What is MRSA and how does it spread. How are MRSA infections diagnosed and treated. What precautions can prevent MRSA transmission. How should patients care for MRSA skin infections at home.

Understanding MRSA: A Resistant Bacterial Threat

MRSA, or Methicillin-Resistant Staphylococcus aureus, is a type of bacteria that has developed resistance to many common antibiotics. This makes MRSA infections particularly challenging to treat and a significant concern in healthcare settings.

Staphylococcus aureus bacteria normally live on the skin and in the nose of many healthy people without causing problems. However, if these bacteria enter the body through a cut or other opening, they can cause infections. When the bacteria are resistant to methicillin and related antibiotics, they are classified as MRSA.

Key Facts About MRSA

• MRSA was first identified in the 1960s, primarily in hospitals and nursing homes
• In the late 1990s, a new type of community-associated MRSA emerged
• MRSA can affect anyone, but is most common in hospitalized patients
• It spreads through direct contact with infected individuals or contaminated surfaces

Recognizing MRSA Infections: Signs and Symptoms

MRSA infections can manifest in various ways depending on the site of infection. The most common type is a skin infection, which may appear as:

• Large, red, painful bumps under the skin (boils or abscesses)
• Swollen, hot cuts filled with pus
• Pus-filled blisters (impetigo)
• Sores resembling spider bites (though not caused by insects)

While skin infections are most prevalent, MRSA can also infect other body parts, including the blood, lungs, joints, eyes, and urinary tract. These infections are less common but potentially more severe.

Can MRSA infections occur without symptoms?

Yes, some individuals can carry MRSA without showing any symptoms. These people are known as “carriers” and can still spread the bacteria to others. Proper hygiene practices are crucial even for those who don’t appear to be infected.

Diagnosing MRSA: Laboratory Testing and Analysis

Accurately diagnosing MRSA is crucial for effective treatment. The process typically involves the following steps:

1. A doctor obtains a sample from the infection site
2. The sample is sent to a laboratory for analysis
3. The specimen is cultured on a special plate containing nutrients
4. The plate is incubated to allow bacterial growth
5. The laboratory identifies the type of bacteria present
6. Antibiotic susceptibility testing is performed to determine resistance

This thorough diagnostic process helps healthcare providers distinguish MRSA from other bacterial infections and guide appropriate treatment strategies.

MRSA Treatment Options: Navigating Antibiotic Resistance

Treating MRSA infections presents unique challenges due to the bacteria’s resistance to many common antibiotics. However, effective options are available:

Vancomycin: The Primary Treatment

Vancomycin is often the first-line antibiotic for MRSA infections. It remains effective against most MRSA strains, although some degree of resistance has been observed in rare cases.

Emerging Treatments

As vancomycin-resistant strains of MRSA have appeared, researchers are developing new antibiotics to combat these challenging infections. Healthcare providers may consider alternative or combination therapies for difficult-to-treat cases.

How long does MRSA treatment typically last?

The duration of MRSA treatment can vary depending on the severity and location of the infection. Some skin infections may resolve with a 7-10 day course of antibiotics, while more serious infections may require several weeks of treatment. It’s crucial to complete the entire prescribed course of antibiotics, even if symptoms improve, to prevent the development of further resistance.

Preventing MRSA Transmission: Essential Hygiene Practices

Controlling the spread of MRSA is vital in both healthcare settings and the community. The most effective prevention strategy is proper hand hygiene:

Hand Washing: The First Line of Defense

Thorough hand washing with soap and water is the single most important measure to prevent MRSA transmission. Healthcare workers should wash their hands before and after patient contact, and patients should also practice good hand hygiene.

Additional Precautions in Healthcare Settings

• Use of disposable gloves when in contact with MRSA-positive patients
• Wearing protective gowns during certain procedures
• Proper cleaning and disinfection of medical equipment and surfaces
• Isolation precautions for infected patients when necessary

Are special precautions needed for MRSA carriers in the community?

MRSA carriers who are not actively infected generally do not pose a significant risk to family and friends if basic hygiene practices are followed. However, it’s important to maintain good hand hygiene and cover any open wounds to minimize the risk of transmission.

Caring for MRSA Skin Infections at Home: Patient Guidelines

Proper care of MRSA skin infections is crucial for healing and preventing spread. Follow these guidelines for home care:

Wound Care

• Keep the infected area covered with clean, dry bandages
• Change bandages regularly, especially if they become wet or dirty
• Wash hands thoroughly before and after changing bandages
• Dispose of used bandages in a sealed plastic bag

Personal Hygiene

• Shower or bathe regularly using soap and water
• Use a clean towel each time you bathe
• Don’t share personal items like towels, washcloths, razors, or clothing

Laundry Practices

Proper handling of laundry is important to prevent the spread of MRSA:

• Wash bed linens, towels, and clothing that come into contact with the infection in hot water
• Use a hot air dryer to dry items completely
• Consider using bleach on white fabrics for added disinfection
• Wear disposable gloves when handling contaminated laundry

How often should bandages be changed on a MRSA skin infection?

