MRSA Infections
(methacillin resistant staphylococcus aureus infections)  
Frank Barnhill M.D.
 

MRSA OR methacillin resistant staphylococcal skin infections are the “new” hot topic of the airways and news services. Every article I’ve recently seen and news broadcast I’ve viewed on the topic has reported the near “epidemic” of MRSA skin infections being diagnosed across the country.

The truth of the matter is that MRSA has been around for over thirty years dating into the sixties. Unfortunately, family doctors have been treating increasing numbers of MRSA cases every year since 1980 and that’s why MRSA infections have suddenly gotten a lot of media attention.

To understand what is going on with MRSA, we need to take a look at the past history of this infection. Then, we will discuss how to diagnose the infection, proper treatment and ways for you to protect your family from the MRSA bug.

Staphylococcal skin infections have been around a long time. At any one time in the past and in the present, probably 15% to 25% of us had or have staphylococcus aureus on our skin. Just having the bug on your skin is really no big deal unless you have problems with your immune system (cancer, leukemia, lymphoma, HIV) unless the bug happens to get under the skin’s protective barrier through a cut, puncture wound or scratch. 

If your immune system is out of whack, then even a simple ordinary case of staphylococcus could cause a serious infection. In the past when this occurred, staph showed up as crusty, oozing sores around a kid’s mouth, nose, or chin and was called impetigo. This nasty looking skin disease was usually seen in school age kids and those attending daycare. Despite the way it looked thirty years ago, it was easily treated with amoxicillin and prevented by using good hygiene to avoid spreading the infection.

Then, it happened…

Over the last 30 years have things have gone awry. That normally “innocent” little staphylococcus bug started to adapt to penicillin and mutated to survive in the face of even stronger and stronger antibiotics. Thus was born MRSA, a bug very resistant to all types of antibiotics derived from penicillin. A lot of specialists think MRSA is the result of too many people using antibiotics for infections (such as viruses) that really didn’t need treatment with antibiotics or only using just enough of an antibiotic to get to the point they felt better and saving the leftovers for a future infection. This is called inappropriate use of a drug and often leads to drug resistance.

Key Point: What we’re saying is inappropriate use of antibiotics is probably one of the things that caused staph infections to become resistant to penicillin. Then, as time went on, the resistance spread to erythromycin, cephalexin and many other drugs. You should not take antibiotics for common colds and flu symptoms and when your doctor prescribes antibiotics you should take all of them as directed. Left over antibiotics can be dangerous!

So, what’s the big deal? There are other drugs that can cure staph infections, right?

Until about 25 to 29 years ago, a very powerful drug called methacillin could be used to treat almost 100% of penicillin resistant staph infections. Unfortunately, as we use a drug to treat any type of infection, sooner or later the bug causing the infection will adapt or change and become resistant to that drug and eventually to all similar drugs. That’s what has happened with methacillin. Suddenly doctors were faced with an infection that might not be curable.

Who can be infected?

Anyone can become infected, but the very young are usually at higher risk!

Let’s take a look what can a MRSA infection might look like. It may surprise you that MRSA can masquerade as just about any type of skin lesion or sore. It can be:

·       A few red pus bumps on the chin or buttocks

·       A red, rough, dry, patch of skin on your face or chest

·       An oozing, crusty, ulcer on your cheek or leg

·       A hard red bump on your stomach

·       A soft and mushy sore that won’t heal just about anywhere

·       It can look like ringworm

·       It look just like a spider bite or infected mosquito bite

·       It can be a oozing scabbed area around the nose or mouth

·       It can start as a red bump, fester, rupture, crust over, scab, then appear to heal and go away, just to pop back up in a few weeks or over and over.

I have seen patients with MRSA sores on their legs that were probably there for six months before they asked for a diagnosis. They thought since they always healed after they ruptured, they were different infections or spider bites.

Key Point: Probably 90% of brown recluse spider bites are really MRSA infections picked up from another person or a contaminated object.

How do you make the diagnosis of MRSA?

A sample of the oozing crust or pus must be cultured or grown in a sterile broth to identify the bug under a microscope.

Then, it’s really important to test that growth to see what drugs can be used to cure the infection. That’s called doing a drug sensitivity.

How do we treat MRSA infections since they tend to be resistant to penicillin, cephalexin and erythromycin?

Incision and drainage (lancing) of a pus bump. Abscess or carbuncle will often be enough to stop the infection if it hasn’t already spread and set up housekeeping in deeper tissues or in other parts of your body.

The sulfa antibiotics or doxycycline are almost 97% effective in treating the bug and may be needed to clean up more extensive infections or those that don’t respond to lancing.

So, what can you do to help prevent MRSA?

Good hygiene is the most important step in preventing MRSA infections.

It is imperative that bleach or Lysol be used to clean items that may carry the germ!

MRSA will live on or in:

Dirty towels

Dirty showers

Dirty commodes

Gymnastic or weight lifting equipment

Helmets and uniforms

Toys and children’s play things

Diaper changing tables

MRSA is more common anywhere a lot of kids or adults dwell or exercise, such as in:

Weight lifting rooms

School showers

School bathrooms

Jails or prisons

Daycares or nurseries

Key Point: MRSA can be passed from person to person by skin to skin contact, so hand washing and teaching kids not to touch sores can be effective in both preventing the disease and stopping spread.

Cleaning sports and gymnastic equipment with a disinfectant solution before and after each use can help prevent spreading MRSA germs. Children and adults with crusty oozing sores should not be allowed to participate in contact sports such as football and wrestling.

Of course, all cuts, scrapes, scratches, bites and puncture wounds should be thoroughly cleaned with warm soapy water to remove debris and germs as soon as possible. Then, triple antibiotic ointment should be applied and the wound covered with a clean bandage to protect it as healing occurs.

I advise all parents to check their kids several times a week for suspicious sores or rashes, make sure the kids get a really good bath or shower every day and avoid wearing the same clothing over and over without thorough laundering. In addition, both kids and adults should never share clothing (especially hats and underwear), not share sports equipment such as football helmets, and avoid touching a sore on another person.

While it’s rare that a healthy person would die from MRSA, the germ releases a toxin (poison) that literally destroys skin, muscle, bone and other tissues. So, if the infection goes deep to the skin, surgery may be required to “clean it up” and extensive scarring may result. If MRSA were to get into the bloodstream, it may cause permanent kidney damage and an unusually lethal form of pneumonia.

If in doubt, it’s best to see your family doctor if there is any possibility you or a family member have MRSA!

Here’s to your family’s healthy living.

Dr. Frank

You may wish to review this drhuggiebear.com articles:

When you can send your child back to daycare, nursery or school.
Teaching safe use of public toilets
Antibacterial Soaps

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