MRSA (methicillin-resistant Staphylococcus aureus) is a bacterial infection that does not respond well to common antibiotic treatments used to fight infections. Therefore, it can be difficult to handle and contain. It is transmitted easily, especially in overcrowded spaces, so it can immediately become a threat to public health. Sometimes, the first symptoms are mistaken for a harmless spider bite, so it's important to learn to recognize MRSA immediately before it spreads.
Steps
Part 1 of 4: Recognizing MRSA
Step 1. Locate an abscess or boil
The first symptom of MRSA is the appearance of an abscess or boil, filled with pus, hard to the touch and hot. This red skin bump can have a pimple-like "head" and sizes ranging from 2 to 6 cm or even larger. It can appear anywhere on the body and cause a lot of pain. For example, if it is located on the buttocks, it may prevent you from sitting.
If the skin infection is not accompanied by a boil, it is almost certainly not MRSA, but you should still see your doctor. It is more likely to be a strep infection or staphylococcus aureus
Step 2. Learn to distinguish MRSA boils from insect bites
The initial abscess or boil may resemble a simple spider bite. One study showed that 30% of Americans who reported a spider bite were actually diagnosed with MRSA. Therefore, be very cautious and see your doctor especially if you are aware of an outbreak of MRSA in the place where you live.
- In Los Angeles, an outbreak of MRSA had spread to such an extent that the Public Health Department ordered posters showing a picture of an MRSA abscess with the caption: "This is not a spider bite."
- Patients did not take prescribed antibiotics because they believed it was a spider bite and therefore the doctor had misdiagnosed.
- Be on the lookout for MRSA infection and always follow your doctor's advice.
Step 3. Check if you have a fever
While not all patients experience this symptom, body temperature may exceed 38 ° C and be accompanied by chills and nausea.
Step 4. Look out for typical symptoms of septicemia
"Systemic toxicity" is rare, but possible if MRSA infection affects the skin and soft tissues. Although in most cases, patients can wait for test results to confirm the diagnosis of this infection, septicemia is dangerous and needs immediate treatment. Symptoms include:
- Body temperature above 38.5 ° C or below 35 ° C;
- Heart rate greater than 90 beats per minute;
- Fast breathing;
- Swelling (edema) localized anywhere in the body;
- Changes in mental status (such as disorientation or unconsciousness).
Step 5. Don't underestimate the symptoms
In some cases, the MRSA infection goes away on its own without treatment. The boil can spontaneously rupture and the immune system takes action to fight the infection. However, in people who have a weakened immune system, it can occur in a more severe form. If the infection worsens, the bacteria risk entering the bloodstream, causing a life-threatening septic shock. Also, since it is very contagious, there is a risk that it will spread to other people if left untreated.
Part 2 of 4: Treating MRSA
Step 1. See your doctor for a correct diagnosis
Since healthcare professionals observe and treat numerous cases per week, it is reasonable to assume that they are capable of diagnosing this infection. The most frequent symptom is the characteristic boils or abscesses. However, for confirmation, a culture is prescribed on a sample of cells taken from the lesion site that the laboratory will analyze for bacteria belonging to MRSA.
- It takes approximately 48 hours to detect the growth of bacteria in the culture medium. If the exam is ready before this time, it is likely not very accurate.
- However, new molecular tests that can detect MRSA DNA within hours are increasingly popular.
Step 2. Use a warm compress
Hopefully, as soon as you suspect a MRSA infection and see your doctor, you can get treated before it becomes dangerous. The initial treatment consists of applying a warm compress to the skin protuberance in order to draw the pus towards the surface of the skin. This way, when the doctor cuts it to drain the abscess, he can completely remove the purulent exudate. Antibiotics can speed up this process. Sometimes, the combination of antibiotics and warm compresses can promote spontaneous drainage that excludes the need for an incision.
- Dip a clean cloth in the water.
- Put it in the microwave for about 2 minutes or until it warms up (it must be bearable, it must not burn).
- Leave it on the lesion until it cools down. Make 3 applications in a row.
- Repeat the whole process 4 times a day.
- When the bump has softened and you can clearly see the pus in the center, it means it is ready to be drained by the doctor.
- Sometimes, however, this operation can make the situation worse. It is possible that the hot compress is painful and the lesion will redden further and increase in proportion. In this case, stop applying and call your doctor.
Step 3. Allow the doctor to drain the wound
Once you have drawn the infected pus to the surface, the doctor will cut the bump to drain the exudate safely. First, he will anesthetize the affected area with lidocaine and clean it with Betadine. Then, using a scalpel, he will make an incision on the "head" of the abscess, emptying it of infected pus. Then to make sure that all the infected material has been extracted, he will press on the entire lesion, as if he were to let the pus out of a squeezed pimple. Finally, he will deliver a sample of liquid to a laboratory so that through the analyzes the antibiotic to which the bacterium responsible for the infection is sensitive is identified.
- Sometimes, honeycomb sacs of pus form under the skin. They are eliminated with the help of Kelly forceps which allow the doctor to hold the skin open while dealing with the infection below the surface.
