Everything You Need to Know About the Superbug MRSA

MRSA stands for methicillin-resistant Staphylococcus aureus, a type of staph bacteria that’s resistant to the usual antibiotic drugs used to treat common staph infections.

When bacteria are resistant to antibiotics, there are fewer drugs available to kill them, and there’s a higher risk of developing a serious infection. (1)

You can carry MRSA and not show any signs of infection. But in some cases, MRSA can cause a life-threatening infection, especially if you have a weakened immune system or are in a healthcare setting.

In otherwise healthy people, MRSA can cause skin infections. In hospitals and other healthcare settings, it can lead to more severe infections, including bloodstream infections and pneumonia. (2)

Researchers have blamed the development of MRSA on the overprescribing of antibiotics — including prescribing them for viral infections, such as colds and the flu.

Because they only affect bacteria, antibiotics are useless at treating infections caused by viruses. (3)

Common Questions: MRSA

What is MRSA?

MRSA stands for methicillin-resistant Staphylococcus aureus (S. aureus), a type of staph bacteria that’s resistant to the usual antibiotics that treat staph infections. This means there are fewer drugs available to kill this bacteria, making it more difficult to treat. There are two types of MRSA infections: healthcare-associated (known as HA-MRSA) and community-associated (CA-MRSA). In general, S. aureus itself is not uncommon — for example, it’s often found in people’s nasal passages and on the skin, and it’s considered part of the skin’s normal flora.

What are the signs of MRSA?

Most people who carry MRSA never develop symptoms. When a CA-MRSA infection occurs, it can cause a red, pus-filled bump on the skin and a fever. HA-MRSA may occur in the bloodstream, heart, lungs, or in the area of a recent surgery. Signs include chest pain, chills, fever, rash, and wounds that won’t heal.

What does a MRSA rash look like?

The first sign of infection is usually a small bump or boil that can be mistaken for a spider bite. The bump and the surrounding skin may become red, swollen, painful, and inflamed (cellulitis). The bump itself may also be warm to the touch and filled with pus.

How is MRSA treated?

Treatments for MRSA include having a medical professional drain the abscess, and antibiotics, which may be given orally or intravenously. Do not try to drain an abscess yourself. It’s vital that the procedure is done correctly, using sterile tools, to avoid worsening the infection. If the abscess is small, applying a warm compress to the area might help it drain on its own, but if this does not work, you should seek a medical evaluation.

Types of MRSA

HA-MRSA occurs most often in people who have spent time in a healthcare setting, such as a hospital, nursing home, or dialysis center.

CA-MRSA is spread by skin-to-skin contact or in crowded conditions. High school and college athletes, as well as people who live in dormitories, prisons, and military barracks, are at higher risk for this type of MRSA infection. (3)

How Common Is MRSA?

An estimated 2 percent of the population carries MRSA, according to the Centers for Disease Control and Prevention (CDC). Most of these people don’t show any signs of infection at a given time.

It’s unknown how common MRSA infections are outside of healthcare settings, according to the CDC.

A CDC study found that serious MRSA infections in hospitals dropped by 54 percent between 2005 and 2011, and there were 9,000 fewer deaths in 2011 than in 2005 as a result of MRSA. However, these declines slowed between 2013 and 2016. (1)

How Is MRSA Spread?

MRSA can spread through contact with an infected wound or by sharing personal items, including towels and razors, that have come into contact with an area of infected skin.

The risk for MRSA infection is greater in any situation that involves skin-to-skin contact or crowded conditions, such as sports, military, and certain school and day care settings. (1)

The risk factors for acquiring a MRSA infection in a healthcare setting (HA-MRSA) are different from those for an infection in a community setting (CA-MRSA).

Risk factors for HA-MRSA include:

Staying in a Hospital People with weakened immune systems, including older adults and those recovering from surgery or an illness, are especially vulnerable to MRSA.

