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MRSA, MRSA Everywhere

Stephen Leinenweber is a pediatric intensivist with WakeMed Children’s Hospital.

In the past, we would typically only see Methicillin-resistant Staphylococcus aureus (MRSA) infections in patients who had been in the hospital for a long period of time.  Now, we are seeing more and more community acquired infection.  In other words, we are now seeing patients who have had no history of a hospital stay present with MRSA infections to physician offices and emergency departments.

MRSA is a particular strain of Staphylococcus aureus, which is a bacteria commonly found on the skin, that has become immune to many of the antibiotics we commonly use to treat skin infections.  It is likely that MRSA became resistant to many of antibiotics due to antibiotic overuse.  Regardless of the origin, MRSA is here to stay and it is a significant problem.

I estimate that we admit at least one pediatric patient in need of IV antibiotics or even surgery due to advanced MRSA infections per day.  Children being admitted to the hospital represent the worst of all cases, and I am certain primary care physicians, pediatricians, and emergency rooms are seeing an even higher number of less severe cases.

The majority skin infections are from non-resistant Staph or streptococcus infections. MRSA is not something to fear, but it is a good idea to know a little something about this increasingly common skin infection.


Does MRSA impact children as well as adults?

The short answer is yes.  However, anecdotally it also appears as if children are more susceptible to develop more serious MRSA infections, but we don’t really know why.  It might be that kids receive more antibiotics due their frequent exposure to more illnesses.

Can you prevent MRSA?

You can’t eradicate staph living on the skin.  The best prevention is just to practice good skin care.  You don’t want the skin to be too dry or too moist.  It is also a good idea to have limited contact with someone you know is being actively treated MRSA.  And, as always, wash your hands and your children’s hands frequently.  It’s a good idea to regularly wash your children’s toys and sports equipment, as well.

How can you tell it’s MRSA?

MRSA’s symptoms are the same as any other skin infection (because it really is just a certain strain of bacterial infection). Look for red streakiness of the skin, skin that is warm to touch or a painful area that might suggest an abscess or bad skin infection.  If you or your child has any of these signs, seek medical advice from a primary care physician or, if severe enough, the emergency room.

Realize too, that often physicians will not swab and culture the infection, instead choosing to treat the infection as if it were MRSA.  So, do not be surprised if the diagnosis of MRSA is never confirmed. From a medical standpoint unless the infection is severe, typing the infection does not matter.

Should I avoid people I know have been treated for MRSA?

There are a lot of social stigmas associated with MRSA, but again MRSA is everywhere.  And, yes, I have and I will continue to allow my children to go play with another child who has been treated for MRSA.  I arm them with education, so they understand the importance of good hand hygiene.

Want to learn more about MRSA?  Dr. Mark Piehl, medical director WakeMed Children’s Hospital, was quoted in a story in yesterday’s News & Observer about MRSA infecting otherwise healthy people.