MRSA Infection in the Community (Methicillin Resistant Staphylococcus Aureus)

Staphylococcus aureus, often simply called "staph," are common bacteria (germs). Everyone has bacteria on their skin and in their noses. Some bacteria can cause infections if there are tiny breaks in the skin. In the United States, staph bacteria are among the most common causes of skin infections. Most of these infections are minor and can be treated without antibiotic medicines. Sometimes, though, staph bacteria can cause serious wound infections. In the past, most serious staph infections were treated with a certain type of antibiotic related to penicillin. Over the past 50 years, it has become harder to treat these infections. The staph bacteria have become resistant to many antibiotics in the penicillin family. These resistant bacteria are called Methicillin-Resistant Staphylococcus Aureus, or MRSA.

People can have MRSA bacteria in their bodies and not get sick. Infection occurs when the bacteria cause disease in the person. Many times the first sign is an infected boil or red, raised areas, often mistaken for “spider bites.”

MRSA Infection

Many children who develop MRSA abscesses (boils) are exposed through sources in the community. MRSA is spread by contact with infected skin or contaminated objects.

Risk factors include:

• Recent, frequent antibiotic use
• Sharing items like toothbrushes, towels and sports equipment that have the bacteria on them.
• Having active skin infections
• Living in crowded settings
• Getting tattoos at an unlicensed place
• Close contact with others who have MRSA germs growing on their skin (such as in gym class or locker room).

Treatment

Many staph skin infections may be treated just by draining the boil or abscess. Most staph, including MRSA, can be treated with certain antibiotics. If the doctor prescribes an antibiotic, it is very important to take all the medicine as ordered.

• If an ointment is prescribed, apply it to all the skin sores, even the tiny ones.
• If an incision was made and the area was packed with a gauze dressing, your doctor may want you to come back for repacking the wound. Be sure to follow your doctor’s instructions.
• Sometimes the doctor may order special antibacterial ointment to be placed in the child’s nose or a special soap for bathing. 
• Your child should not take part in contact sports until the infection has healed.

Other Family Members

Other family members and household pets may be at risk for getting the MRSA infection or for being carriers. If family members develop boils or infected sores, they should contact their doctor for advice. If you notice signs of skin infection on your pets, contact your veterinarian.

Prevention

MRSA is usually spread by direct contact and not through the air. It can also be spread by touching objects (towels, sheets, wound dressings, clothes, workout areas or sports equipment) that have touched the infected skin of a person with MRSA. Here are some things that you can do to prevent the spread of MRSA infection:

• Teach your child not to share towels, clothing, toothbrushes, combs, sports equipment, etc.
• Wash your hands often for 15 to 20 seconds (Picture 1). Use a hand sanitizer or antibacterial soap and water, especially after touching infected skin or bandages.
• Keep cuts, scrapes and sores clean. Keep them covered with a clean bandage until healed.
• Place soiled bandages and other disposable waste in a separate trash bag and close tightly.
• Do not touch other people’s wounds or items that have touched their wounds. Teach your child not to touch or pick at the wound.
• Students should shower after every athletic activity and use clean towels. Students with boils should not participate until the infection is completely healed.
• Wear rubber gloves and scrub the bathtub after each use with a bleach solution (or bathroom cleanser that contains bleach).

Hospital Acquired MRSA

MRSA in the community does not mean the person was exposed to the bacteria in the health care setting. The two forms of MRSA are different types of organisms (germs). However, in the hospital, the things that increase a person’s chances of getting sick from MRSA include:

• Patients who have an open wound (such as a bed sore) or a tube going into their body (such as a urinary catheter or IV).
• Recent surgery or being in the hospital for a long time, especially in an intensive care unit or burn unit.
• Receiving broad-spectrum antibiotics (drugs that kill many kinds of bacteria).
• Spending time around other people who have MRSA.

Staph bacteria can also cause bone infections or severe life-threatening bloodstream infections.

When to Call the Doctor

• If your child’s condition gets worse (more swollen, more painful, redder, etc.).
• If your child develops a fever, has trouble breathing or has other signs of becoming sicker (such as vomiting, diarrhea, always sleeping, etc.).
• If your child or another family member develops new skin sores, abscesses or boils (Picture 2).
• If your child won’t take the medicine that the doctor prescribed.

If you have any questions, be sure to ask your doctor or nurse.

MRSA Infection (PDF)

HH-I-244 11/04 Revised 9/11 Copyright 2004 - 2011, Nationwide Children’s Hospital