Your MRSA Questions Answered
Look, MRSA is difficult to deal with and doctors don’t always have the answers you need. We have tried to share answers so you can better understand this horrible infection.
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According to the Mayo Clinic, “MRSA infection is caused by Staphylococcus aureus bacteria — often called “staph.” MRSA stands for methicillin-resistant Staphylococcus aureus. It’s a strain of staph that’s resistant to the broad-spectrum antibiotics commonly used to treat it. MRSA can be fatal.”
“Most MRSA infections occur in hospitals or other health care settings, such as nursing homes and dialysis centers. It’s known as health care-associated MRSA, or HA- MRSA. Older adults and people with weakened immune systems are at most risk of HA- MRSA. More recently, another type of MRSA has occurred among otherwise healthy people in the wider community. This form, community-associated MRSA, or CA- MRSA, is responsible for serious skin and soft tissue infections and for a serious form of pneumonia.”
About 0.8% (2.3 million people) of the U.S. population is colonized with MRSA, and these people are called MRSA carriers. The proportion of health-care-associated Staphylococcal infections that are due to MRSA (known as hospitalized or HA- MRSA) rapidly increased from 2% in intensive-care units in 1974 to 64% in 2004. Approximately 126,000 hospitalizations are due to MRSA yearly. Recent data suggest that MRSA causes about 59% of all skin and soft tissue infections. Invasive (serious) MRSA infections occur in approximately 94,000 people each year and are associated with approximately 19,000 deaths, reportedly more deaths than HIV per year. Of these MRSA infections that cause death, about 86% are HA- MRSA and 14% are CA- MRSA (community-acquired MRSA ;MRSA infections that are acquired outside health-care settings).
Both hospital- and community-associated strains of MRSA still respond to certain medications. In hospitals and care facilities, doctors often rely on the antibiotic vancomycin to treat resistant germs. CA- MRSA may be treated with vancomycin or other antibiotics that have proved effective against particular strains. Although vancomycin saves lives, it may become less effective as well. Some hospitals are already seeing strains of MRSA that are less easily killed by vancomycin (VRSA).
According to the Centers for Disease Control (CDC), MRSA was responsible for an estimated 94,000 invasive life-threatening infections and close to 19,000 deaths (more than AIDS). MRSA annual incidence and death rates are 1.5 times HIV rates. The annual incidence MRSA in the US is 32 per 100,000, compared to HIV’s rate of 21 per 100,000. While the death rate, per 100,000, is 6.3 for MRSA and 4.4 for HIV.
WebMD states “Garden-variety staph are common bacteria that can live on our bodies. Plenty of healthy people carry staph without being infected by it. In fact, 25-30% of us have staph bacteria in our noses. But staph can be a problem if it manages to get into the body, often through a cut. Once there, it can cause an infection. Staph is one of the most common causes of skin infections in the U.S. Usually, these are minor and don’t need special treatment. Less often, staph can cause serious problems like infected wounds or pneumonia”.
“Staph can usually be treated with antibiotics. But over the decades, some strains of staph — like MRSA— have become resistant to antibiotics that once destroyed it. MRSA was first discovered in 1961. It’s now resistant to methicillin, amoxicillin, penicillin, oxacillin, and many other antibiotics.”
“While some antibiotics still work, MRSA is constantly adapting. Researchers developing new antibiotics are having a tough time keeping up.” Might this signal the end of the antibiotic age and if so, what might replace it?
WebMD goes on to say “MRSA is spread by contact. So you could get MRSA by touching another person who has it on the skin. Or you could get it by touching objects that have the bacteria on them. MRSA is carried, or “colonized,” by about 1% of the population, although most of them aren’t infected.”
“MRSA infections are most common among people who have weak immune systems and are living in hospitals, nursing homes, and other health care centers. Infections can appear around surgical wounds or invasive devices, like catheters or implanted feeding tubes. Rates of infection in hospitals, especially intensive care units, are rising throughout the world. In U.S. hospitals, MRSA causes more than 60% of staph infections.”
MRSA is also showing up in healthy people who have not been living in the hospital. This type of MRSA is called community-associated MRSA, or CA-MRSA. The CDC reports that in 2007, 14% of people with MRSA infections had CA-MRSA.
Studies have shown that rates of CA-MRSA infection are growing fast. One study of children in south Texas found that cases of CA-MRSA had a 14-fold increase between 1999 and 2001. CA-MRSA skin infections have been identified among certain populations that share close quarters or experience more skin-to-skin contact. Examples are team athletes, military recruits, and prisoners. However, more and more CA-MRSA infections are being seen in the general community as well, especially in certain geographic regions.
It’s also infecting much younger people. In a study of Minnesotans published in The Journal of the American Medical Association, the average age of people with MRSA in a hospital or health care facility was 68.
According to the CDC, surgical site infection with MRSA (SSI) is more common than we care to admit. Here are some points to know about contracting MRSA from a hospital or medical institution:
- An infection is considered to be an SSI when it occurs at the site of surgery within 30 days of an operation or within 1 year of an operation if a foreign body (e.g., an artificial heart valve or joint) is implanted as part of the surgery.
- Most SSIs (about 70%) are superficial infections involving the skin only. The remaining infections are more serious and can involve tissues under the skin, organs, or implanted material.
- The majority of SSIs do not become life-threatening.
- Patients should maintain a healthy weight, stop smoking at least 30 days prior to surgery, work with their doctors to keep blood sugar levels under control if diabetic, and take a shower or bath the day before surgery.
- Patients can also ask that doctors make sure to use antibiotics correctly during surgery and follow proper infection control practices before, during, and after surgery. This includes practicing good hand hygiene and using clippers at the incision site instead of a razor if hair removal is necessary.
- Signs and symptoms of an SSI can include fever and redness, swelling, heat, or pain at the surgical wound site.
- Drainage of cloudy fluid or sudden opening of the surgical wound can also suggest an SSI.
- Patients should receive instructions from their doctor before surgery explaining what to look for and what to do if they think they might have an infection.
In the hospital, people who are more likely to get an MRSA infection are people who:
- Have other health conditions making them sick.
- Have been in the hospital or a nursing home.
- Have been treated with antibiotics. People who are healthy and who have not been in the hospital or a nursing home can also get MRSA infections. These infections usually involve the skin. More information about this type of MRSA infection, known as “community-associated MRSA” infection, is available from the Centers for Disease Control and Prevention (CDC).
Yes, there are antibiotics that can kill MRSA germs. Some patients with MRSA abscesses may need surgery to drain the infection. Your healthcare provider will determine which treatments are best for you.
To prevent MRSA infections, doctors, nurses, and other healthcare providers MUST:
- Clean their hands with soap and water or an alcohol-based hand rub before and after caring for every patient.
- Carefully clean hospital rooms and medical equipment.
- Use Contact Precautions: when caring for patients with MRSA. Contact Precautions mean:
- Whenever possible, patients with MRSA will have a single room or will share a room only with someone else who also has MRSA.
- Healthcare providers will put on gloves and wear a gown over their clothing while taking care of patients with MRSA.
- Visitors may also be asked to wear a gown and gloves.
- When leaving the room, hospital providers and visitors remove their gown and gloves and clean their hands.
- Patients on Contact Precautions are asked to stay in their hospital rooms as much as possible. They should not go to common areas, such as the gift shop or cafeteria.