MRSA: On the Rise in Native Communities

September 9, 2009

By Maranda Herner

MRSA is a type of Staphylococcus aureus, or “staph,” bacteria. This particular strain poses heightened concern because it is resistant to most antibiotics used to treat staph infections. Accordingly, MRSA stands for methicillin-resistant Staphylococcus aureus. Fortunately, MRSA can be treated with specialized antibiotics. Most MRSA cases occur in hospitals, nursing homes, and dialysis centers and earn the name health care-associated MRSA (HA-MRSA). Recently, MRSA has been expanding to the general community and these cases have adopted the title community-associated MRSA (CA-MRSA) [1].

In both forms, MRSA can infect otherwise healthy people, but it presents most seriously and most often in more vulnerable populations. Particularly vulnerable populations include the elderly, the very young, and people with compromised immune systems. A person’s immune system may be weakened by pregnancy, stress, or chronic medical conditions such as diabetes, liver disease (often a result of alcoholism), cardiovascular disease, respiratory impairments (often found in smokers), or high blood pressure. Due to the high frequency of these conditions among Native people, reservation communities need to take particular caution to prevent MRSA.

MRSA, like other strains of staph bacteria, can infect many body systems, but most often targets the skin. About 30% of healthy people harbor staph bacteria in their noses or on their skin but are not actually infected. About 1% of healthy people carry the specific MRSA strain [1]. These individuals are still capable of spreading the bacteria to others who may or may not become infected. For those who do develop infections, MRSA may incubate for days to years before symptoms appear [2]. MRSA can also dangerously affect the lungs, possibly inducing pneumonia, and can cause serious body-wide infections if it enters the bloodstream, joints, heart valves, or other soft tissues [3].

MRSA spreads mainly through skin-to-skin contact, especially via open wounds or sores, but can also be transmitted through contaminated objects. Poor hygiene and close living conditions elevate the potential for bacterial transmittance [4]. Athletes that play contact sports, people in communal settings such as schools or public swimming pools, and patients receiving care in facilities such as clinics or hospitals must use disease control and prevention techniques. Additionally, people with compromised immune systems must also follow these techniques.

• Wash hands often with soap and water for at least 20 seconds or use an alcohol-based antibacterial hand sanitizer
• Clean commonly used objects and surfaces with Lysol, bleach, or other disinfectants
• Do no share personal items, such as towels, clothes, or razors
• Shower immediately after participating in sports, public swimming pools, or other events with frequent skin-to-skin interactions
• Immediately clean any open cut with soap and water and apply a bandage
• Keep all wounds covered with clean bandages, particularly to prevent spreading MRSA if a wound is already infected
• Avoid contact with infected persons

Skin infections of MRSA initially may resemble spider bites or pimples but can grow into red, swollen, pus-filled, and painful boils. These must be treated early because the bacteria can penetrate the skin layers and become life-threatening infections in the other body tissues mentioned [1]. If you notice any abnormal bites, pimples, or boils and/or if you develop an unexplainable fever, you should visit your medical care provider. The doctor will most likely collect a culture sample from the infected cut to test for the MRSA bacteria. The provider may also request blood, urine, or sputum samples to determine the extensiveness of the infection.

Minor skin infects can usually be cured with drainage performed by a doctor, continual cleansing, and typical wound care. Health care providers may also prescribe an oral antibiotic specific for MRSA.

If you are prescribed an oral antibiotic, be sure to finish taking all the pills in the given time frame. Ending the treatment early, perhaps when symptoms begin to go away, may leave some MRSA bacterial alive in the body. These bacteria can then multiply, revive the infection, and may grow resistant to the antibiotics [4].

If an outbreak of MRSA occurs in your town or home, be particularly diligent with the prevention tips noted above. Any infected individuals should be more isolated from usual contact and should keep any wounds clean and bandaged. A 2003 study reports that about 12% of clinical MRSA cases are community-associated, but this varies depending on the population. The Center for Disease Control suggests that populations such as Native Americans, Pacific Islanders, Alaskan Natives, children, athletes, military recruits, and prisoners are at an increased risk for contracting CA-MRSA and should focus on disease prevention and universal hygiene [1].

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Sources:
[1] Community-Associated MRSA Information for the Public (June 30 2008). Center for Disease Control and Prevention. Retrieved June 24, 2009 from, http://www.cdc.gov/ncidod/dhqp/ar_MRSA_ca_public.html#8.
[2] Methicillin Resistant Staphylococcus Aureus/ MRSA. (March 2008). Northern Kentrucky Health Department. Retrieved June 25, 2009 from, http://www.nkyhealth.org/docs/Healthy%20Start/MRSA.pdf.
[2]MRSA Infection. (May 30 2008). MayoClinic. Retrieved June 24, 2009 from, http://www.mayoclinic.com/health/mrsa/DS00735.
[4] Understanding MRSA Prevention. (December 1 2008). WebMD. Retrieved June 24, 2009 from, http://www.webmd.com/skin-problems-and-treatments/understanding-mrsa-prevention.