Wednesday, February 29, 2012

MRSA Could Lead to Bigger Problems

MRSA Could Lead to Bigger Problems

Feb 29, 2012

The presence of a boil on the body should not be taken lightly, according to Dr. Bertha Ayi.

Leaving it untreated, she said, could result in serious health consequences, even death.

"If you have a boil, don't just lance it at home and forget about it," said Ayi, medical director of Mercy Infectious Disease & Epidemiology Center -- Sioux City. "See a physician and take a culture to see if it's (Methicillin-resistant Staphylococcus aureus), because it can progress."

According to Ayi, studies have show that 50 percent of patients suffering from boils who visit emergency rooms nationwide have Methicillin-resistant Staphylococcus aureus (MRSA).

In October 2007, the Centers for Disease Control and Prevention (CDC) released a study outlining the full extent of MRSA infection in the U.S. population. That study noted that in one year, MRSA infections killed more people than Human Immunodeficiency Virus (HIV).

Soon after the CDC report, MRSA made national headlines when several U.S. schools closed their doors when students died or became seriously ill from MRSA infection.

Four years after the study was released, Ayi said MRSA is present in Sioux City and around the country.

"Am I seeing more cases?" she said. "I've seen more cases in the past than now. I may not be seeing as much because other physicians are getting more comfortable treating it."


Staphylococcus aureus, the cause of common boils, has been around a long time, according to Ayi.

But over the years, she said the bacteria has become resistant to Methicillin, an antibiotic commonly used to treat ordinary staph infections. Hence Methicillin-resistant Staphylococcus aureus or MRSA.

Ayi said MRSA used to be found only in hospitals, but from 1995 to 1998 doctors began seeing healthy, young children, who had had no contact with the health care system, developing severe pneumonia and brain infections.

"They died within three to four days. It was due to the Methicillin-resistant Staphylococcus aureus," she said. "The thought was that over time (MRSA) acquire certain characteristics that allow them to get into the environment and cause infections in previously healthy young people."

Today MRSA is common in places where there is overcrowding, such as prisons. Ayi said MRSA is also prevalent among the homeless, who may leave wounds untreated.

Athletes participating in football and wrestling are at a higher risk of contracting MRSA, according to Ayi, because of the nearly constant skin-to-skin contact required in the sport.

"Among athletes, if somebody carries it on their skin they can pass it on without necessarily having an open wound," she said.


Cuts, scrapes and scratches allow bacteria to enter the skin, according to Ayi, leading to infection

It's important to clean and disinfect cuts and scrapes and cover them with bandages or sterile dressings.

If the wound becomes infected and a boil develops, Ayi said the patient should seek treatment from a medical professional immediately.

Ayi explained that a boil has blood flowing around it, meaning that the infection could spread into the blood stream leading to sepsis a potentially fatal illness where the blood is stream is overwhelmed by bacteria.

Those suffering from MRSA, Ayi said, could also develop infections of the brain and spinal chord, as well as necrotizing pneumonia - where the pieces of the lung are literally eaten away by the bacteria.

One of her patients, Ayi said, had a small MRSA infection on his thigh that spread into his femur bone.

"It can get into any tissue -- feet, ankle joints," she said. "Some times people will have joint replacement. It's a pretty bad infection to acquire."

Washing hands well and covering all wounds are key to preventing the spread of MRSA, according to Ayi.

"If somebody has MRSA we go in there with gloves, gowns and we dispose of their bodily fluids very well," she said. "We don't go in there with our bare fingers and try to examine the wounds. We make sure we're protected."

An athletic team in the midst of a MRSA outbreak, Ayi said, can attempt to "decolonize" the bacteria by putting cream in their nostrils, by avoiding sharing towels and clothing, and by washing with an antiseptic solution.

She said athletes with active lesions should refrain from participating in the sport.


How to treat MRSA, depends on the severity of the infection, according to Ayi.

She said a current patient has a MRSA infection in her elbow. The woman was taking antibiotics in pill form, but it didn't cure her infection. Now, Ayi said she is receiving antibiotics intravenously.

"Intravenous antibiotics -- usually people are a lot sicker," she said. "Maybe it involves their lungs or spinal chord or you can tell based on clinical judgment that it could aggressively progress to a more severe disease."

Ayi advises those who have previously suffered from MRSA tell their physicians whenever they go to a clinic or hospital for medical care.

"The care providers can think about it and put it in their differential diagnosis," she said.

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