Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
What is methicillin-resistant Staphylococcus aureus (MRSA)?
MRSA stands for methicillin-resistant Staphylococcus aureus (S. aureus)
bacteria. This organism is known for causing skin infections in addition to many other types of infections. There are other designations in the scientific literature for these bacteria according to where the bacteria are acquired by patients, such as community-acquired MRSA (also termed CA-MRSA or CMRSA), hospital-acquired or health-care-acquired MRSA (also termed HA-MRSA or HMRSA), or epidemic MRSA (EMRSA). Statistical data suggest that as many as 19,000 people per year have died from MRSA in the U.S.; data supplied by the CDC in 2010 suggest this number has declined by about 28% from 2005 to 2008, in part, because of prevention practices at hospitals and home care.
Although S. aureus has been causing infections (Staph infections) probably as
long as the human race has existed, MRSA has a relatively short history. MRSA
was first noted in 1961, about two years after the antibiotic methicillin was
initially used to treat S. aureus and other infectious bacteria. The resistance
to methicillin was due to a penicillin-binding protein coded for by a mobile
genetic element termed the methicillin-resistant gene (mecA). In recent years,
the gene has continued to evolve so that many MRSA strains are currently
resistant to several different antibiotics such as penicillin, oxacillin, and
amoxicillin (Amoxil, Dispermox, Trimox). HA-MRSA are often also resistant to tetracycline (Sumycin), erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone), and
clindamycin (Cleocin). In 2009, research showed that many antibiotic-resistant genes and
toxins are bundled and transferred together to other bacteria, which speed the
development of toxic and resistant strains of MRSA. S. aureus is sometimes
termed a "superbug" because of
its ability to be resistant to several antibiotics.
What does a MRSA infection look like?
In addition, these organisms have been termed "flesh-eating bacteria" because of their occasional rapid spread and destruction of human skin. Additionally, a number of older (2004-2008)
web and popular press articles are titled or include the erroneous term "MRSA virus." This is a misnomer that has confused many people; there is no contagious MRSA virus, and if readers examine these articles, they may realize the content is usually about MRSA bacteria.
Unfortunately, MRSA strains of bacteria can be found worldwide. In general, healthy people with no cuts, abrasions, or breaks on their skin are at low risk for getting infected. However, the bacteria can be passed from person to person by direct contact with infected skin, mucus, or droplets spread by coughs in both adults and children. Indirect contact also can spread the bacteria; for example, touching items like towels, utensils, clothing, or other objects that have been in contact with an infected person can spread the bacteria to other uninfected individuals. Investigators estimate that about one out of every 100 people in the U.S. are colonized with MRSA (have the organisms in or on their body but not causing infection), and these individuals may transmit MRSA bacteria to others by the same methods listed above. Another term for people colonized with MRSA is "carrier" which means the person carries the organism in or on the body and may transfer the organism to another person
who subsequently may become infected. A common place for carriers to harbor MRSA organisms is the nose.
What does a MRSA infection look like?
On the skin, MRSA infection may begin as a reddish rash with lesion(s) that looks like a pimple or small boil. Often it progresses to an open, inflamed area of skin (as pictured below) that may weep pus or drain other similar fluid. In some instances, it may appear as an abscess, a swollen, tender area, often with reddish skin covering. When the abscess is cut open or spontaneously bursts open, pus drains from the area (see Figure 2). See the first web citation for more clinical MRSA pictures, or see the MRSA slideshow listed above.
Figure 2: Picture of a MRSA abscess. SOURCE: CDC/Bruno Coignard, MD; Jeff Hageman, MHS
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
A boil is a skin abscess, a collection of
pus localized deep in the skin. There are several different types of boils. Among them are the following: furuncle or
carbuncle, Cystic acne, Hidradenitis suppurativa, and Pilonidal cyst.
Staphylococcus or Staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness directly by infection or indirectly by the toxins they produce. Symptoms and signs of a Staph infection include redness, swelling, pain, and drainage of pus. Minor skin infections are treated with an antibiotic ointment, while more serious infections are treated with intravenous antibiotics.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
A sty (sometimes spelled stye) is a tender, painful red bump located at the base of an eyelash or on, inside, or under the eyelid, which is the result of an acute infection of the oil glands of the eyelid. Complications of a sty can be blepharitis and chalazion.
