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Methicillin-resistant Staphylococcus aureus (MRSA)

What is MRSA and What Can You Do To Prevent It?

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Updated May 16, 2014

Most everyone has heard of it. MRSA -- Methicillin-resistant Staphylococcus aureus -- is the infection that has caught everyone's attention, medical professionals and lay people alike. It has become a public health issue. What is MRSA, how does it impact the HIV positive person, and what can be done to decrease your risk?

What is Methicillin-resistant Staphylococcus aureus - MRSA?

Staphylococcus aureus is one of a group of bacteria that are responsible for infections ranging from mild to fatal. Directly, "Staph" as it is called causes infections of the skin and tissues. Indirectly, toxins produced by staph causes illnesses such as food poisoning.

Staph aureus is traditionally treated with antibiotics. Under normal circumstances antibiotics are effective. However, certain strains of staph have changes in genetic structure making staph resistant to antibiotics. The term "Methicillin-resistant staph aureus" refers to staph aureus that is resistant to the antibiotics methicillin, oxacillin, amoxicillin, and penicillin.

Who's At Risk For MRSA?

In 2005, over 95,000 cases of MRSA were identified. These infections were most often found in people hospitalized or recently hospitalized, in nursing homes, or had a weakened immune system. In fact, about 85% of all MRSA infections are related to hospitalization. Oddly, two-thirds of these occur after the person left the hospital.

Healthy people who have not been recently hospitalized can also get an MRSA infection. About 14% of all MRSA infections fit into this category called community-associated (CA)- MRSA infections. CA-MRSA is characterized by skin infections, abscesses, boils, and pus-filled lesions.

Does HIV Increase the Risk of MRSA?

A definitive connection between MRSA risk and HIV has not been made. Whether HIV increases the risk of CA-MRSA needs more study. In a study presented at the XVI International AIDS Conference in August 2006, the investigators stated in their study HIV positive patients had an 18-fold increase in their risk for CA-MRSA. However, several studies since have said HIV doesn't increase the risk significantly. There have been reports of MRSA clustered among populations of men who have sex with men (MSM). While MSM have higher HIV rates than the general population, this does not imply that HIV patients are at a higher risk for MRSA.

Where Can MRSA Be Found?

MRSA can be found in many places, making control a bit more difficult. Some places you can find staph and MRSA include:

  • the nasal passages (most common)
  • moist folds in the groins and perineum
  • the surface of the skin especially the hands
  • in and around the anus
  • bed linens
  • clothing
  • hospital equipment

MRSA is spread by contact, especially with moist areas and skin folds. For this reason, it is extremely important to observe strict handwashing and hygiene.

What Are The Symptoms Of MRSA?

As was mentioned earlier, MRSA is primarily a skin infection. However if left untreated, MRSA can spread throughout the body. Some of the signs to look for include:

  • red, swollen, and painful pimples or boils that may contain pus or discharge
  • more serious infections may cause pneumonia, bloodstream infections, or surgical wound infections.

Can MRSA Be Treated?

Despite its resistance to Methicillin type antibiotics, MRSA is treatable. Strong antibiotics are given through a vein in the arm allowing for faster action. The most commonly used intravenous antibiotic is called Vancomycin. Despite using a powerful antibiotic like vancomycin, MRSA can be very difficult to clear from the body entirely. There are people who carry MRSA without having serious illness. In attempts to clear MRSA entirely from these "MRSA carriers," oral antibiotics, antibiotic creams, skin shampoos, and soaps are sometimes used in conjunction with good hygiene, cleaning bed linens, etc. This is especially important in those people who live in close contact with someone known to carry MRSA or have an MRSA infection.

Antibiotic Fact Sheets

General Prevention Suggestions to Decrease MRSA Risk

MRSA is best controlled by avoiding infection. Because MRSA is related primarily to hospitalizations, the medical profession has placed an emphasis on stopping the spread of MRSA. Their efforts include:

  • Stressing good handwashing by medical staff throughout the institution.

  • Cleansing hands with alcohol hand gel or soap and water between patients.

  • Some hospitals have considered screening patients for MRSA prior to admission but the benefit of such testing has not been proven. In fact, a study published in the journal JAMA in March 2008, indicated that such pre-admission testing was of no benefit at all.

  • Antibiotics should only be prescribed when absolutely indicated and in line with established antibiotic guidelines.

  • Improved cleaning and inspection of patient care units.

  • Caring for people with MRSA in private rooms until the MRSA infection has cleared.

  • Establishing an infection control policy regarding MRSA management.

The Proper Way To Wash Your Hands

We can each do our part in slowing the spread of MRSA. Individually, people can reduce their risk of MRSA by taking these prevention steps.

  • Maintain good hygeine.

  • Don’t share soap or towels.

  • Keep cuts and scrapes clean and covered until healed.

  • Avoid contact with other people’s wounds or bandages.

  • If you are hospitalized, make sure staff is washing hands between patients and tasks.

  • Make sure you take antibiotics as instructed until gone even if you are feeling better.

Sources:

Ball, S.; "Methicillin-resistant Staphylococcus aures Infection in a Man with HIV Disease"; The AIDS Reader 26 Sept 2005.

Centers for Disease Control; "Community-Associated MRSA Information for the Public"; 3 Feb 2005.

Cancer Research UK; "What is MRSA?"; 4 May 2007.

Harbath, S.; "Universal screening for methicillin-resistant staphylococcus aureus at hospital admission and nosocomial infection in surgical patients."; JAMA 12 Mar 2008, Vol 299, No.10.

N. Crum-Cianflone, B. Hale, A. Burgi and others; "Increasing rates of CA-MRSA infection among HIV infected persons."; XVI International AIDS Conference, Toronto, August 13-18, 2006.

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