Community-acquired MRSA (methicillin resistant staphylococcus aureus) is an infection with staphylococcus bacteria that is resistant to certain antibiotics. MRSA occurs most often in hospital settings (HA MRSA), but it can occur in the general population, and is defined as community-acquired (CA) if the infected person has not had any contact with a hospital for a year. Though generally milder, the disease is of concern because of its potential to spread, especially among people in close proximity to each other, such as in schools, on sports teams or in family settings. Recognizing, treating and following guidelines to reduce contagion help protect communities from widespread infection.
There are several differences between community-acquired MRSA and HA forms. HA MRSA mostly attacks the medically vulnerable and may more readily infect many areas of the body. CA MRSA is frequently limited to skin infections that look like pimples or boils and can infect healthy people. CA forms don’t always require the same treatments as HA MRSA. Antibiotics aren’t always used to treat CA MRSA, unless the condition is clearly spreading, runs risk of blood infection, or is infecting the lungs, which is rare. Additionally, HA MRSA is still much more common, though concern exists about growing prevalence of CA cases.
Symptoms of community-acquired MRSA include presence of a pimple, boil or abscess on the skin that could be draining pus. It will usually feel warm, and fever, swollen glands or tiredness might occur. Size of the abscess, in absence of treatment, may enlarge and spread. More rarely, CA MRSA presents as pneumonia. A doctor should analyze pneumonia or rash symptoms, and any suspicious boil could be cultured to determine if it contains methicillin resistant bacteria.
Depending on the patient's overall health, a couple of treatment strategies might be adopted. Most boils are drained and the patient is instructed to keep the wound completely covered, and to wash hands immediately after contact with the infected area. Caregivers are also instructed to wash hands frequently, especially after touching the infection site, and to avoid sharing personal items like razors, towels, and linens. If these guidelines are observed, risk of spreading community-acquired MRSA is relatively low.
Decision to give antibiotics that can effectively treat MRSA depends on the patient and severity of the infection. Any evidence of spreading infection, medical vulnerability, or failure to respond well to draining of the abscess could be an indication to include antibiotic treatment. Patients with community-acquired MRSA have several follow-ups with physicians to make certain an infection is healing.
Concern exists about guidelines for contact with others during a case of CA MRSA. Provided full covering of wounds and handwashing protocol are followed, community-acquired MRSA won’t spread to others easily. On the other hand, especially in places like school settings, children aren’t necessarily reliable about hygiene; even healthcare workers sometimes fail to wash their hands. There remains debate about whether people with active infections should expose others, and some argue that those with MRSA should have limited exposure to others to prevent spread.
