipment surfaces thoroughly after use
treatments for a simple cold or flu. Increasingly, the medical community is coming to the realization
• Maintain a cleaner environment through man-
dated cleaning procedures for frequently touched
conventional antibiotics due to the over prescribing
• If you think you have an infection, contact your
Prevention — Cleaning Up Your Act
Now that you understand the dangers of MRSA and
SOURCES:
CA-MRSA in more detail, your emphasis should be on avoiding infection and outbreaks by practicing
CDC Web site. The American Academy of Family Physicians Web site. WebMD Web site.
common sense and good personal hygiene. This
Capriotti, T. Dermatology Nursing, Jan. 26, 2004; vol 15: pp 535-538. Johnson, L.
advice, based on recommendations by the CDC
Infections in Medicine, 2005; vol 22: pp 16-20.
and healthcare professionals is not solely applicable
Klevens, R.M. The Journal of the American Medical Association, Oct. 17, 2007; vol 298: pp 1763-1771.
to individuals. If you hold a position of responsibility
R. Monica Klevens, DDS, MPH, Division of Healthcare Quality Promotion, CDC,
with a business or concern where close human
contact is frequent, you should pay particular
Elizabeth Bancroft, MD, Acute Communicable Disease Control, Los Angeles
attention to the following recommendations:
CDC Basic Statistics, HIV/AIDS Status Report, 2005. WebMD Medical News:
• Make sure your hands are clean by thorough
“MRSA Rates Much Higher Than Thought.”
CDC Press Release, “CDC estimates 94,000 invasive drug-resistant staph infections occurred in the U.S. in 2005.” October 16, 2007.
Linezolid for the treatment of methicillin-resistant Staphylococcus aureus infections
hand sanitizer and/or antimicrobial cleanser
in children. Kaplan SL - Pediatr Infect Dis J - 01-SEP-2003; 22(9 Suppl): S178-85
— especially after changing bandages or
Prospective comparison of risk factors and demographic and clinical characteristics
of community-acquired, methicillin-resistant versus methicillin-susceptible Staphylococcus aureus infection in children.
• Take your time washing your hands — it
Sattler CA - Pediatr Infect Dis J - 01-OCT-2002; 21(10): 910-7
should take as long as it takes for you to recite
Methicillin-resistant Staphylococcus aureus in the community. Bratcher D - Pediatr Infect Dis J - 01-DEC-2001; 20(12): 1167-8
• Constantly clean cuts and scrapes and cover
• Discard any soiled bandages and used
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Intake of phenol-rich virgin olive oil improves the postprandialprothrombotic profile in hypercholesterolemic patients1–3 Juan Ruano, José Lo´pez-Miranda, Rafael de la Torre, Javier Delgado-Lista, Javier Ferna´ndez, Javier Caballero,María Isabel Covas, Yolanda Jiménez, Pablo Pérez-Martínez, Carmen Marín, Francisco Fuentes, andFrancisco Pérez-Jiménez ABSTRACT concentrations have