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The MRSA Fight
Defeating the tough bacteria
By Catherine O’Keefe, DNP, APRN
MRSA, Methicillin-resistant Staphylococcus aureus, is a type of germ (bacteria) that is difficult to treat with common antibacterial medicines (antibiotics). It can cause skin and other more serious infections. MRSA used to be limited to people with weak immune systems in hospitals and nursing homes, but now it is being seen in healthy adults and children as well. Parents need to become educated about MRSA — how it’s contracted, how they should protect their children and how it can be treated.
Routine Staph or MRSA?
Staphylococcus aureus, commonly referred to as staph, is normally found on our skin and in our noses. These bacteria are one of the most common causes of skin infections in the United States. When a child has a cut or scrape these bacteria can enter underneath the skin, and a routine staph skin infection may develop. A routine staph infection usually can be easily treated with cleansing followed by an antibacterial ointment or oral antibiotics. However, over time, staph bacteria known as MRSA have developed the ability to resist treatment by our most common antibiotics.
It’s difficult to tell the difference between a routine staph infection and an MRSA infection. Both may appear as a skin sore that is red, swollen, draining or full of pus, painful and accompanied by fever. The skin sore is often described as looking initially like a spider bite. However, spider bites alone do not cause staph or MRSA infections.
The only way to tell the difference between routine staph and MRSA is to have your health care provider obtain a swab sample of the pus from the infection. This sample is sent to the laboratory where the staph is grown and tested against various antibiotics. If some of the common antibiotics cannot kill the staph, the report indicates MRSA.
Who Gets It
Anyone can get a MRSA infection, but it’s more likely to occur with the following:
• Close skin-to-skin contact with an individual with a staph infection
• Contact with surfaces that have staph on them
• Crowded living conditions (nursing homes, group homes, hospitals)
• Poor personal and environmental hygiene.
In the past, most MRSA was found in health care settings, but recent reports indicate it is being found in community settings as well.
Treatment for MRSA
MRSA infections can be treated with specific antibiotics, and the full course of antibiotics must be taken. The pus may also be drained from the infected area, but only by a qualified health care provider. The infected area should also be kept clean and covered.
Some MRSA infections can become serious and not respond to the initial treatment. If your child is being treated for an MRSA infection and continues to have fever, or develops a fever after treatment has started, you should notify the child’s provider immediately. Other worrisome symptoms include spreading redness around the sore, increased pus or complaints of pain at the site of the infection. More serious MRSA infections require hospitalization and specific antibiotics that can only be given directly into the vein.
 How to Prevent the Spread of MRSA
The best way to prevent the spread of MRSA infections is by washing hands frequently or using gel hand sanitizers. Children should be taught to wash their hands before eating, after using the bathroom and after coughing, sneezing or blowing their noses. Wash hands with warm water and soap, rubbing hands and fingers together for at least 15 seconds. Remember that MRSA can live on items such as grocery carts and linens. These items should be cleaned frequently with hot, soapy water or gel sanitizers as well. Children and teens should not share personal items such as towels, razors and protective sporting gear like shin guards, shoulder pads or helmets.
According to the Centers for Disease Control and Prevention (CDC), children who have an MRSA skin infection do not need to stay home from school. This is not a condition that has to be reported to public health or school officials. It is really a matter of individual responsibility. Children who have MRSA skin infections should be instructed on to use the precautions discussed to prevent the spread of infection to other children.
Once MRSA, Always MRSA?
It is possible to have repeated MRSA infections. This means that your child has been “colonized” with MRSA. In other words, these bothersome bacteria have set up housekeeping in your child’s nose and/ or on her skin. If your child continues to have MRSA skin infections, her provider will first treat the infection, then may try an antibacterial ointment applied inside the nose for a specified period of time.
This treatment sometimes works to kill the MRSA inside the nose. The skin will also need to be cleaned daily with a special antibacterial surgical soap to assist in ridding the skin of this unwanted guest. Lastly, all your child’s linen, towels and clothing will need to be washed daily after each use.
Unfortunately, there are no guarantees that this laborious approach will work. If it is determined that your child is colonized with MRSA, you will notice that her health care providers will wear masks, gowns and gloves. It is important that you and your child understand that they are doing this to prevent the spread of MRSA to other children who may be very sick with other illnesses.
We can all do our part in reducing the number of bacteria that develop resistance to antibiotics. One of the ways is by not overusing antibiotics. Children have many colds, earaches and sore throats. Antibiotics are not always indicated because many of these illnesses are caused by viruses, and antibiotics do not affect viruses. Another way to reduce the incidence of resistant bacteria is to take antibiotics as prescribed by your provider — taking the full course of antibiotics helps to completely kill all the bacteria causing the illness.
The CDC has recently launched a National Campaign to Prevent MRSA Skin Infections. For more information, go to:
www.cdc.gov/ncidod/dhqp/ar_mrsa.html
Catherine O’Keefe, DNP, APRN, is a certified PNP at Creighton University Medical Center, Division of Pediatric Infectious Diseases, Omaha, NE, and an Assistant Professor of Nursing at Creighton University School of Nursing.
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