Methicillin Resistant Staphylococcus Aureus

What is methicillin resistant Staphylococcus aureus?

• Methicillin resistant Staphylococcus aureus (MRSA) is a type of germ called bacteria. MRSA bacteria can cause infections in your body. Antibiotic medicines are used to kill germs. When the germ called Staphylococcus aureus (Staph) becomes resistant to (not killed by) certain antibiotic medicines, it is called MRSA. The Staph germ is often found on the skin and in the nose. A person may carry the Staph germ but not get infected or sick. A carrier of MRSA can give it to other people and make them sick.
  
  
• MRSA infection is very contagious. This means that it spreads easily from person to person. Anyone can get an MRSA infection. You can catch MRSA inside or outside of a hospital. MRSA may cause a mild, severe (very bad), or deadly infection in your body. The infections may be in your skin, blood, lungs, heart, or brain.

What increases my risk of getting an MRSA infection?

• Using antibiotics: If you do not follow your caregiver's instructions when taking antibiotics, it can cause germs to become resistant. Taking antibiotics often, for a long time, or when you do not need them may cause resistance. When certain germs cannot be killed by medicine, you may get an MRSA infection.
  
  
• Staying in the hospital: This includes having surgery, being in the ICU (intensive care unit), or being on a ventilator (breathing support machine). A long hospital stay, or sharing a room with someone who has an MRSA infection increases your risk of getting MRSA.
  
  
• Having tubes, lines or metal implants in your body: Medical tubes placed into your body increase your risk of getting an MRSA infection. These tubes include intravenous (IV) tubes, and large tubes called central venous lines. A central venous line may be used if you need to have dialysis or other treatments. Other tubes that increase your risk of getting MRSA include feeding tubes, and catheters. A urinary catheter is a tube that is used to drain out urine. MRSA may also live on and around metal implants, such as prosthetics (man-made body parts).
  
  
• Having a weak immune system: MRSA will more likely cause an infection if you have a weak immune system. The immune system is the part of your body that fights infection. Having diabetes (high blood sugar) or certain kidney problems may weaken your immune system. If you have recently had chemotherapy (medicine to kill cancer), this may also weaken your immune system.

What else increases my risk of getting an MRSA infection?

• Not keeping clean: This includes not washing your hands well (using soap and water), or long enough. Hand washing must be done after visiting or taking care of a person who has an MRSA infection.
  
  
• Having a family member with an MRSA infection: If you have someone living in your home with an MRSA infection, you are at a higher risk of catching it.
  
  
• Using intravenous drugs: Using illegal IV drugs (street drugs) increases your risk of getting an MRSA infection.
  
  
• Sharing exercise equipment: MRSA may spread through shared exercise equipment that is not cleaned well.
  
  
• Living in a crowded space: Prisoners, soldiers, and people in long-term care facilities are at a higher risk of getting MRSA.
  
  
• Sexual contact: Men who have sex with men are at a higher risk of getting an MRSA infection.

What problems can an MRSA infection cause?

MRSA can cause serious and sometimes deadly infections. Ask your caregiver for more information about any of these infections:

• Skin, soft tissue, or wound infections: Small or large infected areas may grow on and in the skin, muscles, and other soft tissue areas. You may also get infections in wounds caused by an injury, illness, or a cut made during surgery.
  
  
• Urinary tract infections: A urinary tract infection (UTI) is an infection of the kidneys, ureters or bladder. These organs make and store your urine.
  
  
• Osteomyelitis or arthritis: Osteomyelitis is an infection in your bone. Arthritis is a disease where your joints swell. Joints are the places in your body where two bones meet, such as your knees and elbows.
  
  
• Infection of abdominal organs: The organs in your abdomen, such as your liver and spleen, may get infected.
  
  
• Meningitis: Meningitis is swelling of the coverings of the brain and spine.
  
  
• Infective endocarditis: Endocarditis is when there is infection and inflammation (swelling) of the inner lining of your heart.
  
  
• Pneumonia: Pneumonia occurs when there is infection and swelling in your lungs.
  
  
• Bacteremia: Bacteremia occurs when MRSA germs enter your blood stream, and cause a blood infection.

What are the signs and symptoms of an MRSA infection?

Your signs and symptoms depend on what area of your body has an infection. They can include:

• Fever: This is a high body temperature.
  
  
• Infected skin: You may have an area of skin that is red and swollen, and feels warm and painful. You may have a red spot on your skin that looks like a spider or an insect bite. You may have boils, dead skin, or pus on or under your skin.
  
  
• Joint effusion: Fluid may build up in one of your joints, causing swelling, pain and stiffness.
  
  
• Cough: You may have a cough, and you may cough up blood.
  
  
• Breathing problems: You may find it hard to breathe.

How is an MRSA infection diagnosed?

Your caregiver will check your body and he may ask if you had contact with someone who has MRSA. You may need one or more of the following tests:

• Blood tests: Samples of your blood may be taken to learn if you have a MRSA infection.
  
  
• Cultures: Your caregiver may take samples of sputum (mucus) from your throat or nose. He may take samples of pus from a wound. These fluids are sent to the lab and checked for MRSA.
  
  
• Biopsy: A biopsy may be done by taking a sample of skin or other tissue that is infected. This tissue will be sent to the lab and tested for MRSA.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers may use the x-ray to look for signs of infection (such as pneumonia), or a collapsed lung.
  
