Gail Hacker, MD, Medical Director The Doctor Is In archives

Greetings and Good Health!

Everyone is talking about MRSA these days. While it is true that there are more germs that don’t respond to common antibiotics nowadays, there is no reason to panic. Common sense approaches, like frequent hand washing and covering up wounds, will prevent most problems. This edition of “The Doctor is In” will address questions you may have regarding MRSA: what it is, how it is passed between people, and how you can avoid getting it. You can also visit the web site for the Center for Disease Control (CDC) http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html for additional information.

As a side note, remember, antibiotics ONLY work for bacterial infections. If you have a cold or other viral infection, and you do not receive antibiotics from your health care provider, there is a very good reason for that----we don’t want to expose anyone to more antibiotics than is absolutely necessary. This is where bugs like MRSA get their start.

What is MRSA?
MRSA stands for methicillin resistant Staphyloccus aureus.

• Methicillin is an antibiotic.
• Staphylococcus aureus (staph) is a common bacterium (germ) found on the skin of healthy people.
• MRSA is a particular type of staph that is resistant (does not respond to or get better with) to the antibiotic methicillin. It also is resistant to a number of other commonly prescribed antibiotics.

There are two types of MRSA

• Community acquired MRSA means it is found on generally healthy people who have not been in the hospital, nursing home or other inpatient type health care setting. It generally causes skin infections like boils or abscesses that can grow very rapidly. It will occasionally cause more severe infections like pneumonia.
• Hospital acquired MRSA infects people who have been in the hospital or similar setting when they get sick. It is usually much more severe than community acquired MRSA because it is resistant to many more antibiotics and usually affects people who aren’t that healthy to begin with.
• The difference between the two types is becoming less distinct with time.

How do I catch MRSA?
MRSA is spread by direct contact with infected secretions such as pus from an abscess. It requires a break in the skin barrier to set up an infection.

How do I know if I have MRSA?
Many people are “colonized” with MRSA and don’t know it. This means that they have MRSA on their skin or in their noses all the time, but are not sick from it. If they cut themselves, though, the MRSA can get under the skin and cause infection.
If you get a sudden and rapidly growing skin infection after a cut you may have a MRSA infection. MRSA abscesses are often mistaken for spider bites.

How do I get rid of MRSA?
If you have an infection, such as a boil, your health care provider will probably recommend that you have it drained and might treat you with an antibiotic that is still active against MRSA. Some of the pus will probably be sent to the lab to be cultured. It is extremely important that you keep any draining wounds covered to prevent others from getting colonized or infected.

If you are colonized, or have the bacteria on your skin but aren’t currently sick from it, there is not much that can be done to get rid of MRSA. Some people have used an antibiotic cream in the nose to decrease the amount of MRSA living there, but this has not been all that successful at getting rid of MRSA forever, and we are concerned about MRSA becoming resistant to the creams. Likewise, it doesn’t always work to take antibiotic pills to get rid of MRSA because it often comes back after you stop taking the antibiotics, and it might not respond to them if you get a bad infection.

How do I keep from getting MRSA then? WASH YOUR HANDS. Frequently. Or use alcohol containing gels. Frequently. If you get a cut, wash it with soap and water, and cover it up. See your health care provider if it looks red or has pus in it. Don’t share razors or anything that might be contaminated with infected secretions.

Gail Hacker, MD