Medically reviewed by Scott Hultman, MD, MBA, FACS
Did you know that all kinds of germs can hang out on your skin and inside your nostrils?
On healthy children and adults, germs are typically harmless and just along for the ride. But, there are times when germs — specifically, staph bacteria — will enter deeper parts of the body, and that’s where the trouble begins.
Staph bacteria are usually benign. Sometimes, they can cause manageable skin infections. Other times, the bacteria can break through the skin barrier and lead to severe infections — lethal enough to cause sepsis or even death.
You’ve probably heard of MRSA, or Methicillin-resistant Staphylococcus aureus (MRSA) infection, but you may not know that it’s a specific type of staph bacteria and is often resistant to many treatments. Why is this? Scientists have found that genetic mutations in MRSA allow it to evolve and resist antibiotics, such as penicillin. For this reason, it is one of the leading causes of skin infections in the United States in both children and adults.
MRSA infections that reach the bloodstream are responsible for several complications, such as:
And, as mentioned earlier, MRSA can also lead to fatalities, killing up to 30 percent of patients.
While children may be less likely to die from an MRSA infection, their risks for complications are higher. Children may also be more likely than adults to return to the hospital within 30 days of discharge following a serious MRSA infection.
Clearly, MRSA has the potential to be a big deal, so let’s learn how to spot it and appropriate next steps if you test positive.
What MRSA Looks Like
MRSA infections begin as small, painful, red bumps that might look like pimples or spider bites. The area may also be warm to the touch, filled with pus or draining. This area can quickly turn into deep and painful abscesses. And, the pus or drainage containing infectious bacteria can be spread to others.
Who Gets MRSA
Anyone can get an MRSA infection. If you have open wounds from abrasions, burns, cuts or rashes, this is often the site of the infection.
MRSA is also contagious and spreads through skin-to-skin contact. If one person in a family is infected with MRSA, the rest of the family may get it. This also means where non-family members live or spend a significant amount of time in close quarters — childcare centers, schools, youth camps, sports facilities, nursing homes, prisons, dorms, military barracks, etc. — there is a greater chance for infectious spread.
Infants and children are particularly at risk. Very young babies have a less developed immune system, so they are more prone to catch MRSA from an adult caregiver. Children are more at risk for mild skin injuries — that can serve as the site of an MRSA infection — from falls, rough play and contact sports since they have less developed gross and fine motor skills than adults.
Dr. Scott Hultman, the inaugural Chair of the Department of Plastic & Reconstructive Surgery explains, “MRSA is quite common in children. Children who participate in contact sports and dress out in gym lockers rooms are especially susceptible, so it is important to keep an eye on any skin irritations that appear infected.”
How Fast MRSA Spreads
MRSA infections can progress rapidly, within hours or a day. When you see the first signs of it, see a medical provider immediately.
Signs of MRSA skin infection:
- Full of pus or other drainage
- Painful
- Red
- Swollen
- Warm skin at the sight of the infection
Here are signs of a potentially dangerous infection:
- A fever above 101.3
- Heart rate faster than 90 beats per minute
- Mental confusion
Tests for MRSA
If your provider suspects MRSA, he or she may take a sample culture from your infected blood, nose, saliva, skin or urine and send it to a lab. A positive result means you have MRSA. In this case, the provider will need to determine how best to treat the infection.
Treatments for MRSA
When results are positive, treatment will depend on the infection, itself. For mild skin infections, your provider may clean, drain and cover the wound. You may also be prescribed an antibiotic to apply directly to the wound or to take orally.
In severe cases, patients may be hospitalized and treated with an intravenous (IV) medication. The intravenous antibiotic is usually continued until the patient shows signs of improvement. After discharge, antibiotics are often continued and administered by IV or by mouth.
Overuse or misuse of antibiotics has allowed MRSA to evolve, rendering it challenging to treat. While it is a staph bacterium that certain antibiotics in the penicillin family should be able to remedy, they typically cannot because MRSA is extremely resistant. However, other non-penicillin antibiotics can effectively treat most MRSA infections. A few include trimethoprim-sulfamethoxazole, clindamycin, minocycline, linezolid or doxycycline.
Because of the potency of MRSA, sometimes it will resolve and then reappear. This can happen repeatedly. In this case, your provider may need to take additional measures to stop the infection from returning.
How to Prevent MRSA Infections
You can take these steps to reduce your risk and your child’s risk of contracting an MRSA infection:
- Maintain bodily hygiene. Clean your body regularly, especially after exercise.
- Keep cuts, scrapes and wounds clean and covered until they heal.
- Do not pick at or pop a skin sore.
- Follow your health care provider’s instructions about proper care of the wound. Pus from infected wounds can contain MRSA.
- Steer clear of sharing personal hygiene items, such as towels, wash clothes, clothes and razors.
- Wash dirty laundry, and clean your hands after touching dirty clothes.
- Schedule immediate medical care if you think you might have an infection.
