ARTICLE What Does MRSA Look Like? Explore infection causes, symptoms, treatment, and transmission. See pictures to learn to identify MRSA infections ( courcecy.- medicineNet.com )
MRSA
MRSA infections facts
- Staphylococcus aureus (Staph aureus, S. aureus, or SA) is a common bacteria (a type of germ) in the nose and on the skin of people and animals.
- MRSA means "methicillin-resistant Staphylococcus aureus." It is a specific "staph" bacteria (a type of germ) that is often resistant to (is not killed by) several types of antibiotic treatments. Most S. aureus is methicillin-susceptible (killed by methicillin and most other common treatments).
- In general, healthy people with no cuts, abrasions, or breaks on their skin are at low risk for getting infected.
- About one out of every three people (33%) are estimated to carry staph in their nose, usually without any illness. About two in 100 (2%) carry MRSA. Both adults and children may have MRSA.
- Like common S. aureus (SA), MRSA may cause deep (invasive) or life-threatening infections in some people. Because it is resistant to commonly used antibiotics, it can be harder to treat or become worse if the right treatment is delayed. MRSA is one of the bacteria listed by the U.S. Centers for Disease Control and Prevention(CDC) as a "superbug" resistant to multiple antibiotics.
- MRSA skin infections can be picked up either in the general community (community-associated MRSA or CA-MRSA infection) or in health care facilities (health care-acquired or HA-MRSA). In the hospital, MRSA can cause woundinfections after surgery, pneumonia (lung infection), or infections of catheters inserted into veins. Invasive MRSA infections include soft tissue infections, heart valve infections, bone infections, abscesses in organs, joint infections, or bloodstream infection (sepsis, "blood poisoning").
- Because HA-MRSA can be life-threatening, the National Healthcare Safety Network (NHSN) and Emerging Infections Program (EIP) of the CDC monitor hospital MRSA rates. The CDC also advises hospitals and health professionals about preventing and lowering MRSA infection rates.
- Rates of MRSA bloodstream infections in hospitalized patients fell nearly 50% from 1997-2007 since hospitals began using prevention measures. MRSA is transmitted from person to person by direct contact with the skin, inhaling droplets from coughing, or items touched by someone who has MRSA (for example, sink, bench, bed, and utensils). People can be carriers of MRSA even if they don't have an infection. This is called colonization. A common place for MRSA colonization with MRSA is inside the nose.
- One way to keep visitors and health-care staff from carrying MRSA from one patient to others is to follow CDC-guided precautions by wearing disposable gloves and gowns (and sometimes masks) when visiting hospitalized people who have MRSA. A sign at the door provides instructions that should be carefully followed.
Superbug Staph Spread in Community
Community-associated MRSA infections usually affect the skin, causing pimples and boils in otherwise healthy people. Infected areas may be red, swollen, painful, and have pus or other drainage.
What is methicillin-resistant Staphylococcus aureus (MRSA)?
Staphylococcus aureus (SA) is a common skin bacteria. It is sometimes called staph, and it most often causes skin and soft tissue infections. Although S. aureus has been causing staph infections as long as humans have existed, MRSA has only been around since 1961. Methicillin was one of the first antibiotics used to treat S. aureusand other infections. S. aureus developed a gene mutation that allowed it to escape being killed by methicillin, so it became resistant to methicillin. That makes it harder to treat someone who gets an infection. Stronger, more expensive, or intravenous antibiotics may be needed.
Since the 1960s, MRSA has picked up more resistance to different antibiotics. Overuse of antibiotics has increased resistance in MRSA and other infectious bacteria, because resistance genes (the genes that code for resistance) can be passed from bacteria to bacteria.
If a doctor orders a test for bacteria on a specimen of pus, for example, the laboratory will alert the doctor if the test shows MRSA, so that precautions can be taken, and the right treatment can be started.
What is methicillin-resistant Staphylococcus aureus (MRSA)? (Continued)
A deadly complication of MRSA is a deep infection, necrotizing fasciitis, which causes rapid spread and destruction of human tissues. Some but not all strains of MRSA are more likely to behave like "flesh-eating bacteria." It is impossible to predict which MRSA infection will be "flesh-eating."
How many strains of MRSA are there?
In general, there are two major strains of MRSA, "community-acquired” or CA-MRSA and "hospital acquired" or HA-MRSA. CA-MRSA differs from HA-MRSA in that it is often resistant to fewer antibiotics and it is by definition picked up outside of the hospital or health care institution. CA-MRSA strains are often able to cause more severe and deeper infections in healthy people than HA-MRSA. They often have a variety of "virulence factors" that are responsible for this. Some of these are "leucocidin" proteins that are toxic to immune cells that fight infections or cause more inflammation and tissue damage; Panton-Valentine leucocidin (PVL) protein is a well-known example that is produced by the USA300 strain of CA-MRSA. The "phenol-soluble modulin" (PSM) proteins are a recently discovered class of leukocidins that increase the likelihood of causing severe disease in various ways.
