What a MRSA Rash Looks Like

Medically Reviewed by Poonam Sachdev on June 26, 2022

This tiny cluster of bacteria is methicillin-resistant Staphylococcus aureus (MRSA), seen under a microscope. This strain of the common “staph” bacteria causes infections in different parts of the body — including the skin, lungs, and other areas. MRSA is sometimes called a “superbug” because it doesn’t respond to many antibiotics. Though most MRSA infections are minor, some can be life-threatening.

MRSA infections can appear as a small red bump, pimple, or boil. The area may be tender, swollen, or warm to the touch. Most of these infections are mild, but they can change, becoming deeper and more serious. 

Bug bites, rashes, and other skin problems can be confused with MRSA because the symptoms are similar. ER doctors often ask patients who think they have a spider bite whether they saw the spider. These “bites” may turn out to be MRSA. When a skin infection spreads or doesn’t improve after 2-3 days on usual antibiotics, contact your doctor.  

MRSA can also lead to cellulitis, an infection of the deeper layers of skin and the tissues beneath them. Cellulitis can spread quickly over a few hours. The skin looks pink or red, like a sunburn, and may be warm, tender, and swollen. The condition usually affects the legs and arms, but not exclusively.

Skin infections from staph, including MRSA, are prone to forming abscesses. An abscess is a painful lump under the skin that’s filled with pus. Treatment may require surgical drainage and antibiotics.

MRSA is spread by touching an infected person or exposed item when you have an open cut or scrape. It can also be spread by a cough or a sneeze. Poor hygiene — sharing razors, towels, or athletic gear can also be to blame. Two in 100 people carry the bacteria on their bodies, but usually don’t get sick.

People who’ve had recent surgery or a hospital stay are more likely to get MRSA. It’s also seen in older people, those living in nursing homes, and people with weakened immune systems. A chronic disease like diabetes, cancer, or HIV raises your chances of coming down with this stubborn infection. And recent antibiotic use is also a risk.

Hospitals are the main sources of MRSA infections due to the high traffic of ill or wounded patients. They’re working to curb the problem. Efforts include screening patients for MRSA, good hand hygiene, and wearing gloves. It’s paying off — MRSA infections are down an estimated 50% in health care settings. 

Yes. Infections are showing up more in people outside of hospitals. These outbreaks — called community-associated MRSA — are seen at schools, gyms, day care centers and other places where people share close quarters.

It looks like MRSA has jumped from humans to household pets, where it can linger without clear symptoms. Animals can carry the bacteria on their skin and may give it right back to the pet owner or spread it to other animals. 

MRSA has been found in the sand and water at beaches in the U. S. Staph bacteria can live in seawater for several days and reproduce in the sand. A few ways to protect yourself: Cover scrapes before playing in the sand, wash your hands often, shower when you come out of the water, and don’t wear a swimsuit again without washing it.

If you think you have a MRSA skin infection, cover the site with a bandage. Contact a health care provider, who may swab a sample of the area and send it to a lab for testing.

Some infections may only need to be drained, cleaned, and covered at the doctor’s office. Oral antibiotics can treat MRSA, but because it doesn’t respond to many common drugs like methicillin, amoxicillin, penicillin, oxacillin, and cephalorsporins, your doctor may use clindamycin, trimethoprim-sulfamethoxazole, or linezolid. Invasive MRSA can be treated intravenously with Vancomycin.  

The FDA is fast-tracking new treatments for MRSA. It has approved three new antibiotics in the past few years: Dalvance (dalbavancin) and Orbactiv (oritavancin), which you get through an IV, and Sivextro (tedizolid phosphate), a pill that you take every day.

If drugs are prescribed, it’s important to finish all doses — even if your symptoms fade. Stopping early can cause the infection to come back or allow the MRSA bacteria to become immune to the drugs that still work. Keep the sore covered until it has healed and change the bandages when your doctor’s tells you to. You should also wash any used bedding, towels, and clothes.

MRSA can spread from a small, contained infection to one that involves your internal organs and body systems. It has been linked to pneumonia and bloodstream infections like sepsis. Current estimates for the United States place the number of severe MRSA infections as high as 90,000 with approximately 20,000 deaths per year. 

Frequent hand washing with soap and water and using an alcohol-based hand sanitizer are great ways to avoid MRSA. Wipe down surfaces you come into contact with at the gym and shower promptly after any skin-to-skin contact. Don’t touch other people’s wounds or bandages or share personal items. During a hospital stay, remind staff members to wash their hands before they touch you.

