MRSA (How You Get it, What to Look For, How to Treat), Fall 2014 Newsletter

Given all of the recent news coverage on the Ebola virus outbreak in Africa, it is worth reviewing one of the most common disease-causing pathogens here in the United States, Staphylococcus aureus. In particular, Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of bacteria that may cause concerning infections. MRSA is resistant to most antibiotics which are commonly used to treat skin or systemic infections. MRSA may cause serious infections in people who are elderly, debilitated, or have weakened immune systems. Serious infections typically occur in patients who are hospitalized or in nursing homes. However, community-associated MRSA can affect young healthy people who have no other health issues.

In the general community, MRSA can be spread through physical person-to-person contact. However, it can also be transmitted through contact with contaminated items such as a towel or the surface of an object. MRSA can survive for several days on an object or surface, but it is easily killed by commercially available cleansers and disinfectants. Frequent hand washing and showering after physical activities will typically prevent the spread of MRSA from person to person.

Infection of the skin by MRSA may present in a variety of ways. At first, localized redness and discomfort are the only findings. Infected areas then may begin to swell and the skin may become firm and hot to the touch. There may be fluid filled cysts, boils, or abscesses which can vary in size. Some may be small like a pimple, but in worse cases, affected areas may swell to golf-ball size or larger and become very painful. Eventually infected areas will often drain either spontaneously, or after being opened in the dermatology clinic. In more advanced cases, large areas of skin may become involved, especially in individuals with pre-disposing conditions such as active eczema.

Minor cases of MRSA infection may resolve spontaneously in young healthy people, however, there is always the threat of worsening infection which may lead to more serious complications. In the dermatology clinic, active boils should be opened and drained, leading to quicker resolution. In addition, patients may receive oral or topical antibiotics. More serious infections should be cultured to positively identify the offending organism. Lastly, patients are counseled on wound care for their infected areas, as well as how to avoid spreading MRSA infection to others. In some cases, especially when MRSA infection becomes recurrent, patients will be advised to bathe in a dilute “bleach bath” every few days to decontaminate their skin.