Fighting the “Super Bug:” The Spread of MRSA

When a strand of bacteria is dubbed a “super bug,” people tend to pay attention. If you closely follow medical headlines, you might have read about an alarming malady known as a MRSA (methicillin-resistant staphylococcus aureus) infection. While still a rare occurrence, the slow but steady up-tick of MRSA infections has deeply troubled some health officials, who fear the disease may one day swell into a massive public health treat. As with other serious illnesses, educating yourself about the risks of MRSA can help you maintain a clean bill of health.

The Origins of MRSA

Doctors have long known about Staphylococcus aureus (abbreviated as s. aureus for short) for well over a century, first discovering this type of bacteria in the 1880s. Patients unlucky enough to be sickened by this bacteria risked suffering a number of painful skin conditions, such as boils, impetigo and scalded-skin syndrome. Alarming as these symptoms were, they didn’t represent the worst impact that s. aureus could have on its victims. In the most severe cases, an s. aureus infection would result in a patient’s death.

In this timeframe, S. aureus was hardly the only type of bacteria to infect people by the millions. Up until the mid-twentieth century, humankind was often at the mercy of endless waves of harmful microbes, leading to routine outbreaks of pneumonia and tuberculosis. In the year 1900, the leading causes of death in the United States – gastrointestinal infections, tuberculosis and influenza/pneumonia – could largely be attributed to the persistent menace of harmful bacteria.

All of this drastically changed with the advent of antibiotics, medicines specifically designed to attack and kill disease-causing bacteria. Conditions such as pneumonia became more a nuisance than a threat, whereas some diseases (like tuberculosis) virtually disappeared altogether. Likewise, the first wave of antibiotic medications initially proved to be effective remedy for s. aureus.

These new medicines might have delivered a stinging setback to s. aureus, but this microscopic foe was not about to roll over and die. By the 1950s, s. aureus had developed a resistance to penicillin, the antibiotic doctors had previously used to kill it. In response, researchers created a new antibiotic known as methicillin, a drug tailor-made to wipe out penicillin-resistant s. aureus. Unfortunately, s. aureus quickly countered this strategy as well. The first strains of methicillin-resistant s. aureus were uncovered in the Britain in 1961; a short seven years later, MRSA made the trip across the Atlantic to the United States.

Spreading From Hospitals

People tend to view hospitals as safe havens for those afflicted by either injuries or disease. However, with so many ill patients confined in a small area, hospitals can unfortunately function as a breeding ground for infectious bacteria, including MRSA. The hospitalized patients most likely to contract MRSA tend to have immune systems weakened by unrelated illnesses.

In the past, MRSA bacteria were confined almost exclusively to hospital environments. This has begun to change in recent years, with otherwise healthy people becoming infected at a steadily growing rate. The bacteria itself is spread through several avenues, including skin-to-skin contact and contact with contaminated surfaces. Open wounds, such as cuts and abrasions, can also allow MRSA bacteria to jump to a new victim.

Outside of a hospital setting, MRSA bacteria can thrive in cramped locations shared by large groups of people. Dormitories, athletic facilities, military barracks and prisons can all fit these criteria to a tee. As a result, MRSA infections have become a growing problem amongst college students, student-athletes, enlisted military personnel and the incarcerated population.

There is significant evidence to suggest that MRSA is spreading at a slow yet steady pace in the United States. Consider that in 1974, MRSA accounted for just 2 percent of all infections involving strains staph bacteria. By 1995, this figure had increased tenfold to 22%. This already troubling trend accelerated greatly in the following decade. According to the Centers for Disease Control and Prevention (CDC), a stunning 63 percent of all 2005 staph infections were attributable to MRSA. The growing prevalence of MRSA bacteria has been accompanied by a worrisome spike in MRSA-related deaths. Over 18,000 Americans died of MRSA infections in 2005.

Symptoms of a Super Bug

You would be correct in assuming that contracting a “super bug” would be an exceptionally unpleasant ordeal. What may surprise you, however, is just how common our good friend s. aureus actually is. The CDC estimates that 25 to 30 percent of Americans have s. aureus on either their skin or inside their nasal cavity.

Before getting all worked up over this factoid, it should be stressed that the very few of these patients actually have MRSA. There are actually over thirty strains of staphylococcus aureus, most of which can be treated with conventional antibiotics should they act up. Even minor problems from s. aureus are the exception rather than the rule, as most s. aureus bacteria cause no discernable symptoms. This is referred to as bacterial colonization; in other words, bacteria roam freely through the body without disrupting the patient’s health.