Bandages should be changed at least daily, or more frequently if they become wet, soiled, or loose. Always wash your hands before and after changing bandages to prevent spreading the infection.

MRSA in the Community: Recognizing and Addressing CA-MRSA

Community-Associated MRSA (CA-MRSA) has become increasingly prevalent since the late 1990s. This strain of MRSA affects individuals who have not been hospitalized or undergone medical procedures, distinguishing it from healthcare-associated MRSA.

Risk Factors for CA-MRSA

• Close skin-to-skin contact (e.g., in sports teams or crowded living conditions)
• Cuts or abrasions in the skin
• Contaminated surfaces or equipment
• Poor hygiene practices
• Frequent antibiotic use

Preventing CA-MRSA in Community Settings

To reduce the risk of CA-MRSA transmission in schools, gyms, and other community spaces:

• Encourage regular hand washing
• Keep cuts and scrapes clean and covered
• Avoid sharing personal items
• Shower after participating in sports or using shared equipment
• Clean and disinfect shared surfaces and equipment regularly

How does CA-MRSA differ from healthcare-associated MRSA?

CA-MRSA often affects younger, healthier individuals and may cause more aggressive skin infections. It can also be sensitive to a broader range of antibiotics compared to healthcare-associated strains, although treatment can still be challenging.

The Future of MRSA: Research and Emerging Treatments

As MRSA continues to evolve and develop resistance to existing antibiotics, researchers are working on new strategies to combat this persistent threat:

Novel Antibiotic Development

Scientists are exploring new classes of antibiotics that may be effective against MRSA and other resistant bacteria. These efforts aim to stay ahead of evolving resistance patterns.

Alternative Therapies

Researchers are investigating non-antibiotic approaches to treating MRSA, including:

• Bacteriophage therapy (using viruses that attack bacteria)
• Immunotherapy to enhance the body’s natural defenses
• Antimicrobial peptides derived from natural sources

Prevention Strategies

Ongoing research focuses on developing new ways to prevent MRSA infections, such as:

• Improved screening methods to identify MRSA carriers
• Vaccines to protect against Staphylococcus aureus infections
• Advanced materials for medical devices that resist bacterial colonization

What promising treatments are on the horizon for MRSA?

Several innovative approaches show promise, including CRISPR-based therapies to target MRSA genetically, nanoparticle-delivered antibiotics for enhanced efficacy, and combination therapies that may overcome resistance mechanisms. However, these treatments are still in various stages of research and development.

As MRSA continues to pose challenges in healthcare and community settings, ongoing research and vigilant prevention efforts remain crucial. By understanding the nature of MRSA, recognizing its symptoms, and implementing effective prevention strategies, we can work together to minimize the impact of this resistant bacterial threat.

Methicillin-Resistant Staphylococcus Aureus (MRSA)

• “Methicillin-Resistant Staphylococcus aureus” is also available in Portable Document Format (PDF, 47KB, 2pg.)
• Versión en español
• Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA)
• Antibiotic Resistance

What is MRSA?

MRSA refers to a type of bacteria (Staphylococcus aureus) that is resistant to many antibiotics. It is a common cause of hospital-acquired infections.

Who gets MRSA?

Anyone can get MRSA, but it is found most often in hospitalized patients.

What are the symptoms associated with MRSA infection?

MRSA infections can cause a broad range of symptoms depending on the part of the body that is infected. These may include surgical wounds, burns, catheter sites, eye, skin and blood. Infection often results in redness, swelling and tenderness at the site of infection. Sometimes, people may carry MRSA without having any symptoms.

How is it transmitted?

The staph bacteria is generally spread through direct contact with the hands of a health care worker or patient who is infected or carrying the organism.

How long can an infected person carry MRSA?

Some people can carry MRSA for days to many months, even after their infection has been treated.

How are MRSA infections diagnosed?

MRSA infections can be diagnosed when a doctor obtains a sample or specimen from the site of infection and submits it to a laboratory. The laboratory places the specimen on a special “culture” plate containing nutrients, incubates the plate in a warmer and then identifies the bacteria. The final step is for the laboratory to conduct tests using various antibiotics to determine if the bacteria are resistant (able to withstand or tolerate) or sensitive (susceptible to killing) to select antibiotics.

What is the treatment for MRSA?

Although MRSA cannot be effectively treated with antibiotics such as methicillin, nafcillin, cephalosporin or penicillin, it can usually be treated with an antibiotic called vancomycin. Recently, however, a few strains of Staphylococcus aureus have even developed some degree of resistance to vancomycin. The vancomycin-resistant strains may be more difficult to treat. Newer antibiotics are being developed to address this problem.

