By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

PREVENTION BEST TREATMENT FOR MRSA AND OTHER STAPH INFECTIONS

Question: School has started again and there is concern about getting skin infections with MRSA at my school. They had some problems last year. Now, every kid with a pimple is getting sent home from school. That is quite a few in middle school. Is my school going overboard with this?

Answer: I am not sure if I can answer questions about your school’s policies, but I can give you information about MRSA. First, this abbreviation stands for Methicillin-resistant Staphylococcus aureus. What this means in plain English is that infections with this type of Staph bacteria are resistant to certain antibiotics. These antibiotics include methicillin, which is no longer used clinically, as well as amoxicillin, oxacillin and penicillin.

Staphylococcus aureus is a very common bacterium, and it lives on the skin and in the noses of over 25 percent of the population. These people are “colonized” with staph, which means the bacteria is present but not causing infection. Only about 1 percent of colonized people have the MRSA type of Staph.

Being such a common bacterium, it’s not surprising that Staph is the most common cause of skin infections. It can also cause potentially lethal infections such as pneumonia, wound infections and bloodstream infections. Of all Staph infections, about 12 percent are of the MRSA variety.

In the past MRSA was seen primarily in health care settings such as hospitals, nursing homes and dialysis centers. But in more recent years, MRSA has started showing up in the community at-large. This is called community-associated MRSA, or CA-MRSA. It can cause skin and soft tissue infections in otherwise healthy people who have no history of hospitalization in the last year. It has become near-epidemic within some community populations. These include prisoners, athletes who share equipment or personal items, and children in daycare facilities.

Like a regular Staph infection, CA-MRSA can appear as a boil or pimple. This is probably what your school officials are worried about.

While most Staph bacteria are easily killed with standard antibiotic therapy, there are fewer antibiotics that are effective against MRSA. Several common oral antibiotics continue to work against CA-MRSA, but these bacteria mutate frequently and may become harder to treat in the future.

CA-MRSA (or any Staph infection) can be spread by close skin-to-skin contact, openings in the skin such as scrapes and cuts, contaminated items, overcrowding and poor hygiene. As with many things, prevention is better than treatment. Many of these infections can be easily prevented by practicing good hygiene. This includes keeping your hands clean through regular washing or use of alcohol-based hand sanitizers, keeping scrapes and cuts covered and avoiding the use of other people’s towels or razors.

If you do get a Staph or CA-MRSA infection, it will usually respond to oral antibiotics. Sometimes with a boil or abscess, just draining the wound is enough to cure the infection. Either way, you should see a physician and practice good hygiene and wound care to prevent spread to others.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.