MRSA is found in about one in fifty Americans, though this shouldn’t be taken to mean that 2 percent of Americans have MRSA symptoms. Like other forms of bacteria, MRSA can simply colonize rather than infect a patient. It is estimated that over 400,000 Americans have been colonized with MRSA without knowing it.

When MRSA bacteria do infect the body, its subsequent symptoms can vary greatly from patient to patient. In some cases, only the body’s skin will show signs of infection. Some of the potential effects of MRSA on the skin are detailed below:

• Pain
• Redness
• Swelling
• Boils
• Blisters
• Sores which emit ooze or pus
• The skin around the sore(s) becomes noticeably hot and uncomfortable

The symptoms may not stop there. Should the MRSA bacteria find its way inside the body, it can latch onto the lungs, heart and bones. It can also wreak havoc with the body’s bloodstream. Such a scenario is referred to as invasive MRSA, and it can lead to a number of health-related complications:

• Frequent pains in the chest area
• Coughing
• Lack of energy
• Fever and chills
• Headaches and body aches
• Skin rash
• Dizziness and fainting

The most alarming symptoms of invasive MRSA are endocarditis (a condition in which the heart’s lining becomes inflamed), pneumonia and blood poisoning. MRSA bacteria can also trigger toxic shock and septic shock, two chemical reactions that scatter toxins throughout the body. Each of these conditions afflicts the patient with a barrage of additional health problems, to the point that both toxic and septic shock can be life-threatening.

Treating and Preventing MRSA

Given its accumulated defenses against antibiotics, treating an MRSA infection can be quite a conundrum for doctors. Some patients develop abscesses on the surface of their skin (abscesses are unsightly areas of swollen tissue that are filled with pus). To remove the abscess, the doctor may opt to make a surgical incision in the swollen tissue, allowing the pus within to drain. If the infection is not particularly severe, this technique might be enough to clear the infection from the patient.

Though MRSA long ago bested methicillin, there still exist antibiotics that can kill it. If the doctor determines that antibiotic medications are necessary, the two drugs most likely to be used first on the patient include bactrim and vancomycin.  Should these first-line treatments fail, doctors do have a number of multi-syllabic secondary options to choose from, including Tygacil, clindamycin, minocycline, Zyvox, Cubicin, and Synercid. Many of these drugs must be administered intravenously, meaning that they can only be effective after being injected directly into the patient’s bloodstream.

Though they have a decent track record of success, MRSA bacteria appear to be developing a resistance against some of these drugs as well.

Making the issue of treatment even complex is that some cases require combinations of antibiotics. True to their nature, MRSA bacteria can become immune to these medical cocktails in short order. This can eventually develop into a cat-and-mouse type of situation, in which the patient’s doctors are forced to keep trying different combinations to keep up with an ever-changing opponent.

Protecting your body from MRSA depends largely on your surroundings. In a hospital setting, it is highly advisable for patients and visitors alike to follow some common-sense guidelines. For example, patients should wash their hand after their hands after using the bathroom, along with before and after meals. Visitors at best served by keeping their distance from the patient, and should avoid sitting on the patient’s bed. In addition, visitors are encouraged to wash their hands both prior to and after visiting the patient’s ward.

Other locations require a slightly different approach. The preventative measures against MRSA in schools, athletic facilities and prisons are detailed below:

• Wounds that are draining fluids or filled with pus should be covered by sterile bandages.
• As in hospitals, harmful bacteria can be eliminated by regular hand-washing with soap and water. Hand sanitizer can be used in lieu of soap, provided it is at least 62% alcohol.
• Personal items, such as razors, towels and wash cloths, should not be shared if they may have had contact with an infected wound or bandage. This rule also extends to clothing.
• Student-athletes can avoid infecting others by keeping wounds covered until they are completely healed. Showering immediately after physical activity and regularly washing/drying uniforms can also contain MRSA.
• Patients who contract MRSA should strictly follow the treatment regimen prescribed by their doctor. Failing to do so can actually aid MRSA bacteria in their efforts against antibiotics. When a person ceases taking their medication prematurely, some stubborn staph bacteria might survive. In this scenario, what doesn’t kill the MRSA microbes can very well make them stronger, allowing them to successfully resist addition antibiotic treatment.

With a steadily growing impact on their American public, MRSA infections will continue to be a headache for public health officials. Despite the threat it poses, proper hygiene along with prompt medical treatment can be effective weapons against this dangerous bacteria.