This past summer, a fourteen-year-old came to my adolescent health center complaining of a blistering rash. “Is this the ‘super-bug?’” his trembling Mom cried out. “No,” I reassured her, “it is merely a case of poison ivy.” Many sighs of relief.
As the director of a large ambulatory network in the metropolitan New York region, I hear, on a daily basis questions like:
- Is this “super-bug” new?
- How can I prevent catching this killer strain?
- Should my school shut down since they found MRSA (Methicillin-resistant Staphylococcus aurues) there?
- Is there any treatment for it?
The Facts
The so-called Methicillin-resistant Staph germ (MRSA) has been around for many, many years. Like the “flesh-eating” hysteria of last year, there are myths and truths that may help to set the record straight.
- Staphylococcus aureus (“staph”) is a common germ (i.e. bacterium) that is carried on the skin or in the nose of approximately 30 percent of healthy people. Most never develop any symptoms or illness. Staph is a leading cause of skin and soft tissue infection and when an infection does occur, it is usually mild and without consequence.
- Infrequently, staph infections may go deeper to form a boil or abscess. Such so-called “invasive” staph infections are different from skin and soft tissue infections and are more serious.
- Methicillin-resistant Staphylococcus aureus (MRSA) is a type of staph which is resistant to some of the antibiotics that typically have been used to treat skin and soft tissue infections. Although commonly and historically found in hospitalized patients, “community acquired” MRSA (CA-MRSA) is showing up outside of hospitals. Although an intuitive link exists between hospital-acquired and community-acquired MRSA, the jury is still out on this causal relationship. As is MRSA, CA-MRSA is resistant to methicillin and other penicillin type antibiotics such as amoxicillin and the cephalosporins, but there are medications which are effective—including vancomycin, clindamycin, and trimethoprim-sulfamethoxazole.
How does CA-MRSA spread?
Staph infections are spread by direct physical contact with the bacteria, almost always person-to-person, but can be spread through contact with contaminated surfaces, personal items, or equipment. Spread of staph infections may occur through skin-to-skin contact when playing sports, such as football or wrestling, or from surfaces in gyms and locker rooms.
Can CA-MRSA be Treated?
Staph infections are treatable. The treatment may include drainage of the infection site and/or treatment with antibiotics as mentioned earlier. Again, there are antibiotics available for all forms of staph infections, including MRSA and CA-MRSA.
Top Three Methods of Prevention
1. Washing hands
2. Washing hands
3. Washing hands
Although medicine is advancing at amazing speed, time-proven, basic washing of one’s hands with warm water and soap (for fifteen to twenty seconds) has been scientifically proven to be the best method to prevent common viral illnesses such as influenza and gastroenteritis—as well as bacteria including staph, MRSA, and CA-MRSA. Washing hands is obviously extremely important at critical points such as after using a toilet, changing a baby, or handling raw foods. But don’t forget to wash hands more than usual during the winter months.
The Soap: Regular or Antibacterial?
- So-called “antibacterial soaps” (i.e. those containing “triclosan”) are no more effective than plain soap and water for killing disease-causing germs. In fact, there is evidence that “antibacterial” soaps may cause come bacteria to become resistant to widely used antibiotics such as amoxicillin.
- If soap is not available, alcohol-based sanitizers should be used. (Editor’s note: just be mindful how much you use and keep bottles out of reach of young children at all times. See: Danger with Sanitizer Gel Use
What’s a Parent to Do?
- Remember … good hygiene is the best prevention! Children should be encouraged to wash their hands frequently with warm water and soap. Parents should educate children about the importance of hand washing, particularly after nose-wiping.
- Skin cuts, scrapes, or breaks should be kept clean and dry to minimize the chance of developing an infection. Proper bandages should be used and changed daily or more frequently, if necessary, to keep all infected wounds clean and covered.
