Is MRSA Cause for Alarm?

5/26/2008

The media frenzy over the recent cases of methicillin-resistant Staphylococcal aureus (MRSA) has not served the public well, scaring people unnecessarily. I always advise parents to ask three questions about the latest “hot” health story: Does it make sense? Is the source reputable? Does it fit with other research? Remember, the goal of the media is not just to inform, but also to sell—and the stock in trade of some journalists is fear.

MRSA has actually been an emerging problem for many years. Until recently, it was mostly a problem in hospitals, where the sickest patients getting the most and strongest antibiotics were found. The rise in MRSA is tied to the increase in antibiotic-resistant bacteria in response to overuse and misuse of antibiotic drugs. As a result, a bacteria normally found on the skin and in the nasal passages and upper airways of about 25% of us sometimes mutates into something more dangerous.

In the past few years MRSA has moved out of the hospital and into the community. It most commonly appears as a skin infection that looks like a spider bite. MRSA infections are more likely to show up in people recently discharged from hospital, long-term care facilities, or jail, and those who live with them.

Before you freak out about a skin problem in your family, consider these facts:

• Although skin infections of all sorts are common in children and families, rarely do they turn out to be serious, much less deadly.
• Very few people who do carry Staph. aureus have the MRSA type.
• Even in cases of MRSA, the vast majority of people with normal immune systems respond beautifully to oral antibiotic treatment.

MRSA is generally transmitted by direct person-to-person contact. There have been reports of MRSA being transmitted among members of sports teams with a high degree of skin contact, such as wrestling, football, and basketball. Although contamination through objects is believed to be very uncommon, in the interests of safety, it is being suggested that athletes not share towels or athletic equipment. Any athlete with a wound should be evaluated by a health care provider and promptly treated. The New York City Health Department recommends that any wrestler with a MRSA-infected wound not be allowed to return to the sport until the wound has fully healed and medical clearance has been given. Other athletes should be checked on a case-by-case basis: If their wounds cannot be completely covered and contained, they should not participate.

The best ways to prevent the spread of MRSA are:

• Hand washing and good personal and home hygiene.
• Not sharing towels in school or health club locker rooms.
• Not pressuring your healthcare provider to give you an antibiotic prescription when not indicated.
• An annual flu shot for any children between 6 months and 6 years of age, older children with chronic medical conditions, and immuno-compromised children. MRSA pneumonia is a known, life-threatening complication of flu, especially in the very young and very old.

Resources:

• Centers for Disease Control patient page on community-associated MRSA at http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html
• Also from the CDC, “Questions and Answers about Methicillin-Resistant Staphylococcus aureus (MRSA) in Schools” at http://cdc.gov/Features/MRSAinSchools/

Journal of the American Medical Association
Patient page MRSA Infections at
http://jama.ama-assn.org/cgi/content/full/298/15/1826