- Since MRSA is an antibiotic resistant bacterium, drainage is the most effective treatment method.
Step 4. Keep the wound clean
After the drainage is complete, the doctor will disinfect the wound with a syringe without a needle and then carefully bandage it with gauze. It will leave a "wick" so that you can lift the bandage to clean it every day. Over time (typically a couple of weeks), the wound will get smaller and smaller until you no longer need to apply gauze. However, until then, you will need to medicate her every day.
Step 5. Take the antibiotics prescribed for you
Since MRSA does not respond well to all antibiotics, do not insist that your doctor prescribes a treatment that they do not think will help. Excessive antibiotic intake only promotes the resistance of bacteria to this class of drugs. However, there are two approaches to antibiotic therapies: one for mild infections and another for severe ones. Your doctor may prescribe the following:
- For mild to moderate infections, he may prescribe one Bactrim tablet every 12 hours, for 2 weeks. If you are allergic to this drug, you can take 100 mg of doxycycline following the same intake times.
- For severe infections (intravenous therapy), he may tell you to take 1 g of vancomycin as a drip for at least an hour; 600 mg of linezolid every 12 hours or 600 mg of ceftaroline for at least 1 hour, every 12 hours.
- The infectious disease specialist will determine the duration of intravenous therapy.
Part 3 of 4: Freeing a Community from MRSA
Step 1. Learn about hygiene measures to prevent MRSA infection
Since MRSA is very contagious, it is important that all people living closely in a certain environment pay attention to hygiene and prevention, especially in the event of an epidemic.
- Use creams and soaps contained in packages equipped with a dispenser. The risk of spreading this bacterium is greater if everyone puts their fingers in a jar of cream or shares the same bar of soap.
- Don't share personal items, such as razors, towels, or hairbrushes.
- Wash all bed linens at least once a week, and wash towels and washcloths after each use.
Step 2. Take extra precautions in shared or crowded spaces
Since MRSA spreads so easily, you need to know the risks of overcrowded conditions. Such places include common spaces in a home or public areas where there is constant traffic, such as nursing homes, hospitals, prisons, and gyms. Although many areas open to the public are regularly disinfected, you cannot know when the last cleaning was done or who may have passed just before you. So, if in doubt, you should take extra precautions.
- For example, take a towel to the gym and put it on the tools before using them. Wash it as soon as you get home.
- Make good use of the wipes and antibacterial solutions provided at the gym. Disinfect all equipment before and after use.
- If you shower in a shared place, wear a pair of flip-flops or rubber slippers.
- If you have injuries or a compromised immune system (such as diabetes), you are at an increased risk of infection.
Step 3. Use hand sanitizer
You come into contact with numerous bacteria throughout the day. It may happen that a person with MRSA touches a doorknob just before you or that they touched their nose before opening the door. Hence, it is a good idea to use a hand sanitizer, especially in public places. Ideally, it should contain at least 60% alcohol.
- Use it at the supermarket when you get change at the checkout.
- Children should also apply it or wash their hands after playing with other children, as well as their teachers.
- Only use it for safety whenever you think you have been exposed to a risk of infection.
Step 4. Wash the surfaces with bleach
A diluted bleach solution effectively fights the presence of MRSA in the home. Use it during cleaning in case of outbreaks that have broken out in an out-of-hospital setting to decrease the risk of infection.
- Always dilute the bleach before using it, otherwise it could discolour the surfaces.
- Prepare the solution using 1 part bleach and 4 part water. For example, mix 1 cup of bleach with 4 of water to clean the surfaces in your home.
Step 5. Don't rely on vitamins or natural therapies
Research has not shown that vitamins and natural therapies are able to strengthen the immune system enough to ward off a MRSA infection. The only apparently promising study, during which "megadoses" of vitamin B3 were administered to the participants, was discarded due to the posology considered dangerous.
Part 4 of 4: Preventing the Spread of MRSA in the Hospital
Step 1. Learn to distinguish the difference between the various types of infection
When a patient is hospitalized for a MRSA infection, it is referred to as a "community-acquired infection". On the other hand, when he arrives at the hospital to treat another condition and contracts MRSA while in hospital, it is called a "nosocomial infection". Typically, the latter type does not attack the skin and soft tissues, so boils and abscesses do not appear. However, more serious complications often arise.
- Infections caused by MRSA are a major cause of preventable deaths and a widespread epidemic in hospitals around the world.
- Infection spreads rapidly from patient to patient when hospital staff are incompetent and do not apply the correct infection control procedures.
Step 2. Protect yourself with gloves
If you work in a medical setting, you should definitely wear gloves when interacting with residents. However, it is equally important to change them when you switch between patients and to wash your hands thoroughly with each change of gloves. If you don't replace them, you will continue to protect yourself from infection, but in the meantime you will spread it among the sick.
