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By Barbara Morris, M.D.
Decades ago getting treated for an illness was simpler because there were very limited options. You would go to the doctor, get a dose of penicillin and 7 to 10 days later you were (hopefully) better. Unfortunately, the heavy use of antibiotics has led to the rise of resistant strains of bacteria and new health problems for the community.
The latest health concern is Methicillin-resistant Staphylococcus aureus, or MRSA. MRSA is a staph infection resistant to several antibiotics typically used to treat such infections. While several local communities have seen a recent bump in community acquired infections, it is important to remember that such infections are not new. It is also important to know that these infections can be easily treated with commonly available antibiotics. The key is to collect the facts on what this bacteria is all about and how to prevent an infection.
Staphylococcus aureus (or staph) has been causing infections for many years. Staph is a bacteria normally found on the skin or in the nose of 20-30% of healthy individuals. Usually it causes no harm.
However, there are instances when staph can get into the body, most often through cuts. Staph can cause skin infections that look like a pimple or boil and can be red, swollen and painful. If staph gets beyond skin structures, more serious infections can develop and may become lethal.
Staph infections can usually be treated with antibiotics. Penicillin used to be effective but the bacteria adapted and new drugs were needed. Methicillin was then developed and used to counter the resistance. With the increased use of antibiotics, some strains of staph—like MRSA—have become resistant to many drugs that once destroyed them, thus earning the title “superbug.”
Traditionally, MRSA infections have been associated with hospitalization or other healthcare-associated risk factors. According to the June 2007 Kaiser Daily Health Policy Report as many as 1.2 million US hospital patients are infected with MRSA, among whom the mortality rate could be as high as 10%.
In recent years healthcare providers have observed MRSA infections in an increasing number of people who lack traditional healthcare-associated risk factors. These community associated infections, or CA-MRSA, are promoted by close skin to skin contact, openings in the skin such as cuts or abrasions, contaminated items or surfaces, crowded living conditions, or poor hygiene. Military recruits, prisoners, athletes, and some school children are seen with CA-MRSA infections.
There are a few ways to catch MRSA. The first is direct contact with someone who is infected with or a carrier of the bacteria. Human hands are the commonest mode of transmission, according to the Centers of Disease Control and Prevention. The other is physical contact with MRSA on any objects, such as towels, floors, door handles, and linens.
People with a higher risk of MRSA are those with skin outbreaks, weakened immune systems, chronic diseases or those who have undergone invasive medical procedures. Healthcare workers need to take great precautions since they may be repetitively exposed to MRSA.
MRSA infections are diagnosed by a health care provider obtaining a specimen from the infected site and analyzing it in a lab. Once identified, these skin infections can be treated by localized care in a healthcare facility. Antibiotics can be given if necessary. Rarely, the infection can become invasive. This is very unusual in healthy individuals in the community setting. It is important to seek immediate care if you think you might have a MRSA infection.
Careful washing of the hands is the most effective way to control the spread of CA-MRSA. Skin infected with MRSA should be treated and covered to avoid spreading the infection to others. Contaminated personal items should also not be shared. To lessen the transmission of this organism, surfaces (i.e. benches in locker rooms, desks and/or tabletops) should be cleaned with a 1:10 bleach/water solution. Most drug and grocery stores also have commercially available disinfectants that can be used for reducing the spread of this organism.
Staph bacteria is nothing new. However, the rise of resistant strains has resulted in more complicated infections at a higher rate of occurrence. The prevalence of the condition in the media seems alarming but, with proper precautions, the bacteria can be controlled and illness prevented.
Please review the New York State Department of Health’s advisory on MRSA. If you have questions about infection, please contact your healthcare provider.
Barbara Morris, MD is a board certified pediatrician. She practices at Community Care Pediatrics Saratoga, with two office locations at One West Avenue, Saratoga and 5 Mountain Ledge Drive, Gansevoort. Dr. Morris is also Chief Medical Officer for Community Care Physicians, P.C.
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