MRSA, “The Anti-Biotic Resistant Staph Infection”. Natura Dermatology & Cosmetics Helps You Understand MRSA And How To Avoid Becoming Infected.
Managing CA-MRSA “The Dermatologist” Journal
Community-acquired methicillin-resistant Staphyloccus aureus (CA-MRSA) is the most common infection in the United States, and is most prevalent in the US worldwide. MRSA was first identified in 1961, when methicillin was first introduced. At that time, MRSA was initially found in hospitals, nursing homes, and long term facilities. However, in the 1990s, healthy individuals, such as athletes, children, military recruits, and prisoners were being affected. This led to the identification of CA-MRSA. Any individual regardless of background or exposure can acquire CA-MRSA.
CA-MRSA often leads to skin infections which cause boils and abscesses. These infections typically begin with single or multiple forms of erythematous pustular skin lesions that will progress into painful, swollen, and draining abscesses. Often times, these infections spread and develop into a cellulitis and can cause systemic effects.
MRSA at the end of the day is a staph infection. But what makes it more challenging to treat is the “resistance” to the typical antibiotics used to treat this type of bacteria. Clindamycin (Cleocin), doxycylcine (Monodox), tigecycline (Tygacil), trimethoprim-sulfamethoxazole (Bactrim, TMP-SMX) and vancomycin (Vancocin) are common antibiotics that physician’s will prescribe. Clindamycin and doxycline are FDA-approved to treat serious infections caused by staph, but side effects of resistance and gastrointestinal problems make the antibiotics a less attractive choice. Tigecycline, a derivative of the tetracyclines, is also FDA-approved to treat skin and soft tissue infections, but it is not recommended for the treatment of patients with bacteremia, or presence of bacteria in the blood. TMP-SMX is a valuable choice for CA-MRSA. Although it is not FDA-approved for treatment of staph infection, 95% to 100% of MRSA strains have been susceptible to the bacteria, and risk of resistance is low. Lastly, vancomycin is the mainstay of parenteral therapy, however it is typically reserved for multi-resistant MRSA strains and severe systemic infections.
Incision and drainage is the cornerstone of therapy. It is typically done in conjunction with oral antibiotics, but may also be done alone. The physician will lance the abscess and drain the collection of pus. By getting the pus out, you are also removing the bacteria. In addition, the application of heat will also allow the abscess to drain.
Prevention is the key role in the battle against CA-MRSA. For patients that have recurrent staph infections, physicians will often recommend bleach baths. A half of cup of bleach in a full bathtub for 10 minutes will bring the bacterial count down on the skin. Bacteria, in particular staph, will colonize in warm, dark moist places of the body. Mupirocin ointment is commonly prescribed and instructed to apply the nose, peri-anal, axilla, and groin areas three times daily for 5 days in an effort to decolonize the bacteria. It is common to find that family members will spread the infection amongst each other due to close interaction. It is helpful to break the cycle of the infection being spread from one to another by prophylactically disinfecting the skin and apply antibiotic ointment in the nose for about a week.
Proper hand hygiene is the first step in prevention. There is conflicting views on which is better: 20-second to 30-second hand washing versus hand sanitizers. The use of antiseptic products can be an effective substitute for washing with soap and water if the product is used properly. In any event, it is important for healthcare professionals to be conscientious about the products that they use, and that both providers and patients make an effort to practice good hand hygiene in the attempt to decrease the prevalence of CA-MRSA.
Founded in 2006, Natura Dermatology & Cosmetics is wholly owned by Will Richardson, MD FAAD one of Fort Lauderdale’s premiere dermatologists. We offer a variety of procedures including skin checks, general dermatology and cosmetic dermatology at both our Fort Lauderdale and Coconut Creek offices. For more information, please visit our website, www.naturadermatology.com or contact our office at 954.537.4106 and speak to one of our friendly appointment specialists.