Community-Associated Antibiotic-Resistant Staph Infection (CA-MRSA)

What is antibiotic-resistant staph infection?

Antibiotic-resistant staph infection is an infection caused by a type of bacteria that cannot be killed by many commonly used antibiotics. This makes it hard to treat and stop the infection. The bacteria causing these infections are a type of Staphylococcus bacteria. They are often simply called staph. A commonly used name for resistant staph bacteria is methicillin-resistant staphylococcus aureus, or MRSA (often pronounced as “mer-suh”).

MRSA infections happen most often in people who have a weakened immune system and have received healthcare in a hospital or other healthcare facility. Those infections are called healthcare-associated staph infections. An infection is said to be community associated when it happens even though you:

• have been healthy
• have not been recently hospitalized, and
• have not recently had a medical procedure, such as dialysis, surgery, or a catheter

What is the cause?

Staph bacteria are a common cause of skin infections. Most of the skin infections are minor (such as pimples and boils) and heal on their own without antibiotics. However, sometimes the bacteria infect the blood, urinary tract, lungs, or surgical wounds and cause very serious illness. The widespread use of antibiotics has caused some of these bacteria to change and become resistant to antibiotics. This can make it hard to treat these serious infections.

Community-associated MRSA (CA-MRSA) skin infections may spread from:

• close skin-to-skin contact
• openings in the skin, like cuts or scrapes
• crowded living conditions
• poor hygiene
• sharing toys, towels, soap, or equipment, such as sports equipment (like football pads)

CA-MRSA infections seem to be quite contagious. One study found that if one person has the germ, there is a 30% chance that others in the family have it. However, they may not have infections from the germ. They may just have it on their skin, where it can infect them if they get a cut. Or they can pass it on to someone else with a cut who comes in contact with their skin.

What are the symptoms?

When staph infects the skin, it may look like a pimple or boil. The skin may be red, swollen, or painful. You may have pus or other drainage. The infection may look like a rash, with redness and oozing or crusting.

If the infection gets inside the body, especially if it gets into the bloodstream, the symptoms can be very different, depending on where the infection is. Symptoms may include:

• high fever
• pain
• trouble breathing
• confusion
• very low blood pressure
• loss of consciousness

The infection can lead to shock. If it cannot be treated, it may cause death.

How is it diagnosed?

If there is an outbreak of MRSA in the community, your healthcare provider will suspect that your infection may be MRSA. Pus from the infected wound will be tested to see if bacteria can be grown in the lab from the sample. If bacteria do grow in the lab, the bacteria will be tested to see which antibiotics can kill them.

How is it treated?

If you have a pimple or boil that needs to be opened, your treatment may be draining of the sore by your healthcare provider. Drainage of skin boils or abscesses should be done only by a healthcare provider. Trying to treat open sores at home can cause serious health problems. It can also spread the infection.

Often antibiotics are not needed after the infection is drained. If an antibiotic is needed, the infection will be treated with the type of antibiotic that is most likely to kill the bacteria. If you are given an antibiotic, take all of the doses, even if the infection is getting better, unless your provider tells you to stop taking it. Not finishing your antibiotic may cause more resistant bacteria to develop. If the infection does not get better in 2 to 3 days with treatment, tell your provider.

If you are having any of the more serious symptoms listed above, you will stay at the hospital. You will get your antibiotic treatment by vein through an IV (intravenous line) until you are well enough to finish your antibiotics at home. You may be in the hospital 1 to 3 days or for a week or two, depending on how sick you were when your infection was diagnosed.

If other people you know or live with get the same infection, tell them to see their healthcare provider.

How long will the effects last?

The rash or sore usually goes away within a few days of starting the antibiotic. If the sore was treated with draining, it may take several days or a week to heal, depending on how deep the sore was.

How can I help take care of myself?

• If you have an open wound or rash, follow your healthcare provider’s instructions for taking care of your wound at home, including how to dispose of the dirty bandages.
• You may be told to use gloves when you are changing the bandage or dressing. You should wash your hands before putting the gloves on and after taking them off, in case they have a tiny hole in them.
• Ask your provider if you should be putting warm compresses on the infected area or soaking it. If you are doing compresses, be sure the cloths or towels used for the compresses are kept separate from other laundry. They should be washed separately on the hottest temperature recommended by the manufacturer.
• If you are doing soaks, for example in the bathtub, the tub should be cleaned immediately after your soak.
• If you were given a prescription for antibiotics, be sure to get it filled right away. Follow the directions exactly. Take the medicine until it is completely gone. Do not stop taking it just because you feel better. If you do not finish the medicine, you may not completely get rid of the infection, and you may create more germs that are resistant to the medicine.
• Acetaminophen may help decrease your pain.
• Use separate towels for each family member, especially if someone has a rash. Consider single-use paper towels or hand wipes in the bathroom and kitchen; or change cloth hand towels every day.
• If a family member develops a large pimple or crusty rash that does not heal within a day or two, see your healthcare provider to learn whether it needs treatment for MRSA. Treating such infections right away helps prevent their spread.
• Call your healthcare provider right away if:
  • An infection does not begin to get better within 3 days after you started taking an antibiotic.
  • You have a fever of 101.5°F (38.6°C) or higher.
  • A wound is becoming more painful or has red lines leading away from it.
  • You have more drainage from your wound.
  • A wound or bandages smell bad or you have greenish or yellowish drainage.
  • You start to have chills, nausea, vomiting, headaches, or muscle aches.

How can I prevent CA-MRSA skin infections?

To help prevent skin infections, practice good hygiene:

• Keep your hands clean by washing well with soap and water or using an alcohol-based hand sanitizer before you eat or drink, after using the bathroom, and before and after touching any wounds.
• Keep cuts and scrapes clean and covered with a clean, dry bandage until healed.
• Avoid contact with other people's wounds or bandages.
• Don’t share personal items, such as towels or razors.
• Shower after you work out at the gym or on the playing field. If you use shared athletic equipment, such as helmets or pads, use a barrier, such as clothing or a towel, between your skin and the equipment. Wipe surfaces of equipment before and after use. See if you can find a way to use the same equipment with each practice rather than sharing.

It is also important to take antibiotics only when necessary for infections. Finish all antibiotics as prescribed by your healthcare provider. Don’t share antibiotics with other people, and don’t save them for another time.

To prevent spreading a staph infection to others, follow these steps:

• Cover your wound.
• Put dirty bandages and tape in a sealed plastic bag.
• Clean your hands.
• Keep your nails clean and trimmed short.
• Don't share personal items, like clothing or toiletries.
• Tell any providers who treat you that you have or had a staph or MRSA skin infection.