How can the spread of MRSA be controlled?

Careful hand washing is the single most effective way to control spread of MRSA. Health care workers should wash their hands after contact with each patient. If the patient is known to have an MRSA infection, the health care worker should wear disposable gloves. Depending on the type of contact, a gown should also be worn. Patients must also wash their hands to avoid spreading the bacteria to others.

What about contact with carriers?

If basic hygiene precautions are followed, MRSA carriers are not a hazard to others including their family and friends.

Learning about MRSA: A guide for Patients

• Download a print/booklet version of this document: Learning about MRSA: A guide for Patients (PDF)
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• Download a factsheet version of this document: Learning about MRSA Fact Sheet: A guide for Patients (PDF)

On this page:
About MRSA
Transmission
Diagnosis
Treatment
Preventing the Spread
Caring for Yourself
Laundry
Cleaning
Changing Bandages
Important Note

About MRSA

What is MRSA and why is it so serious?

• Staphylococci or “staph” bacteria commonly live on the skin and in the nose. Usually, staph bacteria don’t cause any harm.
• However,if they get inside the body they can cause an infection.
• When common antibiotics don’t kill the staph bacteria, it means the bacteria have become resistant to those antibiotics.
• This type of staph is called MRSA (Methicillin-Resistant Staphylococcus aureus).
• MRSA was first identified in the 1960’s and was mainly found in hospitals and nursing homes.
• In the late 1990’s, a new type of MRSA was identified.
• This type of MRSA is becoming more common among children and adults who do not have medical conditions.

What does MRSA look like?

Most often, MRSA causes infections on the skin. These infections may look like any one of the following:

• Large, red, painful bumps under the skin (called boils or abscesses)
• A cut that is swollen, hot and filled with pus
• Blisters filled with pus (called impetigo)
• Sores that look and feel like spider bites (However, MRSA is not caused by a spider bite or any other insect bite. )

It is also possible to have MRSA in other areas of the body, such as blood, lungs, joints, eyes, and urine. These types of infections are less common, although they can be more serious. Because skin infections are the most common, this booklet will focus on them.

MRSA Transmission

How did I get MRSA?

• Anyone can get MRSA. You can get MRSA by touching someone or something that has the bacteria on it and then touching your skin or your nose.

Some ways that you could get MRSA:

• Touching the infected skin of someone who has MRSA
• Using personal items of someone who has MRSA, such as towels, wash cloths, clothes or athletic equipment
• Touching objects, such as public phones or door knobs, that have MRSA bacteria on the surface and then touching your nose or an open sore, paper cut, etc.

You may increase your chances of getting MRSA if:

• You take antibiotics a lot
• You take antibiotics without a prescription
• You don’t follow your doctor’s directions when taking antibiotics (for example you stop taking your antibiotics before finishing a prescription or you skip doses)
• You frequently get cuts or scrapes on your skin (Your skin serves as a barrier to infection. When the skin gets damaged staph bacteria can enter and increase your risk for infection.)

There are two ways you can have MRSA.

1. You can have an active infection. An active infection means you have symptoms. This is usually a boil, a sore, or an infected cut that is red, swollen, or pus-filled.
2. You can be a carrier. If you are a carrier you do not have symptoms that you can see, but you still have MRSA bacteria living in your nose or on your skin. If you are a carrier, your doctor may say that you are colonized. These words – “carrier” and “colonized” – mean the same thing.

MRSA Diagnosis

Will I always have MRSA?

• Many people with active infections are treated effectively, and no longer have MRSA.
• However, sometimes MRSA goes away after treatment and comes back several times.
• If MRSA infections keep coming back again and again, your doctor can help you figure out the reasons you keep getting them.

If I have MRSA, do I need to do anything special when I go to a clinic or hospital?

• If you have ever had an active MRSA infection or you are a carrier, you should tell your health care providers.
• They will wash their hands and wear gloves when caring for you.
• They may also wear a gown over their clothes and may wear a mask.
• If you are staying in a hospital or nursing home, a “Special Precautions” card may be put on the door of your room.
• This card alerts staff to use extra care to prevent the spread of MRSA.
• Your visitors may be instructed to avoid touching infected skin and to take other precautions such as wearing gloves or gowns when visiting you.

Is there a test for MRSA?

• You would not usually be tested for MRSA unless you have an active infection. If you have a skin infection, your doctor may take a sample of the area to find out what bacteria is causing your infection. This is called taking a culture. The lab will then test the bacteria to find out which antibiotic is best for you. If your MRSA infections keep coming back again and again, your doctor may test you and your family members to see if you are carriers. In this case, the doctor would take a culture from the nose or other areas where MRSA can be found.

