Beware the Superbug!!
By:
Jim Klenner
 Do
you have your PPE at home to protect you against the ravages of
MRSA? OK, I admit that is a little dramatic but lately the media
has been hyperactive in its reporting of MRSA infections. Do they
happen? Yes. Are they widespread and common? No. Are we all going
to succumb to the next epidemic involving MRSA? Regardless of
what you hear in the media reports, the answer is no if common
and routine hygiene practices are applied to your daily activities.
Methicillin-resistant Staphylococcus aureus (MRSA) is a variant
of Staphylococcus aureus, a type of bacteria commonly found in
the environment. By evolving the ability to resist the actions
some antibiotics, e.g., penicillin and methicillin, this particular
microorganism has become especially troublesome in healthcare
settings by causing hospital-acquired (nosocomial) infections.
Patients with open wounds and/or those that are immunocompromised
have a much greater risk for infection than the general public.
Local and national media commonly refer to MRSA as a superbug.
According to CDC statistics, only 14% of MRSA infections involved
persons with no obvious healthcare connection.
While S. aureus is a common colonizer of the anterior
nares (the nostrils), the respiratory tract, open wounds, intravenous
catheters, and urinary tract represent potential sites for infection.
MRSA can be detected by swabbing the nostrils of patients and
isolating the bacteria found inside. Uninfected and healthy individuals
can carry MRSA without any signs or symptoms, for anywhere from
a few weeks to many years. As MRSA is commonly found in human
nares, picking your nose can increase your risk especially if
your unwashed hands come in contact with an open skin wound, abrasion,
or rash.
 MRSA
often results in abscess formation requiring drainage by a healthcare
professional. While the risk of community acquired MRSA infections
is much lower than in hospitalized patients, that risk is increased
by sharing personal items such as razors, towels, etc. If someone
has an open wound you shouldn’t touch it and the person
should have it bandaged. If you do come in contact with an open
wound, regardless of any MRSA infection, the best thing you can
do to prevent any infection is to wash your hands. Systemic MRSA
infections are typically associated with healthcare facilities
and can be a serious matter but treatments are available. New
antibiotics such as platensimycin and treatments involving bacteriophages
specific for Staph are showing promise.
MRSA can survive on solid surfaces and fabrics and complete surface
sanitation is necessary to eliminate MRSA in areas where patients
are recovering from invasive procedures. Ambulances, police vehicles,
artificial-turf surfaces, and sports equipment are also areas
where MRSA can be found. Using a towel to cover athletic equipment
can provide barrier protection for your exposed skin. The National
Association of Athletic Directors (NATA) recommends that cleaning
of athletic gear be done on a regular basis. The EPA has a list
of approved disinfectants at http://www.epa.gov/oppad001/list_h_mrsa_vre.pdf
 The
following are some common questions regarding MRSA. I hope you
find the answers useful and please feel free to contact me if
you have any questions.
What does a typical MRSA infection look like?
- Community MRSA infections are typically at
sites of abrasions and cuts on the skin and form pustules or
boils. Almost all localized infections can be treated by drainage
with or without antibiotics. More serious lung, bloodstream,
or bone infections rarely develop in healthy people with a skin
infection.
How is MRSA spread from person to person?
- MRSA infections can be spread to another person
through skin to skin contact or by sharing personal items (towels,
razors, bandages, etc.)
Where can MRSA infections occur?
- MRSA infections can occur anywhere
- The 5 C’s that increase the chance of
infection are Crowding, frequent skin to skin Contact, Compromised
skin (cuts, abrasions), Contaminated items and surfaces, and
a lack of Cleanliness
- Locations where the 5 C’s can be found
include dormitories, households, and daycare facilities.
How do I prevent getting a MRSA infection?
- Good basic hygiene including washing hands
with soap and water, using a hand sanitizer and showering after
exercising at a public facility.
- Covering all wounds until healed.
- Do not share personal items and use a towel
as a barrier between your skin and exercise equipment.
- Maintaining a regular cleaning schedule for
surfaces that are frequently touched by human skin.
- If you have a MRSA infection, the above recommendations
are especially important to prevent spread of MRSA to others.
References:
Foster T (1996). Staphylococcus. In: Barron's Medical Microbiology
(Barron S et al, eds.), 4th ed., University of Texas Medical Branch.
ISBN 0-9631172-1-1.
McCaughey B, Unnecessary Deaths: The Human and Financial Costs
of Hospital Infections (2nd. Ed). http://www.tufts.edu/med/apua/Patients/ridbooklet.pdf
NATA ISSUES OFFICIAL STATEMENT ON COMMUNITY-ACQUIRED MRSA INFECTIONS
and Addresses Potential Risks and Offers Prevention Tips, 2007-03-16.
http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html
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