MRSA (Methicillin-Resistant Staphylococcus Aureus)

What is MRSA?

Staph (staphylococcus aureus) bacteria are common germs. They are often found on the skin or in the nose. Often the bacteria cause no problem. Most often they can cause mild skin infections. But sometimes severe infections of the skin, lungs, blood, or other organs or tissues may occur. Some staph infections can be easily treated with common antibiotics. But 1 type of staph infection is harder to treat. This type is MRSA (methicillin-resistant staphylococcus aureus). It's called methicillin-resistant because the antibiotic (methicillin) that used to be an effective treatment for it, no longer works. MRSA is common in hospitals and nursing homes or long-term care facilities. It's becoming more common among healthy children and adults outside the healthcare system (called community-acquired MRSA).

A person may have no symptoms but be a MRSA carrier. Or they may have an active infection with the bacteria:

  • Colonization. When a person carries the MRSA bacteria but is healthy, it's called being colonized. This person can spread MRSA to others but has no infection.

  • Infection. When a person gets sick because of the bacteria, it's called being infected with MRSA. This person can also spread MRSA to others. If not treated correctly, MRSA infections can be very serious. They can even cause death.

Who's at risk for MRSA?

Anyone can get MRSA. But there are some things that increase the risk. Some of these include:

  • Recent or long hospital stay

  • Having a surgical wound or IV (intravenous) line

  • Having a weakened immune system due to a health condition or its treatment

  • Living in a nursing home or long-term care facility

  • Recent antibiotic therapy

  • Diabetes

  • Kidney dialysis

  • HIV infection

  • Injection drug use or sharing needles

  • Jail or prison time

  • Living in any crowded facility, such as a dormitory

  • Military service

  • Sharing sports equipment, razors, or other sharp objects

How does MRSA spread?

  • People who are colonized with MRSA have MRSA in their noses, on their skin, and possibly other parts of the body. They may not be sick themselves. But they can spread the germs to others.

  • In hospitals and long-term care facilities, MRSA can spread from patient to patient on the hands of healthcare workers. It can also spread on objects, such as cart or door handles and bedrails.

  • Outside healthcare settings, MRSA often spreads through skin-to-skin contact, shared towels or athletic equipment, or from close contact with an infected person.

What are the symptoms of MRSA infection?

MRSA skin infections often start as small red bumps on the skin. They look like pimples or spider bites. The small bumps may get larger and become swollen, painful, warm to the touch, and filled with pus. A large version of this may be called a boil or a carbuncle. The person may also have a fever. MRSA can also start in other ways. And it can spread deeper into the body. There it can cause 1 or more of the following:

  • Infections in bones, muscles, and other tissues

  • An infection in 1 or both lungs (pneumonia)

  • Infection of a surgical wound

  • Infection in the bloodstream (bacteremia and sepsis)

  • Infection of the lining of the heart (endocarditis)

  • Infection of the urinary tract (bladder and kidneys)

How is MRSA diagnosed?

A sample of blood, urine, or infected tissue may be taken to diagnose a MRSA infection. A swab of the inside of the nose or another part of the body may be taken to diagnose colonization. The sample is then sent to a lab and tested for MRSA. If the infection affects bone, joint, or other organs, a blood test or biopsy may be done. Imaging studies, such as an X-ray or CT scan, may also be needed.

How is MRSA treated?

MRSA infections often need no antibiotics if the infection is limited to the skin and consists of only pimples or a small boil. In that case, many these infections can be treated with warm soaks and by draining any boils. If there's spreading infection, MRSA is often treated with antibiotics. This is sometimes done together with draining the affected area. The antibiotic may be given by mouth in pill form. Or it may be given into a vein by an IV.

People who test positive for MRSA infection or colonization may have a process called decolonization. A topical antibiotic is put inside the nose or in the nostrils to kill the bacteria. A special soap may be used to cleanse the skin. The person's environment and contacts will often need to be decolonized in the same way.

Can MRSA be prevented?

Healthcare provider washing hands in sink.

Hospitals and nursing homes help prevent MRSA by doing the following:

  • Handwashing. This is the single most important way to prevent the spread of germs. Healthcare workers should scrub their hands for at least 20 seconds with soap and clean, running water before and after treating each person. Under the fingernails and between the fingers should also be scrubbed. They also should scrub their hands after touching any surface that may be contaminated. If soap and water aren't readily available, an alcohol-based hand cleaner that contains at least 60% alcohol can be used.

  • Protective clothing. Healthcare workers and visitors may wear gloves and a gown when entering the room of a person with MRSA. They must remove these items before leaving.

  • Private rooms. People with MRSA infections are placed in private rooms or in a room with others who have the same infection.

  • Personal care items. People with MRSA may have their own personal care items, such as thermometers and stethoscopes. These items stay in the person's room.

  • Monitoring. Hospitals watch the spread of MRSA and educate all staff on the best ways to prevent it.

People with MRSA can help prevent spreading it by doing the following:

  • Ask all hospital staff and visitors to wash their hands before touching you. Don’t be afraid to speak up!

  • Wash your own hands often with soap and water. Or use an alcohol-based hand gel.

  • Ask that stethoscopes and other tools be wiped with alcohol before they're used on you.

  • Get tested for MRSA if you have a skin infection.

If you're taking care of someone with MRSA:

  • Scrub your hands well with soap and water according to the directions below before and after any contact with the person.

  • Wear gloves when changing a bandage or touching an infected wound. Discard gloves after each use. Then wash your hands well.

  • Wash the person's bed linens, towels, and clothing in hot water with detergent or liquid bleach.

Everyone can help prevent MRSA by doing the following:

  • Wash your hands often with soap and clean, running water.

    • Rub your hands together.

    • Clean the whole hand, under your nails, between your fingers, and up the wrists.

    • Wash for at least 20 seconds.

    • Rinse, letting the water run down your fingers, not up your wrists.

    • Dry your hands well. Use a paper towel to turn off the faucet and open the door.

  • If soap and water aren't available, use an alcohol-based hand cleaner that contains at least 60% alcohol.

    • Squeeze about 1 tablespoon of cleaner into the palm of your hand.

    • Rub your hands together briskly. Clean the backs of your hands, the palms, between your fingers, and up the wrists.

    • Rub until the cleaner is gone and your hands are completely dry.

  • Keep cuts and scrapes clean and covered until they heal.

  • Cover your nose and mouth when you cough or sneeze. Wash your hands or use an alcohol-based cleaner after.

  • Stay away from the wounds or bandages of others.

  • Don't share towels, razors, clothing, or sports equipment.

Online Medical Reviewer: Barry Zingman MD
Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Marianne Fraser MSN RN
Date Last Reviewed: 10/1/2021
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