Treating MRSA

How is MRSA treated?

• MRSA should always be treated by a doctor. It is important to follow the instructions for treatment that your doctor gives you.

If you have an active MRSA infection, your doctor may choose one or more of the following treatments:

1. Give antibiotics
2. Drain the infection
3. Reduce the amount of staph on your skin and in your nose

1. Give antibiotics

MRSA is resistant to many antibiotics so it can be difficult to treat. However, there are antibiotics that can treat MRSA and make the infection go away. Your doctor may culture your infection and have the lab test the bacteria to find out which antibiotic is best for you. If your doctor gives you antibiotics, take them exactly as prescribed. Do not stop early, even if you feel better or if your infection looks healed. The last few pills kill the toughest germs. Never take antibiotics without a prescription from your doctor.

2. Drain the infection

Don’t do this yourself. It is very dangerous to squeeze or poke a skin infection because it can push the bacteria deeper into the skin and make the infection much worse. Your doctor will open the sore and drain it. After the infection is drained, you must keep it covered with a clean, dry bandage, until it heals

3. Reduce the amount of staph on your skin or in your nose

This may prevent the spread of MRSA if you have an active infection or if you are a carrier.

To decrease the amount of staph on your body your doctor may, for a short period of time:

• Tell you to shower daily with antibacterial soap
• Prescribe antibiotic ointment to put in your nose for several days
• Prescribe antibiotic pills (in some cases)

Contact your doctor if:

• you have any new symptoms during or after treatment for a MRSA skin infection such as a new fever or a fever that won’t go away
• the infection gets worse
• the infection is not healing
• the infection comes back
• you have questions

Preventing the Spread of MRSA

What can I do to prevent spreading my infection to others?

• Clean your hands often with soap and water or an alcohol-based hand sanitizer
• Take a bath or shower often, be sure to use soap to clean your body while showering or bathing
• Wash your sheets and towels at least once a week
• Change your clothes daily and wash them before wearing again
• Do not share towels, wash cloths, razors, or other personal items
• If you get a cut or scrape on your skin, clean it with soap and water and then cover it with a bandage
• Do not touch sores; if you do touch a sore, clean your hands right away
• Cover any infected sores with a bandage and clean your hands right away after putting on the bandage
• Wear clothes that cover your bandages and sores, if possible
• Clean frequently used areas of your home (bathrooms, countertops, etc. ) daily with a household cleaner
• Do not participate in contact sports until your sores have healed
• Do not go to a public gym, sauna, hot tub or pool until sores have healed

Caring for Yourself

Does it matter how I wash my hands?

• Yes. You have to rub your hands for at least 20 seconds to get rid of the bacteria.

How do I clean my hands with alcohol-based hand sanitizer?

• Use enough to cover all the surfaces of your hands.

Clean Your Hands! Poster
This 11×17 poster shows the six steps for washing hands with soap and water or two for cleaning with alcohol-based hand sanitizers.

Laundry

Do I need to be careful when I do laundry?

Yes. Dirty clothes and bedding can spread MRSA bacteria.

• When touching your laundry or changing your sheets, hold the dirty laundry away from your body and clothes to prevent bacteria from getting on your clothes
• Wear disposable gloves to touch laundry that is soiled with body fluids, like drainage from a sore, urine or feces
• Immediately put the laundry into the washer or into a plastic bag until it can be washed
• Wash your laundry with warm or hot water, use bleach if possible
• Dry in a warm or hot dryer and make sure the clothes are completely dry
• Clean your hands after touching dirty sheets or clothing and before touching clean laundry, even if you have been wearing gloves
• Throw gloves away after taking them off (do not reuse them) and clean your hands

How often should I change clothes and bedding?

• Change your sheets and towels at least once a week
• Change your clothes daily
• Do not put dirty clothes or clothes you have just worn back in your closet or drawers until they have been washed

Cleaning

What about cleaning my house?

• Use a household disinfectant or bleach solution to clean surfaces daily
• Pay attention to items that are frequently touched – light switches, doorknobs, phones, toilets, sinks, tubs and showers and kitchen counters
• Wipe the surface or object with the disinfectant and let it dry

Disinfectants to use:

• You can use any cleaner you buy at the grocery store that has the word “disinfectant” on it, remember to read the label and follow the directions
• Make your own solution of bleach and water:
  • Mix two teaspoons bleach into one quart of water in a spray bottle and label it “bleach solution”
  • Make it fresh each time you plan to clean because the bleach evaporates out of the water making it less effective
  • Never mix bleach with other cleaners, especially ammonia
  • Keep the bleach solution away from children and don’t put it in bottles that could be mistaken for something to drink

How often should I clean?

• It is important that you clean daily.