History of MRSA and drug resistance
On March 14, 1942 Anne Sheafe Miller lay dying of a serious streptococcal infection, a common cause of death at the time. She had been hospitalized for a month, in and out of delirium, with fevers spiking to 107 degrees fahrenheit. Her doctors told her there was no hope for her with current treatment, but there was this new medication they could try which might help. She agreed to try it, and that very night her temperature dropped, and by the next day she was better. Her hospital chart is held at the Smithsonian Institution. Penicillin was heralded as a “miracle drug,” and it certainly was. The era of modern medicine began. See “History of Modern Medicine.” http://1dl.us/pbC
MRSA, also called the “flesh-eating” bacteria has become a rather common infection. It can be very serious, even fatal, but most are easily treated and cured with antibiotics without the need for surgery. The photo above is MRSA. Note the spherical grape-like shape. Bacteria shaped like this are called cocci (coccus is singular), thus the name staphylococcus. Sausage-shaped bacteria are called bacilli (bacillus singular) or rods.
When penicillin was first used, it cured not only strep (as described in the miraculous story of Anne Sheafe Miller), but also staph (staphylococcus aureus is the proper name) and many other bacterial infections. It did not take long unfortunately for the phenomenon of resistance to develop. Strep never has developed serious resistance, but staph became very resistant to penicillin. Scientists played around with the penicillin molecule until they found new molecules that worked well on the staph bacteria. This additional weapon again brought staph infections under control. This semi-synthetic penicillin was methicillin. Methicillin could only be given iv, so other molecules were developed that could be taken orally. Cloxacillin and dicloxacillin were two of the first.
Unfortunately that was not the end of the story. Staph developed resistance to the semi-synthetic penicillins including methicillin. This new bug was called Methicillin Resistant Staph Aureus, MRSA. This resistant staph is simply a strain of staph and is otherwise identical to the staph strain that is still killed by methicillin (still sensitive to methicillin).
For the longest time MRSA infections were only found in hospitals where large amounts of antibiotics are used. Something happened several years ago and MRSA infections were being seen in the community. Nobody is certain why this transition occurred, but now most community acquired staph infections are the MRSA variety. Some think that the common use of hand cleansers might have played a role in the transition of MRSA to the community where the normal bacteria colonizing the skin of people in the community was eliminated opening the way for MRSA to colonize normal skin. MRSA has become a serious public health issue. More people in the U.S. now die from MRSA infection than from AIDS. MESA was responsible for an estimated 94,000 life-threatening infections and 18,650 deaths in 2005, as reported by CDC. To keep MRSA infections in perspective though, most patients do fine with proper care.
What is a MRSA infection?
Most of the time MRSA infections are simply boils. Boils are localized infections in the skin that come to a “head” and drain pus either spontaneously or after being lanced by a physician; sort of like a large pimple. The problem with MRSA infections is that not only are the infecting bacteria resistant to commonly used antibiotics, this bacterium is also much more invasive than it’s sister bacterium methicillin sensitive staph aureus. So the MRSA bacteria invade more deeply more quickly which is why more people are hospitalized for aggressive treatment with iv antibiotics and surgery to drain the infection. Drainage promotes healing and slows down the deep invasion.
How do I know if I have a MRSA infection or the methicillin sensitive staph aureus?
Because of the emergence of MRSA, boils should be evaluated by a health care professional. Usually from the appearance your health care professional will have a pretty good idea if it MRSA, but to tell for sure a culture will generally be done. MRSA infections are boils. These are tender nodules and feel fluctuant (mushy) because they are filled with pus. They are warm and tender. There is usually a pustule in the center surrounded by a blueish-purplish discoloration which extends into redness of the skin. MRSA can also cause cellulitis which is a more superficial infection causing an extending area of redness, warmth and tenderness, but a pustule is usually present. Usually antibiotics will be prescribed which are effective for both MRSA and non-MRSA infections until the culture result comes back in 3-4 days. These infections are usually followed very closely. These infections take weeks to months to heal.
How to prevent MRSA from recurring
MRSA infections are very contagious. You can spread to infection to other areas of your body and to other people. Taking antibiotics will clear up the initial infection, but as long as there is colonization of the skin with MRSA bacteria the infection can recur in the same or other areas. If you touch others their skin may become contaminated with the MRSA bacteria and they can develop boils as well.
So to prevent the infection from recurring the bacteria must be removed from the skin. The way this is done is by washing the entire skin daily for two weeks with Hibiclens. Hibiclens is an antibacterial solution. MRSA can also be harbored in the nostrils so Mupirocin intranasal ointment would also need to be applied for ten days. After that it would be wise to use Dial antibacterial soap for several months.
The information presented here and in other articles on this website is meant for general information only, and not for specific treatment recommendations. Speak with your physician or healthcare provider for more information on this topic. This is copyrighted material 2011, all rights reserved familymedschool.com