Invasive Medical Devices Medical tubing, including intravenous (IV) lines and urinary catheters, can provide an entryway for MRSA to enter your body.

Living in a Long-Term Care Facility MRSA is common in nursing homes, where the bacteria can spread from those who carry it to residents with weakened immune systems. (3)

Risk factors for CA-MRSA include:

Playing Contact Sports MRSA spreads easily through skin-to-skin contact in wrestling, football, and other activities, especially if there are cuts or abrasions on the skin.

Living in Crowded or Unsanitary Conditions MRSA is a particular threat to day care centers, college dorms, military training camps, and prisons.

Male Homosexual Activity Men who have sex with men are at higher risk for MRSA infections.

Injecting Illegal Drugs Sharing or reusing needles can provide a way for MRSA to enter your body.

Getting a Tattoo If not properly used, tattoo needles can allow MRSA to enter your body.

Recent Illness or Surgery Having had the flu recently, or having had surgery in the last year, make your body more susceptible to MRSA infection.

Recent Antibiotic Use Your risk of MRSA infection may be greater if you’ve used an antibiotic in the last month.

History of MRSA Infection or Contact Your risk of MRSA infection is greater if you’ve had this infection before, or if you have close contact with someone who has. (2,3,4)

MRSA Symptoms

The vast majority of people who carry MRSA will never develop symptoms of an infection.

When an infection does occur, symptoms of CA-MRSA (community settings) tend to be different from those of HA-MRSA (healthcare settings).

The most common form of CA-MRSA is a skin infection.

MRSA skin infections are more likely to occur where you already have a cut or skin abrasion, and in areas where there is more body hair. (2)

The first sign of infection is usually a small bump that is sometimes mistaken for a spider bite. The bump may be:

• Red
• Swollen
• Painful
• Warm to the touch
• Filled with pus
• Accompanied by a fever (1,3)

If you have skin symptoms typical of MRSA or if you have a fever, schedule an appointment with your doctor immediately.

In the meantime, keep the area covered with a clean bandage and wash your hands frequently.

Don’t try to pop or squeeze pus out of your sore. Doing so could make the infection worse. (1)

Symptoms of HA-MRSA tend to be more severe than those of a typical CA-MRSA skin infection.

MRSA infections acquired in a healthcare setting may occur in your bloodstream, heart, lungs, other organs, or in the area of a recent surgery.

HA-MRSA symptoms may include:

• Chest pain
• Coughing
• Shortness of breath
• Fatigue
• Fever
• Chills
• Headache
• Rash
• Wound that doesn’t heal (2)

MRSA Diagnosis

MRSA infections, like all staph infections, are typically diagnosed from a bacterial culture.

Your doctor will use a cotton swab to take a sample of your skin sore or rash, or from another area, such as your nasal secretions.

This sample is then sent to a lab, where it’s placed in a dish containing nutrients that encourage bacterial growth. After this, the bacteria are tested and identified.

If your infection is found to be caused by MRSA, further testing will determine which antibiotics can be used to treat it.

As an alternative to a bacterial culture, a newer, faster test that detects staph DNA may be used. (2,3)

MRSA Treatment

Treatment for MRSA depends on the type of infection and where it’s located.

If you have a MRSA skin infection, your doctor may need to drain the abscess. This may be the only treatment you need.

Don’t try to pierce or drain an abscess yourself. It’s vital that the procedure is done correctly, using sterile tools, so that the infection doesn’t get worse or spread to other people. (2)

Treatment for a MRSA skin infection may also involve taking certain antibiotics, such as:

• clindamycin (Cleocin)
• trimethoprim (Trimpex)
• doxycycline (Vibramycin)
• minocycline (Minocin)
• linezolid (Zyvox) (5)

For HA-MRSA (acquired in a healthcare setting), your doctor will prescribe an antibiotic. The choice of drug will depend on the location of your infection and your lab results.

