Drug-Resistant Staph Is Here

MRSA Bacteria Now Most Common Skin Infection Seen in Urban ERs

By Daniel DeNoon
WebMD Health News

Reviewed By Louise Chang, MD
on Wednesday, August 16, 2006

Aug. 16, 2006 - Drug-resistant staph is now the most common skin infection seen in city emergency rooms, a nationwide study finds.

And the drug resistant germ is no longer linked to just special risk groups, such as prisoners and athletes.

Known as community acquired MRSA -- methicillin-resistant Staphylococcus aureus -- it's now truly out there in U.S. communities.

UCLA researchers Gregory J. Moran, MD, David Talan, MD, and colleagues, looked at 422 people who showed up in 11 city emergency rooms with skin or soft tissue infections in August 2004.

Despite the current prevalence of MRSA, more than half the patients -- 57% -- were initially treated with antibiotics that don't kill the bacteria.

"Doctors need to change what they've done for decades," Talan said in a news release. "Traditional antibiotics don't work against MRSA."

Fortunately, there are several antibiotics still effective against drug-resistant staph. And even without antibiotics, many people get better after having their boils or abscesses cut open and drained.

The study appears in the Aug. 17 issue of The New England Journal of Medicine.

Spider Bite? Not

People with MRSA skin infections often think a spider has bitten them. That's because the infection often starts out as a painful red swelling, soon becoming a pus-leaking boil or abscess.

That pus is full of MRSA bugs. It's a very contagious infection.

It's easy to spread MRSA from one part of the body to another -- or from one person to another.

So it comes as no surprise the things MRSA-infected patients most often have in common is close contact with someone else with an MRSA infection, or having had one before.

Other common risks: reporting a "spider bite" and haven taken an antibiotic in the last month.

Infected Sites

Arm and leg infections accounted for more than half the MRSA infections seen in the study. The torso was infected in 17% of patients, the perineum (the area between the genitals and the anus) in 14%, and the head/neck area in 13%.

The 11 cities studied were Albuquerque; Atlanta; Charlotte, N.C.; Kansas City, Mo.; Los Angeles; Minneapolis; New Orleans; New York; Philadelphia; Phoenix, Ariz.; and Portland, Ore.

The good news: While MRSA is a serious infection that can leave a nasty scar, all the patients in the study got better.

The bad news is that MRSA doesn't always cause skin infections. It can also cause sometimes-deadly pneumonia or blood infections.

What to Do

Here's the CDC's advice on how to fight MRSA:

  • If you've got an infected wound or pus-filled boil, see your doctor.
  • Carefully follow your doctor's advice on how to care for your wound.
  • Cover skin infections -- especially those with pus -- with clean, dry bandages. Pus from skin infections and infected wounds spread staph to other people.
  • If you have a skin infection or infected wound, tell your family and other close contacts to wash their hands often with soap and warm water. Remember to wash properly: Scrub your hands and fingers while saying the alphabet slowly. Don't stop until you get to Z.
  • Don't share personal items -- including towels, washcloths, razors, or clothing -- that may have come into contact with an infection. Wash bed linens, towels, and clothing in hot water and laundry detergent. Dry these items in a hot dryer, not on the clothesline.
  • If you have MRSA, tell any doctor who treats you that you have an antibiotic-resistant infection.
  • If your doctor gives you antibiotics for a skin infection, be alert for signs of treatment failure. If you get any new boils, sores, or new infections, call your doctor. If your fever gets worse -- or if you get a new fever -- call your doctor. If your infection doesn't look a little better after three or four days, call your doctor. Remember to take all your medicine as prescribed, even if you seem to be better.

The germs you leave alive today are tomorrow's drug-resistant bugs.

SOURCES: Moran, G. The New England Journal of Medicine, Aug. 17, 2006; vol 355: pp. 666-674. News release, UCLA. CDC web site.

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