Community-Acquired Antibiotic-Resistant Staph Infection (CA-MRSA)

________________________________________________________________________

KEY POINTS

• Methicillin-resistant staphylococcus, or MRSA, is a type of staph infection that is hard to treat with most antibiotics. You may get infected after coming in contact with someone who has an infected wound or after sharing personal items that have been in contact with an infected wound.
• Treatment depends on how serious your symptoms are. You may need to be in the hospital to get IV fluids and antibiotic medicine to treat the infection.
• Ask your healthcare provider how long it will take to recover, when you can return to your normal activities, and how to take care of yourself at home.

________________________________________________________________________

What is antibiotic-resistant staph infection?

Staphylococcus aureus, also called “staph,” is a common cause of skin infections. Most of the skin infections are minor (such as pimples and boils) and heal on their own without antibiotics. The widespread use of antibiotics has caused some of these bacteria to change and become resistant to antibiotics. Methicillin-resistant staphylococcus, or MRSA, is a type of staph that is very hard to treat with most antibiotics.

Most MRSA skin infections are community-acquired. This means that you get infected after coming in contact with someone who has an infected wound or sharing personal items, such as razors or towels, that have been in contact with an infected wound.

Sometimes MRSA infects the blood, urinary tract, lungs, or surgical wounds and cause very serious illness. Community-acquired MRSA infections are less likely to cause serious blood infections than hospital-acquired infections.

What is the cause?

MRSA infections are easy to spread because many people have the bacteria on their skin or in their nose without being sick. You are more likely to get a MRSA infection if you:

• Have close skin-to-skin contact with someone who has the bacteria on their skin
• Have openings in your skin, like cuts or scrapes
• Live in crowded conditions, such as prison, military housing, or dorm rooms
• Have poor hygiene, such as if you don’t shower or take a bath every day
• Share towels, soap, or football pads or other sports equipment. Children may be infected by sharing toys.

Taking antibiotics when you don’t need them can cause problems for you and others. Bacteria can change and become resistant to antibiotics. This means that some types of antibiotics may no longer be able to kill the bacteria.

What are the symptoms?

When staph infects the skin, it may look like a pimple or boil. The skin may be red, swollen, or painful. You may have pus or other drainage. The infection may look like a rash, with redness and oozing or crusting.

If the infection gets inside your body, especially if it gets into the bloodstream, the symptoms can be more serious and very different, depending on where the infection is. Symptoms of serious infection may include:

• High fever
• Pain at the site of the infection
• Trouble breathing
• Confusion
• Very low blood pressure
• Loss of consciousness

If MRSA is not treated or cannot be treated because the bacteria are resistant to all antibiotics, it may cause death.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. If there is an outbreak of MRSA in your area, your provider will test you for MRSA. Pus from the infected wound will be tested to see if bacteria can be grown in the lab from the sample. If bacteria do grow in the lab, the bacteria will be tested to see which antibiotics can kill them.

How is it treated?

If you have a pimple or boil that is large or painful, your healthcare provider may drain the infected fluid from it by opening it with a sterile needle or scalpel. Draining skin boils should be done only by a healthcare provider. You may cause a serious problem or spread the infection if you try to do this yourself.

You will be given antibiotics to treat the infection. Take the medicine as prescribed. Not finishing your antibiotic may cause more resistant bacteria to develop. Do not share antibiotics with other people or save them for another time.

If you are very ill, you will need to be in the hospital. Treatment will include IV fluids and antibiotic medicine to treat the infection.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• If you are taking an antibiotic, take the medicine for as long as your healthcare provider prescribes, even if you feel better. If you stop taking the medicine too soon, you may not kill all of the bacteria and you may get sick again.
• Ask your healthcare provider if and how you should cover your wound.
• Wash your hands well with soap and water after caring for any wounds, even when you have used gloves.
• Put gloves, tissues, bandages, or other waste items soiled with blood or other body fluids in a separate bag from your regular trash. The bag should be sealed and leak-proof. For example, use 2 bags, putting one inside the other. Follow your local health department's instructions for disposing of waste products.
• Ask your provider if you should be putting warm compresses on the infected area or soaking it. If you use compresses, keep the cotton cloths or towels used for the compresses separate from other laundry. Wash all linens or clothing soiled with blood or other body fluids separately from other laundry. Use detergent and germicide. Follow your local health department's instructions for safe washing and disposal of the water.
• Bleach baths have been shown to help in treatment. Talk to your provider about how much bleach to use in the bath water. Be careful so that you do not splash water containing bleach onto your face or in your eyes. If you are doing soaks, for example in the bathtub, the tub should be cleaned right after your soak.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen for pain or fever. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
• Use separate towels for each family member, especially if someone has a rash. Consider single-use paper towels or hand wipes in the bathroom and kitchen; or change cloth hand towels every day. Do not share washcloths or towels in the bathroom or kitchen.
• Ask your provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent CA-MRSA?

To help prevent skin infections, practice good hygiene:

• Wash your hands often and especially after using the restroom, coughing, sneezing, or blowing your nose. Also wash your hands before eating or touching your mouth, nose, or eyes.
• Keep cuts and scrapes clean and covered with a clean, dry bandage until healed.
• Avoid contact with other people's wounds or bandages.
• Don’t share personal items, such as towels or razors.
• Shower after you work out at the gym or on the playing field. If you use shared athletic equipment such as helmets or pads, use a barrier, such as clothing or a towel, between your skin and the equipment. Wipe surfaces of equipment before and after use. See if you can find a way to use the same equipment with each practice rather than sharing.
• If a family member develops a large pimple or crusty rash that does not heal within a day or two, they should see their healthcare provider to learn whether it needs treatment for MRSA. Treating such infections right away helps prevent serious infections and keeps infection from spreading to other people.
• Do not overuse antibiotics. Take them only when needed and take them exactly as instructed. If you are having problems with an antibiotic, talk with your healthcare provider.
• Tell any providers who treat you that you have or had a staph or MRSA skin infection.