IMAGES PROVIDED BY:

(1)    Photo Courtesy of CDC
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(3)    SIU/Visuals Unlimited, Scott Camazine/Phototake
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(5)    Scott Camazine/Photo Researchers Inc
(6)    Photo Alto/Eric Audras
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(13)  Medicimage
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(15)  Stock4B
(16)  DAJ, Thinkstock

REFERENCES:

49th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, Sept. 12-15, 2009.

American Academy of Dermatology web site.

American Academy of Family Physicians.

Andreas Sing, MD, Bavarian Food and Health Safety Authority, Germany.

Capriotti, T. Dermatology Nursing, Jan. 26, 2004.

Centers for Disease Control and Prevention web site.

FDA, FDA Approves Dalvance to Treat Skin Infections

Durata Therapeutics: FDA Approves Durata Therapeutics’ Dalvance for Treatment of Acute Bacterial Skin and Skin Structure (ABSSSI) Caused by Susceptible Gram-Positive Bacteria, Including MRSA, in Adults

Johnson, L. Infections in Medicine, 2005.

Kansas Journal of Medicine, 2008.

Kisgen, J.J., American Journal of Health System Pharmacy, April 2014. Tedizolid: a new oral antimicrobial

Lance Peterson, MD, department of microbiology and infectious diseases research, NorthShore University Health System, Evanston, Ill.

Liu, C. Clinical Infectious Diseases, January 2011.

Marilyn Roberts, PhD, department of environmental and occupational health sciences, University of Washington School of Public Health and Community Medicine, Seattle.

The Medicines Company: ORBACTIV™ (oritavancin) for injection

Medscape Reference

National Institute of Allergy and Infectious Diseases web site.

Nemours Foundation. Kids Health for Parents web site.

Sing, A. The New England Journal of Medicine, March 13, 2008.

The University of Chicao Medicine MRSA Research Center.

Up to Date web site.

Vetinfo.com

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Staph can lurk deep within nose, study finds | News Center

December 11, 2013
– By Bruce Goldman

Shutterstock.com

A new study shows that staph bacteria can lurk in areas deep within the nose.

Scientists at the Stanford University School of Medicine have revealed that formerly overlooked sites deep inside the nose may be reservoirs for Staphylococcus aureus, a major bacterial cause of disease.

The results of their study were published Dec. 11 in Cell Host & Microbe.

The Stanford investigators further found an inverse relationship between the presence of S. aureus at these sites and that of a different bacterial species, Corynebacterium pseudodiphtheriticum, suggesting that the two organisms compete with each other and that C. pseudodiphtheriticum — or some molecular product it excretes — may prove useful in countering S. aureus infections.

“About one-third of all people are persistent S. aureus carriers, another third are occasional carriers and a remaining third don’t seem to carry S. aureus at all,” said David Relman, MD, the Thomas C. and Joan M. Merigan Professor and professor of medicine and of microbiology and immunology. Relman, who is also chief of the infectious disease section at Veterans Affairs Palo Alto Health Care System, was the study’s senior author. The lead author was Miling Yan, PhD, a graduate student in Relman’s lab at the time the experiments were performed.

“The nose has been long known to be a primary reservoir of S. aureus,” Relman said. The bug also abounds on the skin, with a special affinity for the armpits and groin. The vast majority of the time, however, it does little or no harm. (If it’s doing any good, no one has figured out yet what that is, Relman added. )

But if the skin is compromised by, for example, a wound or a medical incision or catheter placement, S. aureus can get into the bloodstream and cause serious and even life-threatening problems such as sepsis, pneumonia or infection of heart valves. Close to half of all S. aureus strains are resistant to a family of antibiotics that includes methicillin. In 2011, more than 80,000 severe methicillin-resistant S. aureus infections, as well as more than 11,000 related deaths, occurred in the United States alone, along with a much higher number of less-severe infections.

“Not everyone who carries S. aureus gets sick,” Relman said. “When they’re out walking the streets and otherwise healthy, attempts to rid them of their S. aureus are not necessary, and even sometimes futile. But once a carrier enters a hospital with an underlying illness or a weakened immune system or a high likelihood of undergoing skin-penetrating procedures, S. aureus carriage is a major liability. ”

Rigorous and somewhat tedious regimens for eliminating S. aureus residing on people’s skin or in their noses do exist, but it’s typically a matter of weeks or months before the bacteria repopulate those who are susceptible. The new study offers a possible reason why this is the case.

