Preventing MRSA Infections

What is MRSA?

In short, MRSA is a revved up version of the bacteria Staphylococcus aureus, but not revved up in a good way (from a human perspective). Staphylococcus aureus is a bacteria that is on the skin of about 30% of people. Because of misuse of antibiotics (among other reasons), this bacteria has developed resistance to most of the antibiotics we have in our arsenal. It was first discovered to be resistant to methicillin in 1961 (hence the name Methicillin Resistant Staphylococcus Aureus or MRSA).

Who Gets a MRSA Infection?

MRSA is spread primarily from contact with surfaces or skin that is contaminated with the MRSA bacteria. The MRSA bacteria itself can survive up to 9 days on non-porous surfaces like doorknobs, medical charts, tables and counters. To talk about who gets MRSA, we need to separate our thinking into two types of MRSA –- healthcare associated MRSA (HA-MRSA) and community associated MRSA (CA-MRSA). Basically, you get healthcare associated MRSA from being in a healthcare environment (the hospital, for example) and you get community associated MRSA from non-healthcare settings (like exposure to gym equipment).

Who Gets Healthcare Associated MRSA (HA-MRSA)?

The people most at risk for healthcare associated MRSA are people with weakened immune systems who are in the hospital for a long time. This includes older people (as the immune system ages, it is less effective) as well as just about anyone who is in the hospital (after all, you go in the hospital when you are sick). Risk of HA-MRSA substantially increased is a person is in the hospital more than 14 days. The average age of someone with HA-MRSA is 68. Here are some specific risk factors for HA-MRSA:

• Being in a long-term care facility
• Being a patient in the hospital for more than 14 days
• Being older or having an immune compromising condition
• Recent antibiotic use
• Having an invasive device as part of your medical care (such as dialysis, catheters or feeding tubes)

Who Gets Community Associated MRSA (CA-MRSA)?

Community associated MRSA (CA-MRSA) is a new and growing type of MRSA infection. CA-MRSA comes from a combination of activities in which a cut or open wound are likely (such as contact sports) combined with being in close contact with others’ skin, towels or equipment. This means that the average age of people with CA-MRSA is much lower (23 years old). Here are some specific CA-MRSA risk factors:

• Young children (lots of cuts and scraps, immune system not fully developed)
• Playing contact sports (lots of cuts and skin-to-sin contact)
• Sharing towels, sports equipment or clothing
• Having a weakened immune system
• Living in crowded conditions with poor sanitation (prisons, for example)
• Being a family member of a healthcare worker

Preventing MRSA Infections

MRSA infections in hospitals and other healthcare areas are spread through contact with hands or infected surfaces. Often, MRSA infections are spread through the healthcare worker conducting a procedure (like inserting a catheter) under less than sterile conditions. Here are a few steps you can take to protect yourself:

• Insist that any healthcare workers wash their hands or use an alcohol-based gel before touching you or doing a procedure. Gloves alone are not enough protection.
• Make sure everything remains sterile during hospital procedures. Simply touching a bedrail or table top can contaminate the healthcare worker’s gloves.
• Ask you doctor about a MRSA test before any invasive procedure or surgery to make sure you don’t have MRSA on your own skin that could get into a wound.
• Wash your own hands lots (minimum 15 seconds -– sing “Happy Birthday” to yourself twice to get the timing right) or use an alcohol-based gel when you can’t wash your hands.
• Cover any wounds or open sores you might have.
• Shower as soon as possible after athletic activities, especially if skin-to-skin contact was made.
• Don’t share athletic equipment (without cleaning it first).
• If you have wounds that are red, draining or warm, sit out of athletic activities to protect others (see below for MRSA symptoms).
• Take every does of antibiotics prescribed.

MRSA Symptoms

Usually, MRSA (and Staph) skin infections start with a simple collection of red bumps. These are just tiny red dots that quickly get worse, becoming deep and painful. As long as the MRSA (and Staph) stay at the skin level, they are not terribly threatening. But if the infection penetrates into the body bones, joints and even your heart and lungs can become infected. These types of infections can be life threatening. You should go to the doctor at any signs of redness, warmth to the touch or tenderness.

Must Read: MRSA Infections – How Bad Is the Problem?

_Sources:

CDC page on MRSA

John L. Zeller, MD, PhD, Writer; Alison E. Burke, MA, Illustrator; Richard M. Glass, MD, Editor. The Journal of the American Medical Association. Vol. 298 No. 15, October 17, 2007.

Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States. R. Monina Klevens, Melissa A. Morrison, Joelle Nadle, Susan Petit, Ken Gershman, Susan Ray, Lee H. Harrison, Ruth Lynfield, Ghinwa Dumyati, John M. Townes, Allen S. Craig, Elizabeth R. Zell, Gregory E. Fosheim, Linda K. McDougal, Roberta B. Carey, Scott K. Fridkin, and for the Active Bacterial Core surveillance (ABCs) MRSA Investigators JAMA. 2007;298(15):1763-1771.

National Institutes of Health. Medline Plus. MRSA.

Statistical Brief #35. Healthcare Cost and Utilization Project (HCUP). July 2007. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/statbriefs/sb35.jsp.