MRSA infection is caused by Staphylococcus aureus bacteria — often called "staph." MRSA stands for methicillin-resistant Staphylococcus aureus. It's a strain of staph that's resistant to the broad-spectrum antibiotics commonly used to treat it. MRSA can be fatal.
Most MRSA infections occur in hospitals or other health care settings, such as nursing homes and dialysis centers. It's known as health care-associated MRSA, or HA-MRSA. Older adults and people with weakened immune systems are at most risk of HA-MRSA.
- cellulitis (infection of the skin or the fat and tissues that lie immediately beneath the skin)
- boils (pus-filled infections of hair follicles),
- abscesses (collections of pus in under the skin),
- sty (infection of eyelid gland),
- carbuncles (infections larger than an abscess, usually with several openings to the skin), and
- impetigo (a skin infection with pus-filled blisters).
One major problem with MRSA is that occasionally the skin infection can spread to almost any other organ in the body. When this happens, more severe symptoms develop. MRSA that spreads to internal organs can become life-threatening. Fever, chills, low blood pressure, joint pains, severe headaches, shortness of breath, and "rash over most of the body" are symptoms that need immediate medical attention, especially when associated with skin infections.
There are two major ways people become infected with MRSA. The first is physical contact with someone who is either infected or is a carrier (people who are not infected but are colonized with the bacteria on their body) of MRSA. The second way is for people to physically contact MRSA on any objects such as door handles, floors, sinks, or towels that have been touched by an MRSA-infected person or carrier.
Normal skin tissue in people usually does not allow MRSA infection to develop; however, if there are cuts, abrasions, or other skin flaws such as psoriasis (chronic skin disease with dry patches, redness, and scaly skin), MRSA may proliferate. Many otherwise healthy individuals, especially children and young adults, do not notice small skin imperfections or scrapes and may be lax in taking precautions about skin contacts. This is the likely reason MRSA outbreaks occur in diverse types of people such as school team players (like football players or wrestlers), dormitory residents, and armed-services personnel in constant close contact.
People with higher risk of MRSA infection are those with obvious skin breaks (surgical patients, hospital patients with intravenous lines, burns, or skin ulcers) and patients with depressed immune systems (infants, elderly, or HIV-infected individuals) or chronic diseases (diabetes or cancer). Patients with pneumonia (lung infection) due to MRSA can transmit MRSA by airborne droplets. Health-care workers as a group are repeatedly exposed to MRSA-positive patients and can have a high rate of infection if precautions are not taken. Health-care workers and patient visitors should use disposable masks, gowns, and gloves when they enter the MRSA-infected patient's room.
A skin sample, pus on the skin, or blood, urine, or biopsy material (tissue sample) is sent to a microbiology lab and cultured for S. aureus. If S. aureus is isolated (grown on a Petri plate), the bacteria are then exposed to different antibiotics including methicillin. S. aureus that grows well when methicillin is in the culture are termed MRSA, and the patient is diagnosed as MRSA-infected. The same procedure is done to determine if someone is an MRSA carrier (screening for a carrier), but sample skin or mucous membrane sites are only swabbed, not biopsied.
Both hospital- and community-associated strains of MRSA still respond to certain medications. In hospitals and care facilities, doctors often rely on the antibiotic vancomycin to treat resistant germs. CA-MRSA may be treated with vancomycin or other antibiotics that have proved effective against particular strains. Although vancomycin saves lives, it may become less effective as well. Some hospitals are already seeing strains of MRSA that are less easily killed by vancomycin.
Personnel in contact with patients should wash hands before and after patient care.
Use an antiseptic soap, such as chlorhexidine, because bacteria have been cultured from workers' hands after they've washed with milder soap. One study showed that without proper hand washing, MRSA could survive on health care workers' hands for up to 3 hours.
Contact isolation precautions should be used when in contact with the patient. A private room should be used, as well as dedicated equipment and disinfection of the environment.
Change gloves when contaminated or when moving from a "dirty" area of the body to a clean one.
Instruct family and friends to wear protective clothing when they visit the patient and show them how to dispose of it.
Provide teaching and emotional support to the patient and family members.
Consider grouping infected patients together and having the same nursing staff care for them.
Equipment used on the patient should not be laid on the bed or bed stand and should be wiped with appropriate disinfectant before leaving the room.
Ensure careful use of antibiotics. Encourage doctors to limit antibiotic use.
Instruct the patient to take antibiotics for the full prescription period, even if he begins to feel better.
Good hand washing is the most effective way to prevent MRSA from spreading. This includes hand washing between tasks and procedures on the same patient to prevent cross-contamination of different body parts.