Marion County MO Health Department and Home Health Agency.  Located in Hannibal, Missouri  
Marion County MO Pubic Health Services
Marion County MO Pubic Health Services  


Community Acquired MRSA
(Methicillin–resistant Staphylococcus aureus)

  1. Definition
    1. Historical Perspective
      1. Staphylococcus aureus
        1. Commonly carried on the skin of healthy people
        2. One of the most common causes of skin infections
      2. Methicillin–resistant Staph. aureus (MRSA)
        1. Antibiotics such as methicilin, oxacillin, and penicillin do not work against this organism
        2. MRSA infections occur most frequently among persons in hospital and healthcare facilities who have weakened immune systems. These infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia
      3. Community–acquired MRSA
        1. Antibiotics such as methicilin, oxacillin, and penicillin do not work against this organism
        2. More antibiotics are useful against this strain
        3. More toxins make it more invasive and it has an enhanced capability to evade natural defenses
        4. Illness is caused in persons outside of hospital and healthcare facilities, otherwise healthy individuals
        5. Manifests as skin or soft tissue infections such as pimples and boils
  2. Risk Factors
    1. Athletes
      1. St. Louis Rams
      2. Pennsylvania college football team
      3. Los Angeles college football team
      4. Indiana high school wrestling team
      5. Colorado fencing club
    2. Military recruits
    3. Children (Day Care)
    4. Pacific Islanders
    5. Alaskan natives
    6. Native Americans
    7. Men who have sex with men
    8. Prisoners
    9. Methamphetamine users
    10. Spider bites

  3. Contributing Factors
    1. Close skin–to–skin contact
    2. Openings in the skin such as cuts, rashes or abrasions
    3. Contaminated items and surfaces
    4. Crowded living conditions
    5. Poor hygiene

  4. Incidence
    1. A study in Texas showed that 75% of Staph. infections in the children there were identified as methicillin–resistant
    2. The number of MRSA infections in children more than doubled between 2000 and 2003
    3. More than 60% of these cases were admitted to the hospital and some died

  5. Presentation
    1. Begin abruptly
    2. May develop a large redness on the skin, swelling and pain
    3. A pustule or abscess might develop, or boils and carbuncles (red, lumpy sores filled with pus)
    4. Some have pneumonia or shock symptoms
    5. Initial treatment may not work and symptoms may progress with increased pain and spreading inflammation and may involve the bloodstream and organs

  6. Prevention
    1. Clean your hands frequently with soap and water or alcohol–based hand sanitizer, especially after changing the bandage or touching the infected wound
    2. Cover skin break, cut, abrasion, rash or wound
      1. A bandage will prevent bacteria from getting in.
        1. If infected wounds cannot be covered adequately, consider excluding players with potentially infectious skin lesions from practice or competitions until the lesions are healed or can be covered adequately
    3. Wash open wounds daily with soap and water
    4. Encourage good hygiene
      1. Shower and wash with soap after all practices and competitions
      2. Launder personal items such as towels and supporters after each use
    5. Ensure availability of adequate soap and hot water
    6. Discourage sharing of personal equipment
      1. Towels & washcloths
      2. Razors
      3. Clothing or uniforms
    7. Establish routine cleaning schedules for shared equipment
      1. Wipe surfaces of equipment before and after use
    8. Train athletes and coaches in first aid for wounds and recognition of wounds that are potentially infected
      1. Spread may occur through shared balms and lubricants
    9. Encourage athletes to report skin lesions to coaches and encourage coaches to assess athletes regularly for skin lesions

  7. Treatment
    1. See your doctor
    2. Take all of the doses of antibiotics you are given, even if you seem to be getting better
    3. Only a physician should drain skin boils or abscesses
    4. If the infection is not getting better after a few days, contact your physician again
    5. If other people you know or live with get the same infection, tell them to go to their healthcare provider
    6. Tell any healthcare providers who treat you that you have or had a Staph. or MRSA skin infection

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