BISD News
What You Need to Know About MRSA
Recently, doctors in Texas have been seeing an increasing number of patients with skin infections caused by Staphylococcus aureus ("staph") bacteria that are resistant to many antibiotics, also called methicillin-resistant Staphylococcus aureus - "MRSA".
MRSA is a common bacterium found on people. Up to 30% of the population are unwilling carriers of this bacterium. Because staph bacteria grow best in warm, moist environments, people tend to carry staph in their nose, armpits, groin, and skin folds. Carriers have no symptoms but are at increased risk for MRSA infections if they have a break in their skin. MRSA lesions commonly present as a spider or insect bite that develops into an abscess. MRSA cannot be treated with the usual antibiotic of choice for treating staph infections; therefore, a physician must evaluate any suspicion of an infection.
Symptoms of Staph Infections
The symptoms of a staph skin infection depends on where the infection is. The staph bacteria can cause:
- boils - an abscess within the skin. Also called a furuncle.
- cellulitis - a localized skin infection which can make the skin red, painful, and warm
- folliculitis - an infection of hair follicles
- impetigo - causes blisters (bullous impetigo) or honey colored crusted lesions on the skin
- paronychia - an infection of the skin folds of the nails
In addition to skin infections, the staph bacteria can cause:
- bacteremia - a blood infection
- deep abscesses - a collection of pus somewhere inside the body
- endocarditis - an infection on the valves of the heart
- food poisoning
- lymphadenitis - an infection of a lymph gland, which causes it to be red, swollen, and painful
- lymphangitis - an infection of the lymph channels that drain to lymph glands, causing red streaks in the skin
- osteomyelitis - a bone infection
- scalded skin syndrome
- septic arthritis - an infection of a joint, like the hip or knee
- styes - an infection of the glands on the eyelid
- toxic shock syndrome
The Staphylococcus aureus bacteria can also less commonly cause other infections, including pneumonia, ear infections, and sinusitis.
Diagnosis
The diagnosis of most skin infections is made by the pattern of symptoms and physical exam findings. However, it is not usually possible to know whether the infection is caused by the staph bacteria or another bacteria, like group A Beta-hemolytic streptococcus (Streptococcus pyogenes). And in many cases, it doesn't matter, as the antibiotic your child is prescribed will likely treat both bacteria. To make a definitive diagnosis and to confirm that staph is the bacteria causing the infection, a culture can be done.
Treatments
Antistaphylococcal antibiotics are the usual treatments for staph infections. This may include a topical antibiotic cream for simple impetigo, warm compresses and drainage for abscesses, an oral antibiotic, or an intravenous antibiotic for more serious or persistent infections.
As resistance to antibiotics is now common among staph bacteria, including MRSA, or methicillin resistent staph aureus, the first antibiotic your child is prescribed may not work. Many of these community acquired MRSA infections can still be treated with oral antibiotics though. More serious and multi-drug resistent MRSA can usually be treated in the hospital with the antibiotic vancomycin.
What You Need To Know
The S. aureus bacteria commonly lives on or colonizes the skin of children and adults. It is especially common to find it in the nose, which can make it easily spread as children pick their nose.
To get rid of staph colonization, it can help to treat all family members with mupirocin (Bactroban) nasal gel twice a day for 5-7 days, daily Hibiclens (an Antiseptic, Antimicrobial Skin Cleanser) baths, and encourage very frequent handwashing. Although it can be uncomfortable for your child, having your Pediatrician drain an abscess can be the best way to get rid of the infection.
Keep bites, scrapes, and rashes clean and covered to prevent them from getting infected by the staph bacteria.