- Throw away dirty/used bandages, gauze and tape in the trash. These should not be recycled or composted.
- Clean your hands often and urge others in close contact with you to do the same. You should wash your hands often — for at least 20 seconds per washing — with soap and water. You may also use an alcohol-based hand rub:
- Before cooking
- Upon entering your home
- After changing a bandage
- After touching an infected wound
- After touching dirty clothes
Where to Seek Care
- Primary Care and Pediatric Primary Care — If you have symptoms of an infection, don’t delay care. Your Primary Care provider is typically the least expensive treatment option, and it’s best to work with a physician who knows you, your medical history and medications.
- Urgent Care — Our WakeMed Urgent Care locations offer extended hours, most of the time until 8 pm. We also have dedicated pediatric urgent care facilities in Cary, Morrisville, North Raleigh and in various other areas with PM Pediatrics. This is a good option if you’re unable to get an appointment with your primary care physician or if it’s after regular business hours and your provider’s office is closed.
- Emergency Department — WakeMed Emergency Departments, including the WakeMed Children’s Emergency Department, are open 24 hours a day, every day. If your condition is life-threatening or no other level of care is open, visit your nearest location.
- Virtual Urgent Care — Available via our mobile app, virtual care options are available 24/7 from anywhere in North Carolina. While you can’t get tested for MRSA, physicians can evaluate you, offer guidance and potentially write prescriptions to treat concerning symptoms.
- Plastic & Reconstructive Surgery — Offering specialized wound care and treatment options for patients with complex soft tissue injuries, learn more about the acute care specialty.
About Scott Hultman, MD, MBA, FACS
Dr. C. Scott Hultman is a triple board-certified plastic and reconstructive surgeon with interests in burn and wound care, breast reconstruction, body contouring after significant weight loss, chest and abdominal wall reconstruction, hand and peripheral nerve surgery, skin cancer management, and aesthetic surgery.
Dr. Hultman joins WakeMed as the inaugural Chair of the Department of Plastic and Reconstructive Surgery. He arrives from Johns Hopkins University, where he served as Professor of Plastic and Reconstructive Surgery, Vice-Chair of Strategy and Development, Director of the Johns Hopkins Bayview Burn Center, Fellowship Director for Surgical Critical Care, and Medical Director of the Johns Hopkins Green Spring Ambulatory Surgery Center.
Prior to his recruitment to Hopkins, Dr. Hultman was the Ethel and James Valone Distinguished Professor of Surgery at the University of North Carolina, where he served as Chief and Residency Program Director for Plastic Surgery, Vice Chair of Finance for the Department of Surgery, and Interim Chair of the Graduate Medical Education Committee. He is a Past President of the Plastic Surgery Foundation, the American Council of Academic Plastic Surgeons, and the North Carolina Society of Plastic Surgeons.
He obtained his undergraduate degree in psychology from Brown University and received his medical degree at the University of Pittsburgh. Dr. Hultman then completed training in general surgery and surgical critical care at the University of North Carolina, where he also pursued a two-year basic science fellowship in burn immunology and keratinocyte biology. He completed his training in plastic surgery at Emory University. Dr. Hultman obtained an executive MBA from the UNC Kenan Flagler Business School, with a focus on health care economics and service operations, where mentors included Susan Palmer and Ted Zoller.
A recognized expert in acute burn care and burn reconstruction, Dr. Hultman is an internationally renowned educator, innovator, and leader in reconstructive and aesthetic plastic surgery. Throughout his career, Dr. Hultman has sought to improve the patient experience, which includes not only patient safety and improved clinical outcomes, but also improving patient access and patient satisfaction. Toward that end, he prioritizes shared decision making with his patients and helps them choose the best option to meet their individual goals. His dual training in medicine and business has allowed him to focus on and transform systems of health care. Clinically, he continues to develop novel techniques in wound closure, fat grafting, laser resurfacing, and peripheral nerve surgery to help restore form and function.
The author of more than 200 scientific articles, reviews, and chapters, plus the editor of four medical textbooks, Dr. Hultman has mentored more than 50 surgeons during various stages of their academic careers. In 2016, he received the Distinguished Alumni Award from the UNC Kenan Flagler Business School, and he delivered the commencement address for the UNC Executive MBA class in 2017. Nationally, he serves on the Accreditation Council for Graduate Medical Education and is a senior examiner for the American Board of Plastic Surgery. In addition to being board certified in Plastic Surgery, he remains board certified in General Surgery and Surgical Critical Care.
Dr. Hultman and his wife Suzanne, an ordained Methodist minister in the North Carolina Conference, are excited to return to the Triangle, where they had previously resided for 3 decades. Their children grew up in Chapel Hill and are now pursuing careers in public health, the military, and business. The extended Hultman family lives in Wyoming, California, Pennsylvania, South Carolina, Georgia, and Missouri, but nothing is finer than spending time together in the mountains or on the coast of North Carolina.
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