The scientists recruited 12 healthy subjects and brought them to a Stanford ear, nose and throat clinic run by study co-author Peter Hwang, MD, professor of otolaryngology. Employing special instrumentation to allow them to guide tiny swabs to precise locations within the nose, they took samples from three specific areas. The first location — and far and away the most well-studied because it’s much more accessible — was the anterior naris, a relatively dry skin-like patch of tissue located near the nostril. The second was the middle meatus — a warmer, wetter, mucus-producing fold found about midway up the nasal cavity. And the third was the sphenoethmoidal recess, situated deep within the cavity near the roof of the nose and, like the middle meatus, warm, wet and mucosal.

David Relman

The researchers found that the presence or absence of S. aureus at one nasal site typically correlated with its presence or absence at the other two. An implication: If a person’s anterior naris is carrying the bacteria, the upper mucosal areas probably are, too. This could be why efforts to banish S. aureus have so often proved short-lived. Focusing efforts largely on the bacteria in the anterior naris, which current decolonization procedures do, leaves deeper reservoirs intact.

Relman’s team learned three other things, as well. First, the relative abundance of S. aureus was inversely related to that of another bacterial species, C. pseudodiphtheriticum. When one was present at high levels, the other was present at low levels or absent. One of the study’s co-authors, Sunje Pamp, PhD, a research associate in Relman’s lab, put the two bacterial species on an agar plate to scrutinize this relationship further, and found that C. pseudodiphtheriticum strongly blocked the growth of S. aureus.

The researchers suspect that something C. pseudodiphtheticum produces and secretes — perhaps a protein, or possibly a small molecule — is responsible for S. aureus’ failure to thrive. If such a substance could be identified, Pamp said, it could provide clues to the development of new compounds to prevent or treat S. aureus infections.

Second, the microbial communities in those patients who harbor S. aureus differed in other ways from those in patients who don’t. This could mean that S. aureus alters its environment to make it more or less hospitable to various other microbes. Or it could mean that different microbial communities are more or less hospitable to colonization by S. aureus. If the latter is the case, it may be possible to predict, based on their resident nasal microbes, which patients are most likely to be at high risk of a S. aureus infection — even if they’re not currently carrying it — and monitor and treat them accordingly. Those patients found to be at lower risk could be spared such procedures.

Third, in the middle meatus and the sphenoethmoidal recess — the two deeper, wetter mucosal regions of the nose — microbial communities were similar to each another, but quite distinct from the one inhabiting the more accessible and better-studied outer site, the anterior naris. This suggests that currently routine methods of sampling the nasal cavity for microbe-research purposes may be yielding skewed results.

Other study co-authors were graduate student Julia Fukuyama; otolaryngology resident Do-Yeon, MD; and statistics professor Susan Holmes, PhD. The study was funded by a National Institutes of Health Pioneer Award (grant DP1OD000964), the Doris Duke Charitable Trust and the Thomas C. and Joan M. Merigan Endowment.

Information on Stanford’s Department of Microbiology and Immunology and Department of Medicine, which also supported this work, is available at http://microimmuno.stanford.edu and http://medicine. stanford.edu, respectively.

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About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu.

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Two-hour sepsis test developed

Pennsylvania State University and Stanford University awarded a 5-year grant to develop a rapid sepsis diagnostic system. Its author, Professor Pak Kin Wong of the Department of Biomedical Engineering and Mechanical Engineering, proposed not only to classify a pathogen, but also to determine its sensitivity to an antibiotic based on a single blood test.

Currently, the diagnosis of sepsis pathogens requires several days, during which the infectious agents are first grown from a blood sample and only then their species is determined. In contrast, Wong developed a biosensing strategy in which individual pathogens would first be sorted based on their size and then identified.

Molecular probes applied to bacteria will allow to determine the type of pathogen and sensitivity to antibiotics in just two hours by changing their morphology and metabolism.

Pak Kin Wong and his team are going to develop this test into a diagnostic system. According to scientists, the technique also allows detecting a polymicrobial infection, as a result, an adequate antibiotic can be selected for each pathogen. This will make it possible to prevent rapid death from sepsis and avoid the formation of resistant strains. In US hospitals, sepsis is the cause of one in three deaths, leading to multiple organ failure in a matter of hours.

