MRSA (staph) infections can cause illness and even death when contracted in the community in healthy individuals. 14% of all MRSA infections are now community-acquired. There are several strains of MRSA and the one now that is emerging is USA400 that can cause severe infections. CA-MRSA and HA-MRSA are co-mingling and some patients in healthcare facilities are contracting CA-MRSA strains.

Transmission

Causes of these infections in the community are:

• Touching contaminated surfaces and items
• Skin-to-skin contact with someone who is colonized with MRSA. MRSA can be sexually transmitted.

MRSA can enter through cuts and abrasions in the skin and some core investigators believe it can enter just through the skin alone. Some contributing factors to acquiring an infection are crowded living conditions and poor hygiene. MRSA loves warm and moist conditions so the frequency of transmission can be greater at:

• Gyms
• Daycare centers
• School fitness centers, locker rooms and off sports equipment
• Prisons
• Outbreaks have occurred in military camps.

MRSA can cause skin infections that may look like a spider bite, a pimple, rash or a boil. They may appear red, swollen, painful, or have pus or other drainage. It is important to monitor closely, especially with children and if the eruption becomes larger seek immediate medical attention.

Prevention

• It is also important to clean and cover infections to prevent spreading to others.
• Do not share personal items such as towels, clothing, razors, bedding, etc.
• At the gym, wipe down equipment before and after use and do not touch your face.

Those most at risk for a community-acquired infection are:

• Athletes participating in sports, especially contact sports.
• Those with a weakened immune system, including those that are living with HIV/AIDS.
• Living in crowded or unsanitary conditions.
• Contact with healthcare workers.

 

Decolonization

People should seek medical attention and watch their skin eruptions carefully, especially in children. Your family physician will culture your infection to determine if it is MRSA and antibiotIcs may be prescribed. It is recommended to be tested (screened) to determine if you are colonized in your nares and if a person is found positive, they can be decolonized in five days with the following:

• Five day course of mupiricin (an antibiotic) nasal ointment.
• Chlorhexedine bathing of skin at least twice. (this can be purchased over the counter at any pharmacy).

 

No Stigma

Those who have acquired a community-acquired MRSA infection should not feel stigmatized by this infection, it was not your fault and ANYONE can get an infection. Many do not know where they were infected or colonized. It is rampant in the community and random. Touching an object at the grocery store could have given you the germ and infection. We are still at the infancy stage of this disease and we do not know why some people will get an infection and some will not, but it is not the fault of the victim. Covering your infection will protect others from being colonized or infected. We are at the stage that HIV/AIDS was 25 years ago and the public needs a lot of awarenss and education on MRSA.

MRSA Cellulitis

Cellulitis is a bacterial infection of the skin and lies between the tissue and skin. MRSA cellulitis is cellulitis that has been caused by the pathogen, MRSA. It is most often caused by staph but can be caused also by streptococci and less common by other bacteria.

Cellulitis can develop around a wound or surgical incision and can develop without an obvious source. It can occur anywhere on the body, but the lower legs are the most common site, followed by the arms, head and neck. Cellulitis tends to occur with patients that have conditions that lead to a breakdown of the skin.

Symptoms are:

• Redness
• Swelling
• Tenderness
• Fever may occur with chills, sweats and swollen glands
• Warmth and pain

Treatment

Antibiotics are usually prescribed to treat cellulitis and if the infection is in a small area and has not spread to the bloodstream or lymph system, oral antibiotics can be taken. If the infection has spread to a large area then IV antibiotics may be used or injected.

In mild cases, topical antibiotics in a cream may be administered.