By: Jeanine Thomas
Methicillin-Resistant Staph Aureus (MRSA) infections can be difficult to treat because the bacteria are resistant to many different antibiotics.
MRSA stands for methicillin-resistant Staphylococcus aureus (usually shortened to Staph aureus). It is a bacterium that is resistant to many commonly used antibiotics, including methicillin.
Unfortunately, over time Staph aureus continues to mutate and acquire new antibiotic resistance patterns, making treatment of MRSA infections challenging.
Penicillin: a miracle drug emerges
Staph aureus was discovered in the 1880s. It was known to cause infections, including blood poisoning, and surgical deaths. When the antibiotic penicillin came into use in the 1940s, effective treatment for Staph infections became possible for the first time.
Penicillin was used widely to treat different types of infections. Some people even suggested it should be put into the public water supplies.
Now years later, we see the folly of our ways. The overuse and misuse of not only penicillin but many other antibiotics have allowed Staph (and other bacterial species) to mutate and become resistant to most antibiotics.
The genesis of MRSA
According to the British Medical Journal, on October 2, 1960, the British Professor Patrician Jevons, a microbiologist at the Public Health Laboratory Service in London, was the first to see the new strain of Staph that was resistant to Methicillin.
This was the beginning of the clinical phenomena that we now call MRSA. Since then, MRSA has spread throughout healthcare facilities in Britain, then Europe and later worldwide.
U.S. healthcare facilities began seeing MRSA in the 1970s. It started to become prevalent in the early 2000s. It is believed that MRSA went unchecked, in part, because there the CDC did not have stringent contact precautions.
In those days, the approach was reactive. When a patient was infected with MRSA, they were administered antibiotics. Now, if a patient is suspected or found to have MRSA, proactive preventive interventions, such as disinfecting, are implemented.
Two Types of MRSA Strains
There are two types of MRSA strain in humans:
1. HA-MRSA (Healthcare-Acquired MRSA)
According to the CDC, the majority of MRSA infections and colonization in the U.S. are acquired in healthcare facilities (84 percent).
Patients should be closely followed by doctors and given instructions upon discharge for disinfecting their home environment and body.
Ninety percent of HA-MRSA infections are surrounding the surgical site or caused by central lines and catheters. These can turn in to sepsis or bloodstream infections with mortality rates are as high as 30 percent.
2. CA-MRSA (Community-Acquired MRSA)
CA-MRSA can cause infections and illness in people outside of healthcare facilities. Over 90 percent of people colonized with MRSA will never acquire an infection (asymptomatic).
They are carriers, however, and can, therefore, transmit it to others by sneezing, coughing, etc. as droplets fall on surfaces and contaminate them. MRSA can also be transmitted simply by coming into close contact with a person who is colonized or infected.
Screening for MRSA
Currently, the spread of MRSA is an ongoing epidemic and a public health crisis in healthcare facilities as well as communities across the world.
In 1980, the Netherlands started screening patients admitted to healthcare facilities for MRSA. This together with strict adherence to hand hygiene, decontamination of the environment and prudent use of antibiotics, allowed them to control MRSA to a less than 1 percent prevalence.
Despite growing awareness and increased screening, only 50 percent of U.S. hospitals now screen for MRSA and then only for certain high-risk patients.
In a 2017 report published in the American Journal of Infection Control, the Department of Veterans Affairs’ Veterans Health Administration showed that universally screening patients for MRSA in all 150 of its healthcare facilities since 2007 has decreased MRSA infection rates by over 80 percent, which makes them a leader in the fight against MRSA in U.S. healthcare facilities.
Colonization versus infection
Colonization with Staph aureus means that you “carry” it on your skin or in your nose. This is not an infection.
According to the Centers for Disease Control, about 33 percent of the U.S. population are asymptomatic carriers of Staph. About 2% of the population is colonized with (carry) MRSA. The exact rate of MRSA colonization varies depending on the region or city you live in.
Infection means there are symptoms present such as:
- burning sensations,
- pain or
Red bumps, a rash, boil, lesion or an abscessed wound is cause for concern. If you suspect an infection is present, do not delay seeking care from a doctor. It is always best to seek treatment early for an infection.