Vancomycin (Vancomin) is widely used to treat HA-MRSA. This drug is typically given intravenously (by IV).

Other antibiotics that may be used to treat HA-MRSA include those used to treat skin infections, as well as:

• daptomycin (Cubicin)
• ceftaroline (Teflaro)
• tedizolid (Sivextro)
• dalbavancin (Dalvance)
• oritavancin (Orbactiv)
• telavancin (Vibativ)
• delafloxacin (Baxdela)

Your doctor will decide whether to prescribe an intravenous (IV) or oral antibiotic based on the location and severity of your infection. (5)

MRSA Complications

If left untreated, or if an antibiotic used to treat it isn’t effective, a MRSA infection may spread. Such an infection may become life-threatening.

The infection may spread to your:

• Bones
• Joints
• Blood
• Lungs
• Heart valves (3)

Preventing MRSA

To prevent the spread of MRSA in healthcare facilities, it’s essential for medical professionals to follow procedures designed to contain any infection. These procedures may include:

• Wearing protective garments
• Following strict hand hygiene rules
• Disinfecting contaminated surfaces
• Properly washing contaminated laundry (3)

There are a number of steps you can take to reduce the risk of acquiring a MRSA infection in your community (CA-MRSA):

• Wash your hands thoroughly after coming into contact with others.
• Keep any cuts, bites, or sores clean and covered with a bandage.
• Avoid contact with other people’s cuts, sores, or bandages.
• Don’t share towels, razors, clothing, or cosmetics.

Special considerations for athletes to avoid MRSA include:

• Shower immediately after exercising.
• If a shower facility isn’t clean, shower at home.
• Wash your hands before and after sports activities.
• Use an antiseptic solution to clean shared exercise equipment before using it.
• Place a towel between your skin and shared exercise equipment.
• Don’t share or reuse splints or braces. (2)

Additional reporting by Quinn Phillips.

Favorite Orgs for Essential MRSA Info

MRSA Survivors Network

Started by Jeanine Thomas, a MRSA survivor and national spokesperson, MRSA Survivors Network is a great resource for learning information about MRSA and helping survivors and their families cope with the disease. The site includes a section where you can read survivor stories and another on how to get involved with the organization through volunteer work.

The Empowered Patient Coalition

Created by patient advocates, the organization wants to help the public improve the quality and safety of their healthcare through information and education. The site includes fact sheets about preventing hospital-acquired infections, including MRSA.

The National Patient Safety Foundation

With a broader scope than just MRSA, this patient advocacy organization offers background information and news on MRSA that patients and caregivers will find helpful. Their annual Patient Safety Congress always features panels on MRSA and patient information.

Favorite Online Resources

The Society for Healthcare Epidemiology of America

The Society for Healthcare Epidemiology of America (SHEA) promotes the prevention of healthcare-acquired infections and antibiotic resistance by helping to define best healthcare practices. Their brochure on MRSA provides invaluable information on common signs of hospital-associated infections, how they’re treated, and how you can help prevent them.

Lab Tests Online

Produced by the American Association for Clinical Chemistry (AACC), this health information resource can tell you all about the tests you can expect when being screened for MRSA and answer common questions about the infection.

Favorite Resources for Financial Assistance for People With MRSA

PAN Foundation

While insurance generally covers many expenses related to MRSA, patients often have to cover deductibles and copays for doctor visits and medications. If you’re struggling to cover medical costs, the Patient Access Network (PAN) Foundation, a nonprofit organization, helps federally and commercially insured people with life-threatening, chronic, and rare diseases cover out-of-pocket costs related to prescription medication.

Favorite Resource for MRSA Clinical Trials

ClinicalTrials.gov

This database powered by the U.S. National Library of Medicine provides information on research studies in all 50 states and 209 countries. You can search for studies related to MRSA by typing in keywords in the section called “Find a study.” Before participating in a study, talk to your doctor to learn about potential risks and benefits.