Q&A: Drug-Resistant Staph Infections

Hands being washed.

Experts recommend washing hands thoroughly with soap and water or using an alcohol-based hand sanitizer to prevent staph infections. Joe Raedle/Getty Images hide caption

itoggle caption Joe Raedle/Getty Images

Expert Advice on Preventing Staph Infections

  

Experts recommend practicing good hygiene. That includes:

  

- Washing your hands thoroughly with soap and water or using an alcohol-based hand sanitizer.

  

- Cleaning and covering cuts and scrapes until they are healed.

  

- Avoiding contact with other people's wounds and bandages.

  

- Avoiding sharing personal items such as toothbrushes, razors and towels.

MSRA infections have garnered much news coverage recently because of the release of the first nationwide study of the bacterium published in the Journal of the American Medical Association.

The study, conducted in 2005, showed a surprisingly high number of MRSA infections, which are a type of staph infection. This type of infection was found to be three times more prevalent than previously believed.

Recent studies are also showing that the germ is continuing to evolve into strains that are resistant to even more antibiotics.

Here are some answers about MRSA:

What is MRSA?

MRSA stands for methicillin-resistant Staphylococcus aureus. Staph is a common bacterium, present on the skin or in the noses of about 20 percent to 30 percent of the population. It's usually nothing to worry about. MRSA is a strain of staph that has become resistant to treatment with antibiotics, including penicillin, amoxicillin, oxacillin, methicillin and others. That makes MRSA harder to treat than regular staph infections.

What do staph and MRSA look like?

Both often start out as mild infections on the skin, showing up as pimples or boils. Infections with garden-variety staph are easily treated in most cases. Both staph and MRSA can cause more serious skin infections or they can lead to pneumonia or infections of the bloodstream, urinary tract or the lining of the brain. Surgical wounds are often prime targets for these germs.

How do you catch MRSA?

MRSA is nearly always connected to health care facilities. Most people who have MRSA have been hospitalized within the past year, or they've gotten treatment in an outpatient facility or nursing home. People can acquire MRSA in health care facilities but not show any signs of infection for weeks or months.

But in recent years, MRSA has spread beyond these facilities into places where people are in close contact, such as athletic facilities. The Centers for Disease Control and Prevention (CDC) estimates that about 15 percent of MRSA cases in the United States occur outside health care settings.

Skin-to-skin contact with a person who carries MRSA is believed to be the most common way people get MRSA in the community. In this situation, people who are otherwise healthy may get a skin infection with MRSA. It's also possible to get MRSA from surfaces that are contaminated with the germ, but this is less likely than person-to-person contact.

Who is at risk for MRSA?

The CDC says it has investigated clusters of MRSA skin infections among athletes, military recruits, children, men who have sex with men, and prisoners. Risk factors include close skin-to-skin contact, openings in the skin such as cuts or abrasions, crowded living conditions and poor hygiene.

What about schools?

Recommendations for preventing infections in schools focus on good hygiene. Cleaning regimens vary from district to district. The CDC says that in most cases, it is not necessary to close schools because a student has an MRSA infection. Covering infections will greatly reduce the risks of surfaces becoming contaminated. The CDC says the only surfaces that need to be cleaned are those that have been recently touched by someone with MRSA. "In general," the CDC says, "it is not necessary to close schools to 'disinfect' them."

What about health clubs?

The CDC says that the environment has not played a significant role in MRSA outbreaks, but it advises that you always practice good hygiene. At health clubs, this would include showering after working out and using a barrier such as clothing or a towel between your skin and shared equipment. The CDC also recommends wiping surfaces of equipment before and after use.

Why the sudden outbreak of MRSA?

There hasn't been a sudden increase. Drug-resistant staph germs have been spreading across the country for years now, causing deaths from time to time. In the JAMA study published last fall, the CDC estimated that 94,000 Americans get potentially life-threatening MRSA infections every year. That's three times the previous estimates and came as a surprise to many people.

How is MRSA treated if it is resistant to antibiotics?

So far, MRSA is not resistant to all antibiotics. Vancomycin is one treatment. If your doctor prescribes an antibiotic, take the whole prescription — stopping too soon can cause bacteria to become resistant to that antibiotic.

What is the new resistant staph being reported in gay communities?

It's a variant of the MRSA that's spreading nationally. It's resistant to more antibiotics than regular MRSA — not just penicillin-type drugs like methicillin but also clindamycin, erythromycin and mupirocin. The new strain is called multiply drug-resistant MRSA (MDR-MRSA).

The strain has caused serious infections in hundreds of people so far, mostly in the gay communities of San Francisco, Boston, Los Angeles and New York. Doctors say these infections are more fast-moving, so any delay in recognizing them and treating them with the right antibiotic can cause life-threatening infections.

Researchers think many of the infections so far have been transmitted during sexual activity. But MDR-MRSA is spread through skin-to-skin contact and sometimes by contaminated surfaces or shared towels. So anyone can get infected. The precautions are the same — frequent and thorough washing, and immediate attention to any boils or painful rashes.

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