Most HA-MRSA infections have been due to the USA100 strain. HA-MRSA is more likely to affect people in health care institutions who may have weaker immune systems due to other illnesses. HA-MRSA is less likely to cause problems for healthy people in the community.
What does a MRSA infection look like?
On the skin, MRSA infection may begin as redness or a rash with a pus-filled pimple or boil. It may progress to an open, inflamed area of skin that may weep pus or drain fluid. In some instances, it may appear as an abscess, a swollen, tender area, often with reddish skin covering. When the abscess is cut open or spontaneously bursts open, pus drains from the area. If the infection is severe or may be spreading into the blood (bacteremia), fevers and shaking chills may occur.
What are the risk factors for MRSA infections?
People with higher risk of MRSA infection are those with skin breaks (scrapes, cuts, or surgical wounds) or hospital patients with intravenous lines, burns, or skin ulcers. In addition, MRSA may infect people with weak immune systems (infants, the elderly, people with diabetesor cancer, or HIV-infected individuals) or people with chronic skin diseases (eczemaand psoriasis) or chronic illnesses. People with pneumonia (lung infection) due to MRSA can transmit MRSA by droplets produced during coughing. Patients in health-care facilities are often in these risk categories, so special precautions recommended by CDC may be posted on a sign at the room entrance. Examples include "droplet precautions" -- if the patient has pneumonia, disposable masks, gowns, and gloves must be used by people who enter the room, and they must be taken off before leaving. "Contact precautions" may be posted recommending gowns and gloves only if the patient has skin infection. Precautions must be followed as posted by both health-care professionals and visitors to keep from spreading MRSA to other patients or people at risk of serious infection.
What are the signs and symptoms of a MRSA infection?
The incubation period (time between infection and start of symptoms) is variable and may depend on the particular strain of MRSA and the person's immunity. Most MRSA infections are skin and soft tissue infections that produce the following signs and symptoms:
- Cellulitis, an infection of the skin or the fat and tissues under the skin, usually starting as small red bumps in the skin. It includes redness, swelling of the tissues, warmth, and tenderness.
- Boils (pus-filled infections of hair follicles)
- Abscesses (collections of pus in or under the skin)
- Sty (an infection of an oil gland of the eyelid)
- Carbuncles (infections larger than an abscess, usually with several openings to the skin)
- Impetigo (a skin infection with pus-filled blisters)
- Rash or skin redness (skin appears to be reddish or have red-colored areas)
All of these skin infections are painful.
A major problem with MRSA (and occasionally other staph infections) is that occasionally the skin infection can spread to almost any other organ in the body. When this happens, it is a deep or invasive infection that can spread to the blood and infect internal organs. MRSA infections can cause complications such as infection of heart valves (endocarditis), gangrene or death of the soft tissues (necrotizing fasciitis), and bone or joint infections (osteomyelitis or septic arthritis). This can be deadly. Fever, chills, low blood pressure, joint pains, severe headaches, shortness of breath, and rash over most of the body are symptoms of sepsis (blood poisoning), which requires emergency medical attention.
Is a MRSA infection contagious?
MRSA skin and soft tissue infections can be contagious or spread from person to person by contact with the skin, pus, or infected body fluids of a person who has MRSA. Some people may be "carriers" of MRSA. In other words, the bacteria lives on their skin or nostrils. It may cause no problems, or it may cause infections on that person's body or be transmitted to other people. It is not unusual for people in the community who are in frequent close contact with or who live with a person who has MRSA to also become carriers of MRSA. MRSA is very common in the community, especially in children and even pets.
How is a MRSA infection transmitted or spread?
There are two major ways people become infected with MRSA. The first is physical contact with someone who is either infected or is a carrier (people who are not infected but are colonized with the bacteria on their body) of MRSA. The second way is for people to physically contact MRSA from objects such as door handles, floors, sinks, or towels that have been touched by a MRSA-infected person or carrier. Normal skin tissue in people usually does not allow MRSA infection to develop; however, if there are cuts, abrasions, or other breaks in the skin such as psoriasis (a chronic inflammatory skin disease with dry patches, redness, and white scales), MRSA (or any S. aureus) may proliferate. Many otherwise healthy people, especially children and young adults, do not notice small skin imperfections or scrapes and may be lax in taking precautions about skin contacts. This is the likely reason MRSA outbreaks occur in diverse types of people such as families, school team players (like football players or wrestlers), dormitory residents, and armed-services personnel in constant close contact.
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