MRSA Infection (cont.)

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What is the prognosis (outlook) of a MRSA infection?

The prognosis of MRSA infections depends on the severity of the infection when first diagnosed, the overall condition of the patient, and the patient's response to appropriate treatments and supportive treatments, if needed. Mild to moderate skin infections (boils, small abscesses) in patients with otherwise good health almost always have a good prognosis with full recovery if treated appropriately. However, patients with more severe disease and/or additional health problems (for example, diabetes, immunocompromised status, infected trauma wound) or those who acquire MRSA in an ICU or hospital while recovering from another problem have prognoses that vary from good to poor. MRSA pneumonia or sepsis has a death rate of about 20%. In addition, patients that are treated and do well still have a high risk of recurrent infection that may vary from 20%-40%. In addition, treatment with multiple antibiotics can lead to other infections such as pseudomembranous colitis caused by Clostridium difficile.

How can people prevent a MRSA infection?

Not making direct contact with skin, clothing, and any items that come in contact with either MRSA patients or MRSA carriers is the best way to avoid MRSA infection. In many instances, this situation is simply not practical because such infected individuals or carriers are not immediately identifiable. What people can do is to treat and cover (for example, antiseptic cream and a Band-Aid) any skin breaks or wounds and use excellent hygiene practices (for example, hand washing with soap after personal contact or toilet use, washing clothes that potentially came in contact with MRSA patients or carriers, and using disposable items when treating MRSA patients). Also available at most stores are antiseptic solutions and wipes to both clean hands and surfaces that may contact MRSA. These measures help control the spread of MRSA.

Pregnant women need to consult with their doctors if they are infected with or are carriers of MRSA. Although MRSA is not transmitted to infants by breastfeeding, there are a few reports that infants can be infected by their mothers who have MRSA, but this seems to be an infrequent situation. Some pregnant MRSA carriers have been successfully treated with the antibiotic mupirocin cream (Bactroban).

In 2007, the first incidence of MRSA in a pet was recorded. Although relatively rare, MRSA can be transferred between pets and humans. MRSA has been documented in dogs, cats, and horses but may be found in other animals in the future. Care and treatments are similar to those in humans, but a veterinarian should be consulted on all potential cases.

MRSA has been isolated from the environment (for example, beach sand and water), but there is no good documentation that people have become infected from these sources. Most authors suggest prevention methods should consist of a good soap and water shower after visiting the beach.

The CDC does not recommend (2012 guidelines) general screening of patients for MRSA. However, the CDC does recommend that high-risk patients who are being admitted to the hospital be screened for MRSA and then, if positive for MRSA, follow infection-control guidelines during the hospital stay. A recent study showed that the number of infections with both HA-MRSA and CA-MRSA has dropped since 2005-2008, and authorities speculate that such drops are due to infection-control measures in hospitals and better home-care measures (listed below).

Medically Reviewed by a Doctor on 12/11/2013

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