MRSA carriers are twice as likely to die

Carriers of methicillin-resistant Staphylococcus aureus, or MRSA, die twice as often as people who do not have the bacteria. This result was obtained during a study by the University of Florida. The authors published their findings in the Journal of the American Board of Family Medicine, noting that the statistics provided refer to individuals who are unaware of their carriage.

Researchers analyzed data from the National Health and Nutrition Examination Program for 2001–2004, including data from adults aged 40–85 years. This large, nationally representative study combines a survey with laboratory test results, including nasal swabs for MRSA. The researchers compared the data obtained with data from the National Mortality Index to track deaths over an 11-year period.

This adjusted for factors such as gender, race and ethnicity, health insurance, poverty-to-income ratio, hospitalizations in the previous 12 months, and diagnoses of cardiovascular disease, diabetes, and asthma.

The mortality rate for MRSA carriers was found to be 36%, while for non-MRSA carriers it was only 18%. It is also interesting that the carriage of other strains of staphylococcus did not lead to an increased risk of premature death.

Staphylococcus aureus is found on the skin or in the nasal passages of a third of Americans, but only 1% of the bacteria are MRSA, a strain that is resistant to many antibiotics. Most carriers do not even realize they are infected with staph until they have another infection. And this happens in a quarter of cases of carriage. Hospitalized MRSA patients are particularly vulnerable to infection during their stay in the hospital or after discharge. Wounds, surgeries, and invasive medical devices can also trigger MRSA. The authors of this study believe that routine screening for MRSA carriage may be justified in the elderly to prevent death from sepsis.

New coating kills pathogens within a year

Zonitise, a biotech company, has launched an antimicrobial coating that can kill bacteria and viruses after one year of application. London City Airport was one of the first facilities to implement this coverage shortly after the start of the pandemic and after 6 months it is still providing the same level of hygiene as a sterile operating room. An additional benefit of this innovative product is that it prevents the growth of mold or other microscopic fungi and bacteria that cause bad odour.

A non-toxic and non-mutagenic coating, created using nanotechnology, has the appearance of a translucent film that adheres firmly to any surface and lasts for several months even after cleaning.

Biotech company Zonitise has launched an antimicrobial coating that can kill bacteria and viruses after one year of application. London City Airport was one of the first facilities to implement this coverage shortly after the start of the pandemic and after 6 months it is still providing the same level of hygiene as a sterile operating room. An additional benefit of this innovative product is that it prevents the growth of mold or other microscopic fungi and bacteria that cause bad odour.

A non-toxic and non-mutagenic coating, created using nanotechnology, has the appearance of a translucent film that adheres firmly to any surface and lasts for several months even after cleaning.

Probiotics can suppress nosocomial infections

Italian scientists have found a way to fight the formation of resistant strains of microorganisms in hospitals. To do this, they use sanitation techniques that allow the modification of the hospital microbiota. They published the results of their experiment in the journal Infection and Drug Resistance. This innovative approach, according to the authors of the study, can not only reduce the spread of nosocomial infection, but also save on the cost of antimicrobials. An experiment using a probiotic wash system was carried out in five Italian hospitals.

At the first stage, hospital premises were treated with standard chemical disinfectants for 6 months, and then, also for 6 months, with environmentally sustainable washing probiotics containing spores of three types of bacteria of the genus Bacillus. During the entire experiment, samples were taken twice a day from three types of surfaces – sinks, floor and recorder rack. The results showed that the use of the probiotic system led not only to an 83% reduction in the most common pathogens, but also to a significant reduction (70–99.9%) antimicrobial resistance. Thus, in Staphylococcus aureus (the most common type of nosocomial flora), resistance to antibiotics after treatment with probiotics decreased by 63.9–93.5%.

The authors of the study note that they first assessed the economic impact of the new sanitation system. Statistics showed that all hospitals experienced a 75.4% reduction in costs due to a reduction in the consumption of traditionally used hygiene products. But saving money, according to scientists, is just the “tip of the iceberg” in the fight against nosocomial infections, which in Europe alone affect 3.2 million people annually and lead to the death of more than 37 thousand patients. The introduction of probiotics into hygiene practice can reverse the formation of antibiotic-resistant microorganisms.