Infection control and prevention protocols vary from department to department, even within the same hospital. For example, since this is a generally more common infection in intensive care units, the precautions related to contact and isolation are stricter in these areas. In addition to gloves, staff may be required to wear protective gowns and masks
Step 3. Wash your hands regularly
It is probably the most important habit for preventing the transmission of infectious diseases. It is not always possible to wear gloves, so hand cleaning is the first line of defense against the spread of bacteria.
Step 4. Run tests on all new patients
If you are exposed to inpatient body fluids - whether through sneezing or surgery - it is preferable to get preventative checks for MRSA. Anyone traveling in a hospital environment is both a potential risk and a potential risk. The test to detect this bacterium consists of a simple nasal swab that can be analyzed within 15 hours. Preventing all new patients - even those who do not show symptoms - can reduce the spread of the infection. For example, one study showed that about 1/4 of patients who had no symptoms of MRSA before surgery were still carriers of the bacterium.
- It may be that a preventive check-up of all patients is not granted for reasons of time or is not within the scope of the hospital. Consider having this screening only for those who need to be operated on or those who are ill with whom medical personnel need to come into contact in the presence of fluids.
- If a patient tests positive, staff may decide to use the "decolonization" strategy to prevent contamination during an operation or surgical procedure and transmission to others in the healthcare setting.
Step 5. Isolate patients suspected of having MRSA
The last thing desirable in a hospital is for an infected patient to come into contact with other uninfected patients who are hospitalized for other reasons. If single rooms are available, they should be used to isolate suspected MRSA carriers. If this is not possible, they should at least be quarantined in the same ward, separated from uninfected patients.
Step 6. Make sure the hospital has adequate staff
When a facility is understaffed for shifts, the staff present may become stressed enough to lose focus. On the other hand, a rested nurse is more likely to follow the infection control and prevention protocol carefully, reducing the risk of spreading MRSA within the hospital.
Step 7. Watch for signs of a nosocomial infection
Usually, in the hospital setting, patients do not have the initial symptom of the abscess. Those receiving fluids or drugs through the central venous catheter are particularly vulnerable to MRSA septicemia, while those connected to ventilation devices are at risk for MRSA pneumonia. Both infections are life-threatening. MRSA can also appear as a bone infection after hip or knee replacement surgery or as a complication following an infected wound or operation. Either way, life-threatening septic shock could occur.
Step 8. Follow the procedure when placing the central venous catheter
Whether during the insertion procedure or while administering fluids or drugs, neglect of hygiene rules could contaminate the blood and cause an infection. Infections of the blood can travel to the heart and extend to the heart valves causing endocarditis, during which much of the infected material travels in the bloodstream spreading the infection systemically. It is a disease that causes numerous deaths every year.
Endocarditis is treated with repair of the damaged heart valve and 6-week antibiotic therapy to decontaminate the blood
Step 9. Try to comply with hygiene rules when handling artificial ventilation devices
Many patients contract MRSA pneumonia when undergoing artificial ventilation. When the oro-tracheal tube is inserted or manipulated, bacteria can enter the body. It happens that in emergency situations, staff do not have time to wash their hands properly, but everything must always be done to comply with this important preventive measure. If you don't have time to wash your hands, use at least a pair of sterile gloves.
Advice
- Wash and disinfect linens, clothes, and towels that have come into contact with the infected area of the skin.
- Always respect the rules of hygiene. For example, clean and disinfect all surfaces exposed to MRSA injury, such as doorknobs, light switches, kitchen countertops, bathtubs, sinks, and other surfaces in the home because an infected person can spread the bacteria with simple contact.
- Cover any open cuts, scrapes, or wounds with a band-aid until they heal completely.
- Use an alcohol-based hand sanitizer after treating or touching the wound.
- Always take probiotics during and after an oral antibiotic treatment to prevent the negative reactions of these drugs from destroying the bacterial flora.
- Try to cover the lesion with clothing to prevent the bacterium from spreading. If the infection is localized on one leg, wear long pants, not shorts.
Warnings
- MRSA skin infections are very sensitive. You should never try to break, drain, or pinch pimples as the situation could worsen, with the risk of passing the infection to other people. Rather, cover the infected area and consult a doctor to address the problem.
- If the immune system is weak, the MRSA infection could be life-threatening because it is very difficult to treat, especially if it reaches the lungs and enters the bloodstream. In these cases, a long hospital stay with continuous care and monitoring is required.
- Some people are healthy carriers of this infection. In other words, they have MRSA bacteria on their skin, but they do not exhibit infections. Your doctor may order tests for people you live closely with to confirm or rule out this hypothesis. Usually, the test consists of collecting a biological sample with a nasal swab. Healthy MRSA carriers are generally prescribed a continuous dose of antibiotics to completely eradicate the colony of bacteria.
- Some bacterial strains, such as MRSA, have an adaptive system that allows them to develop resistance against the most common antimicrobial drugs. Therefore, antibiotic treatments should be strictly followed without sharing them with anyone else.
- Avoid swimming pools, hot tubs, or any other recreational water facilities until the injury has completely healed. The chemicals in the water can make the infection worse and spread it among users.