Cellulitis is an acute spreading bacterial infection below the surface of the skin characterized by redness, warmth, inflammation, and pain. The most common cause of cellulitis is the bacteria Staph (Staphylococcus aureus).
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Impetigo is a contagious skin infection caused by staph and strep bacteria. There are two types of impetigo: non-bullous and bullous. Symptoms of non-bullous impetigo include small blisters on the nose, face, arms, or legs and possibly swollen glands. Bullous impetigo symptoms include blisters in various areas, particularly in the buttocks area. Treatment involves gentle cleansing, removing the crusts of popped blisters, and the application of prescription-strength mupirocin antibiotic ointment.
Sepsis (blood poisoning) is a potentially deadly infection with signs and symptoms that include elevated heart rate, low or high temperature, rapid breathing and/or a white blood cell count that is too high or too low and has more than 10% band cells. Most cases of sepsis are caused by bacterial infections, and some cases are caused by fungal infections. Treatment requires hospitalization, IV antibiotics, and therapy to treat any organ dysfunction.
Vancomycin-resistant enterococci (VRE) infection is the most common type of infection acquired by patients while hospitalized. Patients at risk for VRE are those who are already ill, and hospitalized, including individuals with diabetes, elderly, ICU patients, kidney failure patients, or patients requiring catheters. Enterococci can survive for months in the digestive tract and female genital tract. Other risk factors for acquiring VRE include those how have been previously treated with vancomycin and combinations of other antibiotics. Treatment of VRE is generally with other antibiotics other than vancomycin. Prevention of VRE can be achieved by proper hand hygiene.
Burns are categorized by severity as first, second, or third degree. First degree burns are similar to a painful sunburn. The damage is more severe with second degree burns, leading to blistering and more intense pain. The skin turns white and loses sensation with third degree burns. Burn treatment depends upon the location, total burn area, and intensity of the burn.
The majority of spiders in the United States are harmless. Two exceptions include the black widow spider and the brown recluse spider. Symptoms of a harmless spider bite generally involve redness, irritation, and pain. alized symptoms of bites from black widow and brown recluse spiders may include: nausea and vomiting, fever, headache, abdominal pain, joint pain, and more. In general, a brown recluse spider bite or black widow spider bite may require medical attention. The information includes pictures of the brown recluse and black widow spiders for identification.
Gangrene may result when blood flow to a tissue is lost or not adequate to keep the tissue alive. There are two types of gangrene: wet and dry. All cases of wet gangrene are infected by bacteria. Most cases of dry gangrene are not infected. If wet gangrene goes untreated, the patient may die of sepsis and die within hours or days. Dry gangrene usually doesn't cause the patient to die. Symptoms of dry gangrene include numbness, discoloration, and mummification of the affected tissue. Wet gangrene symptoms include swelling, pain, pus, bad smell, and black appearance of the affected tissue. Treatment depends upon the type of gangrene and how much tissue is compromised by the gangrene.
Necrotizing fasciitis is also known as a flesh-eating bacterial infection, Fournier's gangrene, suppurative fasciitis, and necrotizing cellulitis. The disease is occasionally caused by fungi, but most cases are caused by bacteria that enter the skin through insect bites, cuts, puncture wounds, or surgical incisions. Symptoms include pain, redness, swelling, fever, chills, skin ulceration, bullae formation, black scabs, gas formation, and fluid draining from the site of infection. Treatment involves hospitalization, the use of intravenous antibiotics, and debridement of the necrotic tissue.
It's important to know whether you will breastfeed or bottle-feed your baby prior to delivery, as the breasts' ability to produce milk diminishes soon after childbirth without the stimulation of breastfeeding. Breast milk is easily digested by babies and contains infection-fighting antibodies and cholesterol, which promotes brain growth. Formula-fed babies actually need to eat somewhat less often since formula is less readily digested by the baby than human milk. This article explores the advantages and disadvantages of both forms of feeding.
Drug resistance (antimicrobial resistance) is the ability of bacteria, fungi, parasites, and viruses to grow, even in the presence of a drug that would normally kill it (or limit it's growth). Drug resistance is a growing problem, particularly for infections such as MRSA, VRE (vancomycin-resistant enterococci), tuberculosis, HIV, STDs, gonorrhea, flu, pneumonia, malaria, E. coli, salmonella, Campylobacter, which causes diarrhea and gastroenteritis. Learn how to protect yourself from resistance to drugs.
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