Nataliya2021-05-24T16:11:10+03:00

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Microbiological (cultural) test for Staphylococcus aureus (Staphylococcus aureus)

Article: 381

Analysis available:

Medical center at Bogatyrsky pr. , 4Laboratory terminal at Aleksandrovskaya Fermy avenue, 8Laboratory terminal at Nastavnikov avenue, 36k2Laboratory terminal at ul. Budapestskaya, 6Medical center on Pulkovskoye shosse, 28A Medical center on Kondratievsky prospect, 62k3Medical center on Prosveshcheniya avenue, 14k4Medical center on Moiseenko, 5Laboratory terminal on the street. Oleko Dundicha, 8, room 2Laboratory terminal on the street. Pestelya, 25AMedical center on Leninsky prospect, 88Medical center on Okhtinskaya alley, 4 (Murino, Leningrad region)Laboratory terminal on the street. Turku, 5/13 St. Petersburg, Exit serviceMedical center on the street. Savushkina, 14

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VKI: smear for staphylococcus aureus (S. aureus)

The study of a smear obtained from the biomaterial of the upper respiratory tract for Staphylococcus aureus (Staphylococcus aureus) is one of the methods for laboratory diagnosis of respiratory diseases.

Despite the fact that these microorganisms are opportunistic representatives of the microflora, they are considered the most likely “culprits” of nosocomial infections. Carriers of bacteria on the skin, nasal mucosa, pharynx, larynx are 30% of healthy people.

Weakening of the immune system, disruption of the composition of normal microflora are excellent conditions for inflammatory lesions of various organs by Staphylococcus aureus, in particular, the respiratory tract. The bacterium can cause pathologies such as tonsillitis, sinusitis, otitis media, pharyngitis, laryngotracheitis, pneumonia.

Method of determination

Microbiological.

Test material

Swabs from the pharynx and nose.

Deadline

4-5 days

Readings

An analysis for Staphylococcus aureus is advisable to carry out if

• it is necessary to confirm that this particular bacterium is the cause of the disease;
• it is necessary to evaluate the effectiveness of antibiotic therapy;
• to detect bacterial carriage;
• conduct a differential diagnosis of diseases with similar symptoms (in particular, acute respiratory infections, pharyngitis, chronic tonsillitis, tonsillitis, diphtheria).

Preparation for analysis

• Eight hours before the test, do not eat or drink, do not brush your teeth.
• Do not smoke for several hours before the test.
• A smear test for staphylococcus aureus is performed prior to antibiotic therapy.

Synonyms: Bacteriological examination of the discharge of the upper respiratory tract for Staphylococcus aureus / Respiratory tract. Staphylococcus aureus culture. quantitative. Bacteria Identification. antibiotic susceptibility.

Equipment: Maldi Biotyper/Bruker Daltonics, Microscan Walk-Away System/Beckman Coulte, Bactec/BD

After sowing the smear on a nutrient medium, the presence or absence of growth of bacterial colonies is assessed. The doctor interprets the result, based on the number of isolated microorganisms.

The detection of S. aureus in a smear is not always a sign of infection. If the number of bacteria on the nutrient medium does not exceed 10 ³ , this indicates a bacteriocarrier. Higher numbers indicate that this bacterium may be the cause of the disease.

When interpreting the result, it is important to take into account the age of the patient. While a S. aureus count of 10 ⁴ is acceptable in children older than one year, in newborns this level of microorganisms already requires intervention.

* For current information, please contact the contact center at tel. 8 (812) 600-42-00

Types of material: throat and nose swabs. The material is taken into special transport media in tupfers

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Analysis available at these centres:

Medical center on Bogatyrsky pr., 4

Medical center on the street. Moiseenko, 5

Medical center on Prosveshcheniya avenue, 14k4

Medical center on the street. Savushkina, 14

Laboratory terminal on the street. Turku, 5/13

Medical center on Okhtinskaya alley, 4 (Murino, Leningrad region)

Laboratory terminal on the street. Pestelya, 25A

Laboratory terminal on the street. Oleko Dundicha, 8, building 2

Laboratory terminal on the street. Budapestskaya, 6

Medical center at Pulkovskoe shosse, 28A

Laboratory terminal at Nastavnikov Ave. , 36k2

Laboratory terminal at Aleksandrovskaya Ferma avenue, 8

Medical center on Leninsky pr., 88

Medical center on Kondratievsky prospect, 62k3

ORTOKROSS clinic on the 5th line of V.O., 8A (official partner)

Laboratory terminal at Kronverksky pr., 31 (official partner)

Clinic “PulkovoStom” on Pulkovskoye shosse, 26, building 6.