Methicillin is an antibiotic in the penicillin family that used to be effective against staphylococci or staph infection. Now staph bacteria have built up a resistance to penicillin-related antibiotics, including methicillin.
Methicillin-resistant Staphylococcus aureus (MRSA) is a type of staph bacteria that is resistant to numerous antibiotics and can cause skin infections, lung infections such as pneumonia, and other health issues. If not treated, MRSA infections can enter critical territory as sepsis, an often fatal reaction to severe infection. In hospitals, nursing homes and other healthcare settings, MRSA bacteria can trigger serious health issues, such as bloodstream infections, respiratory illnesses, and wound infections.
What Is MRSA
MRSA, a contagious bacterial infection, resists the antibiotics methicillin, amoxicillin, penicillin, and oxacillin, which makes it difficult to combat. It’s so effective against our antibiotics, it’s been labelled a superbug. MRSA infection often starts out as a seemingly harmless skin sore, pimple, or boil. If not treated properly, it can become very serious, and even life-threatening.
A staph infection can be mild, but can also be accompanied by serious complications such as: blood poisoning (septicemia), bone infection (osteomyelitis), lung infection (pneumonia), heart valve infection (endocarditis), septic bursitis (tiny fluid-filled sacs under the skin), and urinary tract infection.
Doctors diagnose about 94,360 invasive MRSA infections every year in the U.S, and about 18,650 associated deaths. About 86% of all invasive MRSA infections are acquired in healthcare settings. Germ-killing soaps and ointments have been found to considerably reduce MRSA cases in healthcare facilities.
MRSA, which is resistant to first-line antibiotic treatments, is an important cause of illness and sometimes death, especially among patients who have had medical care. Three-quarters of Staphylococcus aureus infections in hospital ICUs are considered methicillin-resistant. In 2012, encouraging results from a Centers for Disease Control (CDC) report indicated that invasive (life-threatening) MRSA infections in hospitals declined by 48% from 2005 through 2010.
According to the CDC, anyone can contract MRSA on the body from contact with an infected wound or personal items that have come into contact with infected skin. The risk of MRSA infection is greater when among crowds, with skin-to-skin contact, and when sharing equipment or supplies. People who recently received inpatient medical care, as well as athletes, daycare attendees, school students, and military personnel living in barracks are at higher risk than other individuals.
MRSA is caused by bacterial strains that have, due to our overuse of antibiotics, become resistant to these weapons of choice. Highly contagious, MRSA is spread through skin-to-skin contact and from person to object to person. The bacteria can survive for quite a while on many different surfaces and objects, like door handles, floors, sinks, taps, cleaning equipment, and fabric.
Researchers investigated how long resistant staph could survive on five materials commonly found in a hospital: 100% smooth cotton (clothing); 100% cotton terry (towels and washcloths); 60% cotton, 40% polyester blend (scrub suits, lab coats, and clothing); 100% polyester (privacy drapes, curtains, and clothing); and 100% polypropylene plastic (splash aprons).
They injected fabric swatches with 10,000 to 100,000 colony-forming units (CFU) of the MRSA microorganism and examined MRSA survival daily. Results showed that S. aureus survived on:
- Cotton for 4 to 21 days
- Terry for 2 to 14 days
- Polyester blend for 1 to 3 days
- Polyester for 1 to 40 days
- Polypropylene for 40 to greater than 51 days
Researchers advocated for the need for thorough contact control and painstaking disinfection procedures to keep MRSA from spreading.
MRSA skin infections may be mistaken for spider bites or other forms of skin irritation. Most staph-related skin infections, including MRSA, look like a bump or infected patch of skin that appears red, swollen, painful, warm, and full of pus or drainage. It might also instigate a fever.
If you notice any signs of MRSA, such as a skin sore or boil, cover the area with a bandage until a health care provider visit can be arranged. Be sure to have everyone around you wash their hands, and contact your doctor. The latter is especially critical if indications of an MRSA skin infection are accompanied by a fever. Catching infections early on and getting care quickly can reduce the severity of the infections. People who suspect that they have an infection should not try to treat it themselves.