  
• Computed tomography scan: This is also called a CT scan. This is an x-ray that takes pictures of body areas, and can show places where the infection may have spread.

How is an MRSA infection treated?

Your treatment will depend on where the infection is in your body. With treatment, signs and symptoms such as a fever, cough, and pain may decrease, and wounds may heal. Your treatment may include any of the following:

• Antibiotics: This is germ-killing medicine that is used to treat MRSA. You may need to use more than one antibiotic medicine at a time. You may be given antibiotics to take by mouth or through an IV. You may be given antibiotic ointment to put on a wound or in your nose.
  
  
• Steroids: This medicine may be given to decrease inflammation.
  
  
• Isolation: If you are in the hospital, caregivers and visitors will wear a gown and gloves when in your room. Caregivers and others who enter your room may also wear masks. Supplies that are in your room will not be shared with other patients. This is done to prevent spreading your infection to other people. Visitors must also wash their hands before leaving to keep from spreading germs.
  
  
• Surgery: You may need surgery to remove dead tissue, medical devices, prosthetics, or other man-made items from your body. These may include a heart pacemaker, implantable cardiac defibrillator, or man-made heart valve.
  
  
  • Incision and drainage: If you have an MRSA skin infection, caregivers may cut into the infected area of your skin. Doing this will help drain out the fluid (pus) that has collected in the area.
    
    

What are the risks of being treated for an MRSA infection?

• If you are a female who may be, or are pregnant, talk to your caregiver about your risks. Antibiotic medicines used to treat an MRSA infection may cause a headache, rash, nausea, vomiting (throwing up), and diarrhea. They may damage your kidneys, nerves, or eyes. You may feel muscle pain or weakness. Your teeth may be stained, and your skin may become sensitive to light. You may have an irregular heart beat. Your tongue may swell and you may have trouble speaking. Antibiotic medicines may not work well with other medicines that you are taking. Some antibiotic medicines may cause seizures or death.
  
  
• If your MRSA infection is not treated, if can get worse. The infection may spread to your skin, joints, kidneys, lungs, liver, spleen, bones, brain, and heart. You may die from any of these infections. Speak to your caregiver if you have questions or concerns about your MRSA infection or treatment.

How do I prevent getting or spreading MRSA?

• Take antibiotics according to instructions: Always take your antibiotics exactly as ordered by your caregiver. Finish all of the medicine as prescribed, even if you feel better. Not doing this may cause the germ to become harder to kill. Never take prescription medicine without a caregiver’s order. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
  
  
• Wash your hands: Wash your hands often with germ-killing soap and water. Do this after coughing, sneezing and using the bathroom. Always wash your hands before touching food. Use germ-killing soap and water, or you may use alcohol-based hand cleaner. Always wash your hands when they are dirty.
  
  
• Bathe often: Shower regularly with soap, especially after sports involving contact (touching) with other people, and using exercise equipment.
  
  
• Wash all of your clothing: Wash all clothing with soap and water after it is worn by someone who may have, or has, an MRSA infection.
  
  
• Keep wounds covered: Keep any wounds that you have clean and covered with a bandage until they are healed. Follow your caregiver’s instructions for keeping your wound clean and covered.
  
  
• Do not share personal items: Do not share items such as bars of soap, razors, towels, or clothing with other people.
  
  
• Clean surfaces well: Use alcohol or chlorine-based, germ-killing cleaner when cleaning surfaces such as tables, which are shared and touched often. Keep doorknobs, faucet handles, furniture and the floor clean.
  
  
• Get rid of the germ: If someone in your home has an MRSA infection, you and other family members are at a greater risk of getting it. You and your family may need to use antibiotic cream in the nose, or special soap when washing.

Where can I find support and more information?

Having an MRSA infection may be life-changing for you and your family. Accepting that you have an MRSA infection may be hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Contact the following:

• Centers for Disease Control and Preventions
  1600 Clifton Rd.
  Atlanta , GA 30333
  Phone: 1- 800 - 232-4636
  Web Address: http://www.cdc.gov
  

• National Institute of Allergy and Infectious Diseases
  NIAID Office of Communications & Government Relations
  6610 Rockledge Drive, MSC 6612
  Bethesda , MD 20892-6612
  Phone: 1- 301 - 496-5717
  Phone: 1- 866 - 284-4107
  Web Address: www3.niaid.nih.gov
  

When should I call my caregiver?

Call your caregiver if you have:

• A fever (high body temperature).
  
  
• A rash that is itchy, or spreading over your body.
  
  
• Skin areas that are red, swollen and feel warm. These areas also may be painful.
  
  
• A wound or area of pus under your skin that is not going away.
  
  
• Nausea (feeling sick to your stomach), vomiting (throwing up), or diarrhea.
  
  
• Muscle pain or weakness.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You are coughing up blood.
  
  
• You suddenly have trouble speaking.
  
  
• You are having new trouble breathing.
  
  
• You have a fast heartbeat and feel weak or dizzy.
  
  
• Your pain becomes much worse.
  
  
• Your tongue is swelling up.
  
  
• You have a seizure (convulsion).
  
  
• You have a headache with a stiff neck, and are very tired or confused.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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