MRSA: Getting under your skin
Editor’s Note: After the Lee Clarion ran an article addressing MRSA in our Nov 14. issue this article was submitted by the Lee Health Clinic’s Medical Director Dr. Don Robinson to inform students of the details of Staph infection.
Staphylococcus, commonly known as “Staph” has been a recognized pathogenic bacteria for many years.
It is a common bacteria found on the skin, in the mouth and nose. When it invades these tissues it frequently causes an abscess which is a collection of pus.
This is commonly called a boil. A boil typically is a red hard area which is painful. There may be a head on it with a visible pustule or small collection of pus, much like a pimple.
It can also invade the areas under the skin and become what is known as cellulitis, which may or may not include pus, but may only be a painful red area of skin without anything above the skin itself. Staph and Strep are common pathogens which can cause cellulitis. Cellulitis can spread quickly under the skin or invade the lymphatics and become disseminated quickly.
These bacteria produce enzymes and chemicals which allow them to survive the body’s efforts to kill them and allow them to spread and multiply.
In the past few decades, Staph has developed resistance to antibiotics which used to be effective at killing the bacteria. When penicillin was first introduced in the mid 1900’s it was effective at killing Staph. As the years went by, more and more Staph were found to be developing resistance to penicillin.
Overuse of antibiotics also contributed to this resistance. New antibiotics were developed which could kill the Staph bacteria, most notably a drug called Methicillin. Always willing to change in order to survive, Staph finally developed a resistant strain to Methicillin, commonly know as Methicillin Resistant Staph aureus (MRSA).
MRSA is a growing health concern. The CDC recently reported that MRSA was responsible for more deaths in 2005 than AIDS. MRSA may be categorized in two forms…community acquired and healthcare-related.
Most of the 19,000 deaths from MRSA in 2005 were related to the healthcare-related variety. Most of these deaths occurred in individuals who had immune system problems or who had been treated in hospitals, dialysis facilities, or nursing homes.
Community acquired MRSA has become increasingly prevalent in the past 10 years. It usually presents as a skin infection or boil. Frequently, patients think they have had a spider bite, since there often is a painful swollen area with an area on the skin which appears to be a hole or missing area of skin. These areas may worsen with time and often require incision and drainage of the underlying abscess.
Antibiotics may also be used, but drainage of pus is critical. People at risk for community acquired MRSA are athletes, people who are exposed to sweat or skin to skin contact, people who live in confined areas such as dorms, prisons or military barracks, people who share towels, razors, or other instruments which come in contact with the skin of others.
1. Wash hands regularly…not just after using the toilet and before eating, but after skin to skin contact including hand shaking, etc.
2. Use sanitizing hand gels when soap and water is unavailable.
3. Use antibacterial solutions to wipe down areas that might have been exposed to sweat such as athletic areas, mats and gym equipment.
4. Do not share razors, towels, or other personal items
5. Keep skin cuts or infections covered
6. Do not handle other people’s wounds or bandages
7. If someone you know has MRSA sanitize everything you can, but don’t treat them like a leper.
Ninety-five percent of community acquired MRSA infections are on the skin. A few can become disseminated and lead to the need for hospitalization, I.V. antibiotics or critical care. There have been recent deaths reported from disseminated MRSA which were community acquired.
These patients become ill very quickly and require immediate diagnosis and hospitalization. Most of the time these patients run high fevers, have shaking chills and know that they are very sick. The blood pressure may fall and they can die within a short period of time from bacterial sepsis.
We at the Lee Student Health Clinic have been seeing MRSA skin infections more and more during the past few years. While these infections are treatable, there needs to be an awareness that the best treatment is prevention. Here are a few suggestions for prevention of MRSA:
If you think that you may have a boil or a spider bite, come see us at the Lee Student Health Clinic on Parker Street. Early diagnosis and treatment will make things go easier for both of us. For further information about MRSA go to the Centers for Disease Control and Prevention website at www.cdc.gov