Once MRSA is diagnosed, treatment will vary depending on the kind of infection, the location of the infection, the severity of the symptoms, and the kind of antibiotics to which the particular strain of MRSA responds. To manage MRSA infections, clinicians may perform pus drainage from the lesion, culture and susceptibility testing of the drained material, wound care and hygiene, and antimicrobial therapy (for cases of possible cellulitis without abscess). Possible medications for MRSA skin and soft tissue infections may include clindamycin; tetracycline drugs, such as doxycycline and minocycline; trimethoprim and sulfamethoxazole; rifampin; and linezolid.
Preventing the Spread of MRSA
You can take various steps to minimize your risk of MRSA infection:
- Maintain good hand and body hygiene by washing hands frequently and your body regularly, especially after exercise.
- Clean and cover cuts, scrapes, and wounds until healed.
- Discourage sharing of personal items, including towels and razors.
- Seek advice and care as soon as possible if there is a suspected infection.
Patients should cover their wounds and keep them covered with sterile, dry bandages until they are healed. Health care providers will offer instructions about caring for the wound properly. The pus from infected wounds can act as a carrier of MRSA, so it is important to keep the wound covered so that the infection does not spread to others. Discard of all used bandages and tape in the trash.
People affected by MRSA, as well as family, friends, associates, colleagues, and others in close contact, should wash their hands often with soap and water or use an alcohol-based hand rub. This is especially critical if someone changes the bandage or touches the infected wound.
It is also important not to share personal items, such as towels, washcloths, razors, or clothing. Wash and dry infected sheets, towels, and clothes, and be sure to wash your hands after touching contaminated fabrics.
To explore the prevention of MRSA infections in institutional settings, the Department of Health and Human Services funded a study to test three MRSA prevention methods. The study determined that germ-killing soap and ointment helped protect ICU patients more effectively than the other strategies. This methodology can be employed with all patients in intensive care units to cut the number of infections in the bloodstream by as much as 44%. In addition, it can contribute to the decrease of MRSA in intensive care units.
As Carolyn M. Clancy, M.D., director of the Agency for Healthcare Research and Quality (AHRQ), explained, “Patients in the ICU are already very sick, and the last thing they need to deal with is a preventable infection. This research has the potential to influence clinical practice significantly and create a safer environment where patients can heal without harm.”
The study, called the REDUCE MRSA trial, was performed in two segments between the years of 2009 and 2011 by a multidisciplinary team. Researchers from the Centers for Disease Control and Prevention (CDC), Harvard Pilgrim Health Care Institute, the University of California, Irvine, and Hospital Corporation of America (HCA) published their findings in the New England Journal of Medicine. The biggest study to date on this subject, with 74,256 patients and 74 adult intensive care units, demonstrated the efficacy of three practices for preventing MRSA:
- Giving germicidal ointment and soap to all patients in the intensive care unit
- Giving these items just to MRSA patients
- Providing basic care
Besides demonstrating effectiveness in quelling the proliferation of MRSA in intensive care units, the research determined that employing the germicidal ointment and soap on all patients in the intensive care unit was efficacious in stopping infections that were the result of non-MRSA germs.
According to CDC Director Dr. Tom Frieden, M.D., M.P.H., “CDC invested in these advances in order to protect patients from deadly drug-resistant infections. We need to turn science into practical action for clinicians and hospitals. CDC is working to determine how the findings should inform CDC infection prevention recommendations.”
“This study helps answer a long-standing debate in the medical field about whether we should tailor our efforts to prevent infection to specific pathogens, such as MRSA, or whether we should identify a high-risk patient group and give them all special treatment to prevent infection,” said lead author Susan Huang, M.D., M.P.H., associate professor at the UCI School of Medicine and medical director of epidemiology and infection prevention at UC Irvine Health. “The universal decolonization strategy was the most effective and the easiest to implement. It eliminates the need for screening ICU patients for MRSA.”