Posted by - J. Rand Baggesen, M.D.

MRSA (methicillin-resistant Staphylococcus aureus) is the bacterium that has gotten so much press lately. Usually spread by direct contact, it can be responsible for minor to life-threatening infections.

Contrary to what you might believe due to the recent attention paid to this bacterium, this is not a new health threat.

It may surprise you but up to 1 in 5 healthy people carry staphylococcus aureus on their skin. Up to 60 percent of us are colonized with these bacteria from time to time.

What has changed over the past few years is the amount of antibiotic resistance within the different strains of staphylococcus aureus. For years, penicillin was an effective means of treating infections caused by Staphylococcus aureus. Over time – often because of overuse of antibiotics – this bacteria has evolved to render methicillin (a type of penicillin that has been the mainstay of treatment in the past) ineffective against Staphylococcus aureus. As Staphylococcus aureus has become resistant to methicillin, medical terminology has evolved to MRSA, methicillin resistant Staphylococcus aureus.

Staff bacteria have grown resistant to antibiotics for several reasons. Human overuse of antibiotics for viral infections like the common cold and antibiotic use in farm animals combined with the fact that bacteria evolve at a faster rate than more complicated life forms all contribute to this challenging problem. This process has resulted in only a few antibiotics that are still effective against MRSA.

MRSA typically has been found within hospitals, nursing homes and other health care facilities. Recently, there has been an increase in community-acquired infections. As many as 60 percent to 70 percent of the staph bacteria in hospitals is characterized as MRSA – the increase in incidence of resistant bacteria in the community long has been a concern for physicians. Community acquired MRSA has become known as CA-MRSA.

MRSA is usually responsible for soft tissue infections such as folliculitis, boils and cellulitis. It has been increasing in incidence within students, athletes and others exposed to high-density living conditions. It is not a coincidence that we have seen increased rates of infection with students returning to school this fall. There have been many well-publicized news segments highlighting this increasingly common cause of infection. Tragically, several deaths have occurred due to MRSA infection recently.

MRSA infections only can be identified through bacterial culture. Recently, Gov. Timothy M. Kaine has signed legislation requiring that all documented MRSA infections be reported to the health department. Often, seemingly simple soft tissue infections in the outpatient setting traditionally have been treated with common antibiotics. MRSA can sometimes progress rapidly to more serious infections as so many recent highly publicized cases have shown. What’s more, the traditional intravenous antibiotic used to treat MRSA is now becoming ineffective in some strains of the infections. Vancomycin is an antibiotic given through IV that has been the mainstay of hospital treatment for MRSA.

MRSA is usually contracted by direct contact. Any exposure to a hospital or long-term health care facility is a risk factor for contracting MRSA. In the community, common risk factors are young age, participation in a contact sport, a weakened immune system, sharing sporting equipment or clothing and living in crowded conditions.

The Center to Reduce Infection Death lists the following ways for families and students to prevent transmission of CA-MRSA:

1. Encourage students to clean their hands frequently.
2. Tuck a small container of hand sanitizer in your child’s book bag.
3. Hand sanitizer should be placed inside each classroom and be easily accessible at all times.
4. Don’t share gym clothes, towels or other personal items. MRSA bacteria can live on fabrics and hard surfaces for up to 90 days.
5. Don’t share bars of soap. Use pump soap dispensers only.
6. Ensure that all shared sports equipment (wrestling mats, baseball gloves, gymnastics equipment, weight room equipment, etc.) and locker room facilities such as benches are cleaned with detergents, which must remain on the surface for at least 3 minutes. Quick spraying and wiping is not effective.
7. Clean cuts or abrasions immediately and cover the wound. First aid kits should be readily accessible in school.
8. Your school should consider antimicrobial coatings for sports equipment and other high-touch surfaces as well as washable keyboards for computers.
9. Your school should periodically test surfaces in the gym and classroom in order to detect MRSA contamination.
10. Athletes, gym teachers and coaches should be educated to their increased risk of MRSA.

So remember, wash your hands, keep personal items personal, don’t share sports equipment, keep wounds covered and get tested if you’re worried about an infection. Only by wound culture can your doctor tell you whether you have a MRSA infection. Treating infections without culture could delay diagnosis.

This health topic highlights the challenges faced by patients and doctors in today’s crowded and strained medical system. By better educating yourself on health topics like the growing bacterial resistance to antibiotics, you will be in the best position to manage your own health care.

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