Abscesses almost always require surgical drainage — usually in the doctor’s office or in the emergency department. The doctor may send a sample of the abscess fluid to the lab for a culture to determine exactly what type of bacteria is present and to ascertain it’s antibiotic sensitivity.
Some recommendations to reduce the chance of a CA-MRSA infection
1. At home
- Wash hands with warm soapy water thoroughly and frequently
- Carry a hand sanitizer when washing with soap and water isn’t available
- Keep cuts and scrapes clean with an antiseptic wash or soap and warm water; Keep covered until healed
- Do not poke or squeeze sores
- Do not share towels, razors, toothbrushes or other personal items
- Cover nose and mouth when sneezing or coughing
- Change clothes daily and wash sheets and towels in hot water; use household bleach on white or color-safe items to ensure disinfection
- Dry clothes either outside in the sun or use a dryer
- Disinfect hard surfaces in the kitchen and bathrooms, as well as often overlooked areas like light switches and doorknobs, using bleach or other disinfectants
2. Additional Measures for Athletes
- Shower immediately after practice or workout
- Wash workout clothes or uniform after each use in hot water using household bleach on whites or color-safe clothing
- Avoid touching the face while working out
- Wash hands before and after practice or a workout; wipe down equipment before and after use with an antiseptic spray cleaner
- Do not place towel, water bottle or cell phone on equipment
- Keep gym shoes in a designated area at home and do not walk around the house with them
- Clean gym shoes frequently with disinfecting wipes or a spray cleaner that contains bleach.
3. Preventing MRSA at the workplace, school, daycare center, or other communal areas
- Frequently clean and decontaminate highly-touched surfaces with disinfecting solutions
- If a worker or student has an MRSA infection and is cleared to be back at work, the site should be kept bandaged and covered with clothing
- Alcohol-based sanitizers should be available for workers to use and encouraged to use frequently
- Computers, keyboards, phones, copy machines, printers, water fountains, etc. need to be cleaned frequently with antiseptic wipes or spray cleaner containing bleach.
- MRSA cells like warm, moist areas so showers and locker rooms should be cleaned frequently
- Sports or communal equipment should be wiped down after every use
Living with MRSA
If you have a CA-MRSA or HA-MRSA infection, it can be difficult to eradicate. It can become a chronic disease and it may spread to other family members living in the same household.
All family members living in the household should be screened for MRSA if any family member has an MRSA infection.
- If a family member tests positive for MRSA, they can decolonize themselves with a five-day antibiotic ointment in the nares and wash their skin several times with chlorhexidine
- It’s very important to wash all bedding, towels, and clothing using household bleach and hot water to disinfect
- If only one person in the household has MRSA, wash their bedding, towels, and clothes separately
- MRSA cells can remain dormant so it is important to keep cleaning and disinfecting routinely even after an MRSA infection clears up
- It’s very important to get more sleep, eat healthily and try to keep stress levels down as stress can adversely affect the immune system
- If an MRSA patient has had prolonged use of antibiotics to fight infections, this can permanently compromise the immune system. A compromised immune system makes a person susceptible to additional viruses and bacteria
MRSA in Pets
Cats and dogs can also be infected with CA-MRSA from a vet visit or boarding stay. These animals can transmit CA-MRSA to humans, so it is important to keep feeding areas clean and wash bowls with a disinfecting bleach product.
Below are some tips for how to prevent the spread of MRSA in the home if a pet is infected:
- Use gloves when caring for the pet’s sores or wounds and try to keep the infected area covered if possible
- Frequently wash pet bedding and towels separately with household bleach
- Bathe the pet in chlorhexidine when infection is clear to decolonize it from MRSA
- Do not let the pet sleep in your bed and refrain from allowing the pet to lick anyone or be near anyone’s face until the infection clears up
MRSA Survivors Network is an international nonprofit organization for MRSA survivors and family members that helps raise awareness, provide educational materials and provide support.
For more information on MRSA the following websites can be accessed:
Originally published at thedoctorweighsin.com on February 5, 2019.