At a glance
- MRSA can cause severe problems in healthcare facilities.
- MRSA can be resistant to several antibiotics.
- MRSA prevention efforts can reduce infections.
Overview
CDC considers methicillin-resistant Staphylococcus aureus (MRSA) a "serious threat."1 In healthcare facilities, such as hospitals or nursing homes, MRSA can cause severe problems including:
- Bloodstream infections
- Pneumonia
- Surgical site infections
- Sepsis
- Death
CDC encourages clinicians to consider MRSA in the diagnosis of skin and soft tissue infections (SSTIs) compatible with S. aureus infections, especially those that are purulent (e.g., fluctuant or palpable fluid-filled cavity, yellow or white center, central point or "head," draining pus, or possible to aspirate pus with needle or syringe).
Risk factors
People are at higher risk for MRSA infection when they:
- Have surgery.
- Have medical devices inserted in their body.
- Use needles to inject drugs.
How it spreads
In healthcare settings, MRSA usually spreads through direct contact with an infected wound or from contaminated hands. People who carry MRSA but do not have signs of infection (i.e., people who are colonized) can spread the bacteria to others.
How common it is
2 in 100
In the nose
Studies show that about one in three people (33%) carry S. aureus bacteria in their nose (the main site of colonization), usually without any illness.
On the skin
Skin infections caused by MRSA are common in the general community.
Clinical features
Common appearance
Most S. aureus skin infections, including MRSA, appear as a bump or infected area on the skin that might be:
- Red.
- Swollen.
- Painful.
- Warm to the touch.
- Full of pus or other drainage.
- Accompanied by a fever.
Clinical manifestations
SSTIs, carbuncles and abscesses are the most reported clinical manifestations.
The role of MRSA in cellulitis without abscess or purulent drainage is less clear since cultures are rarely obtained.
Prevention
Numerous studies show that MRSA prevention efforts can reduce infections.
Successful MRSA prevention requires action at the healthcare facility level, among both healthcare providers and leadership.
Prevention resources
- CDC's strategies to prevent S. aureus in acute care facilities
- Society for Healthcare Epidemiology of America (SHEA)/Infectious Diseases Society of America (IDSA)/Association for Professionals in Infection Control and Epidemiology (APIC) Practice Recommendation.
Testing
Determine if a patient is carrying MRSA
Providers can test to see if a patient is carrying MRSA in their nose or on their skin by rubbing a cotton-tipped swab in or on the area.
Determine if a patient has a MRSA infection
The only way to know if MRSA is the cause of an infection is to test for the bacteria in a laboratory.
Treatment and recovery
Treatment and decolonization
The main treatment for MRSA skin infections is incisions and drainage. Antibiotics may also be required. Providers can also apply topical medicines and antiseptics to decrease the amount of S. aureus on a person's body.
Antibiotics
Culture and susceptibility testing should guide therapy and antibiotic decisions for patients with severe infections that do not respond to initial treatment attempts.
Complications
MRSA skin infections can develop into more serious infections. It is important to discuss a follow-up plan with your patients in case they develop symptoms, or if symptoms do not improve within 48 hours.
Resources and tools
Guidelines
- Clinical Practice Guidelines by the IDSA for the Treatment of MRSA Infections in Adults and Children (2011)
- Infectious Diseases Society of America (IDSA)