MRSA Infection (cont.)
Charles Patrick Davis, MD, PhD
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
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.
In this Article
- MRSA infections facts
- What is methicillin-resistant Staphylococcus aureus (MRSA)?
- What does a MRSA infection look like?
- What are the risk factors for MRSA infections?
- What are the signs and symptoms of a MRSA infection?
- How is a MRSA infection transmitted or spread?
- How is a MRSA infection diagnosed?
- How should caregivers treat MRSA patients at home?
- What is the treatment for a MRSA infection?
- What is the prognosis (outlook) of a MRSA infection?
- How can people prevent a MRSA infection?
- What are the potential complications of a MRSA infection?
- What is a "superbug"?
- Where are other MRSA information sources?
- Pictures of MRSA - Slideshow
- Take the MRSA Quiz!
- Pictures of Staph Infection - Slideshow
- MRSA Infection FAQs
- Find a local Infectious Disease Specialist in your town
How should caregivers treat MRSA patients at home?
The CDC states that healthy caregivers are unlikely to become infected while caring for MRSA patients at home if they do the following:
- Caregivers should wash their hands with soap and water after physical contact with the infected or colonized person and before leaving the home.
- Towels used for drying hands after contact should be used only once.
- Disposable gloves should be worn if contact with body fluids is expected, and hands should be washed after removing the gloves.
- Linens should be changed and washed on a routine basis, especially if they are soiled.
- The patient's environment should be cleaned routinely and when soiled with body fluids.
- Notify doctors and other health-care personnel who provide care for the patient that the patient is colonized or infected with a multidrug-resistant organism.
What is the treatment for a MRSA infection?
As stated by the U.S. Centers for Disease Control and Prevention (CDC):
- "First-line treatment for mild abscesses is incision and drainage."
- "If antibiotic treatment is clinically indicated, it should be guided by the susceptibility profile of the organism." When the tests are run to determine that the staph bacteria isolated from a given patient are methicillin-resistant, these tests also provide information about which antibiotics can successfully kill the bacteria (its susceptibility profile)."
Fortunately, many MRSA infections still can be treated by certain specific antibiotics (for example, vancomycin [Vancocin], linezolid [Zyvox], and others, often in combination with vancomycin). Most moderate to severe infections need to be treated by intravenous antibiotics, usually given in the hospital setting. Some CA-MRSA strains are susceptible to trimethoprim-sulfamethoxazole (Bactrim), doxycycline (Vibramycin), and clindamycin (Cleocin); although reports suggest clindamycin resistance is increasing rapidly. In addition, some strains are now resistant to vancomycin. In 2011, researchers developed a chemical change in the antibiotic vancomycin that rendered vancomycin-resistant MRSA susceptible to the drug. It is not available commercially, but this discovery, along with ongoing research, is important because it may expand treatment possibilities for MRSA and other drug-resistant bacteria such as VRE (vancomycin-resistant enterococci). Another drug, Teflaro, has been approved for treatment by the FDA for MRSA infections.
A good medical practice is to determine, by microbiological techniques done in a lab, which antibiotic(s) can kill the MRSA and use it alone or, more often, in combination with additional antibiotics to treat the infected patient. Since resistance can change quickly, antibiotic treatments may need to change also. Many people think they are "cured" after a few antibiotic doses and stop taking the medicine. This is a bad decision because the MRSA may still be viable in or on the person and thus is capable of reinfecting the person or others. Also, the surviving MRSA may be exposed to low antibiotic doses when the medicine is stopped too soon; this low dose may allow MRSA enough time to become resistant to the medicine. Consequently, MRSA patients (in fact, all patients) treated with appropriate antibiotics should take the entire course of the antibiotic as directed by their doctor. A note of caution is that, in the last few years, there have been reports of a new strain of MRSA that is resistant to vancomycin (VRSA or vancomycin-resistant S. aureus) and other antibiotics. Currently, VRSA is detected more often than a few years ago, but if it becomes widespread, it may be the next superbug.
The CDC recommends clinicians use the 2011 guidelines published by the Infectious Diseases Society of America (IDSA) that details treatments. The 38-page set of guidelines can be found at http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/MRSA.pdf.
Research is ongoing; in 2013, new discoveries about the bacterial cell wall configuration are leading researchers to try new drugs that may breach this protective area and cause the MRSA bacteria to be susceptible to certain antimicrobial drugs.
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