Sunday, September 7, 2008

MRSA

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria, a.k.a staph, that is resistant to certain antibiotics. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin. Staph infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems.
There is also a type of MRSA known as community- associated MRSA, which affects otherwise healthy people in the wider community (such as children at school).


Symptoms:

Most MRSA infections are skin infections that produce the following signs and symptoms:
* cellulitis (infection of the skin or the fat and tissues that lie immediately beneath the skin, usually starting as small red bumps in the skin),
*
boils (pus-filled infections of hair follicles),which are often red, painful or have pus or other drainage.
*
abscesses (collections of pus in under the skin),
*
sty (infection of eyelid gland),
*
carbuncles (infections larger than an abscess, usually with several openings to the skin), and
*
impetigo (a skin infection with pus-filled blisters).


Transmission:
By direct skin-to-skin contact or contact with shared items or surfaces that have come into contact with someone else's infection (e.g., towels, used bandages).

Prevention:

* practicing good hygiene (washing hands well with soap & water or an alcohol based hand sanitizer). * covering skin abrasions or cuts with a clean dry bandage until healed.
* avoiding sharing personal items (e.g., towels, razors) that come into contact with your bare skin; and using a barrier (e.g., clothing or a towel) between your skin and shared equipment such as weight-training benches;
* maintaining a clean environment by establishing cleaning procedures for frequently touched surfaces and surfaces that come into direct contact with people's skin.


Treatment:

*Trimethoprim-sulfamethoxazole-1 tablet PO bid
*Minocycline or Doxycycline-100 mg PO bid
*Rifampin (Adult dose: 300 mg PO bid x 5 days; pediatric dose: 10-20 mg/kg/day in 2 doses not to exceed 600 mg/d x 5 days) in combination with Trimethoprim-sulfamethoxazole, Minocycline, or Doxycycline has been shown to have a synergistic activity against