From Our 2007 Archives

MRSA: Experts Answer Your Questions

How to Identify MRSA Infections and Reduce Your Risk

By Salynn Boyles
WebMD Health News

Reviewed By Louise Chang, MD

Oct. 24, 2007 -- MRSA, the superbug that is resistant to many antibiotics, has been making headlines recently. This month, a CDC report said there were more deaths from MRSA in 2005 than from AIDS.

WebMD spoke with experts to get answers to nine common questions about MRSA.

What is MRSA?

MRSA stands for methicillin-resistant Staphylococcus aureus, a type of staph infection that is resistant to methicillin and other commonly used antibiotics in the same class, including penicillin, amoxicillin, and oxacillin.

What does an MRSA skin infection look like?

Picture of MRSA Infection
MRSA can be deadly if the infection
spreads to internal organs.

In otherwise healthy people with no recent history of hospitalizations, MRSA often appears as a pimple or boil that can be red, swollen, and painful. The lesion may also have pus or other drainage. Draining the lesion in the doctor's office may be the only treatment needed for localized skin infections, but doctors may also treat skin infections with oral antibiotics that are not resistant to the infection

What is health-care-associated MRSA?

A report issued earlier this month by the CDC concluded that nearly 19,000 people died from MRSA infections in 2005. Almost all of these deaths occurred among people with weakened immune systems who were being treated or had recently been treated in hospitals or other health care settings, including nursing homes and dialysis centers.

Health-care-associated MRSA can occur as surgical wound infections, bloodstream infections, and pneumonia. These life-threatening invasive infections are resistant to many, but not all, antibiotics. Roughly 5% of people treated in U.S. hospitals for MRSA died of the infection in 2005, according to a new report from the government's Agency for Healthcare Research and Quality.

Do I need to worry about MRSA if I am healthy and haven't been hospitalized recently?

Community-associated MRSA infections were first reported about a decade ago and are increasingly common, Virginia Commonwealth University infectious disease specialist Richard P. Wenzel, MD, tells WebMD. But fully 95% of these non-health-care-related infections are confined to the skin and soft tissue, he says.

CDC spokeswoman Nichole Coffin says community-associated skin infections are typically mild in nature. But she adds that in rare cases they can become life-threatening.

The point was illustrated by the death last week from MRSA of a previously healthy 17-year-old high school football player in Bedford, Va.

"We want people to take [MRSA] seriously, but we also want them to understand that most community-acquired infections are mild so that they can make an honest risk assessment."

Who is at risk for community-associated MRSA?

Outbreaks have been reported among athletes, prisoners, and military recruits; risk factors include sharing close quarters and personal hygiene products like razors or towels. Infections are increasingly being seen in the general community and have been reported in schools, gyms, and even day care centers.

While health-care-associated MRSA infections more typically occur among the elderly, the average age of a person with a community-associated infection is 23, according to one study.

How can I protect myself from MRSA?

Close skin-to-skin contact, cuts and abrasions in the skin, contact with contaminated objects, and living in crowded conditions have all been associated with the spread of MRSA, according to the CDC.

Some of the best ways to keep from getting or spreading the infection include:

  • Frequent and thorough hand washing. Experts recommend washing your hands for as long as it takes to slowly recite the alphabet.
  • Covering cuts and scrapes with a clean bandage.
  • Do not touch other people's wounds or bandages.
  • Do not share personal items like towels or razors, and wipe down surfaces you come into contact with at the gym or in a locker room.

I will be entering the hospital soon for a surgical procedure. What can I do to minimize the risk that I will be infected with MRSA or another hospital-acquired infection?

One of the most important steps a patient can take is to make sure doctors, nurses, support staff, and visitors wash their hands or use a hand sanitizer prior to touching them, Coffin says.

"Patients shouldn't be afraid to speak up and be active participants in their health care," she says.

Patients or patient advocates should also ask health care providers what is being done in the hospital to prevent MRSA and other types of hospital-acquired infections, she says.

Late last year, the CDC issued guidelines designed to reduce the spread of multidrug-resistant bugs in the nation's hospitals and other health care settings.

"The bottom line is we think a comprehensive approach is needed, and every [health care facility] should have a program in place," Coffin says. "The goal for everyone should be to get these infection rates down. If the interventions aren't doing this, they need to do more."

How common is invasive MRSA?

It has been hard to get a handle on the magnitude of MRSA infections in the nation's health care settings, but two recent reports have shed some light on the issue.

One study estimated that for every 1,000 patients treated in U.S. hospitals, 46 cases of MRSA occur. The figure was 11 times higher than previous estimates.

In a CDC report, published earlier this month, researchers estimated that just over 94,000 cases of life-threatening MRSA infection occurred in 2005, with nearly 19,000 of these cases leading to death.

Does having HIV infection affect MRSA risk?

According to the CDC, people with weakened immune systems, including HIV infection, may have more severe illness if they become infected with MRSA. People with a weakened immune system should follow the same preventive measures to prevent being infected, including washing their hands frequently, covering wounds with bandages, and refraining from sharing personal hygiene items.

SOURCES: Flannery, B. Alcoholism: Clinical and Experimental Research, May 2007; vol 31: pp 745-754. Barbara Flannery, PhD, research psychologist and senior scientist, RTI International, Research Triangle Park, N.C. James C. Garbutt, MD, professor of psychiatry, Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill. Hommer et al. Alcoholism: Clinical and Experimental Research 20 (Suppl. 2):33A, 1996. DeBellis American Journal of Psychiatry, 2000; vol157: pp 737-744. National Institute on Alcohol Abuse and Alcoholism (NIAAA) web site "Alcohol- An Important Women's Health Issue."

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