MRSA lives harmlessly on the skin of around 1 in 30 people, usually in the nose, armpits, groin or buttocks. This is known as "colonisation" or "carrying" MRSA. Getting MRSA on your skin will not make you ill, and it may go away in a few hours, days, weeks or months without you noticing. But it could cause an infection if it gets deeper into your body. Healthy people, including children and pregnant women, are not usually at risk of MRSA infections.
Having MRSA on your skin does not cause any symptoms and does not make you ill. You will not usually know if you have it unless you have a screening test before going into hospital.
If you need to go into hospital and it's likely you'll be staying overnight, you may have a simple screening test to check your skin for MRSA before you're admitted. This is normally done at a pre-admission clinic or a GP surgery.
A nurse will run a cotton bud swab over your skin so it can be checked for MRSA. They injected the fabrics with colony-forming units of staph and observed the reactions over the following days.
These results demonstrate the need for thorough contact control and meticulous disinfection procedures to limit the spread of bacteria. MRSA frequently causes illness in people with a compromised immune system who spend time in the hospital and other healthcare facilities. A person will have a higher risk of developing healthcare-associated MRSA in the hospital if they have had surgery recently or if they have:.
MRSA is less common outside a healthcare setting. If it does occur, it is more likely to be a skin infection, although some people develop pneumonia and other infections. People can reduce the risk by practicing appropriate hand washing, keeping wounds clean, avoiding sharing personal items — such as towels and razors, and seeking early treatment if any symptoms of an infection appear. Children can develop MRSA through an open wound. Find out how to recognize it and what to do. Many people carry MRSA bacteria in their mucosa, for instance, inside the nose, but they may never develop symptoms that indicate an active infection.
Staph skin infections, including MRSA, appear as a bump or sore area of the skin that can resemble an insect bite. The infected area might be :. Symptoms of a serious MRSA infection in the blood or deep tissues may include :.
The following guidelines can help patients, healthcare workers, and visitors prevent MRSA infections from spreading in the hospital:. It may be necessary for a patient with an MRSA infection to stay in their room until treatment is complete. People can reduce the risk of community-associated MRSA outside of hospitals by:. MRSA infections may affect your:.
Visitors and health care workers caring for people in isolation may need to wear protective garments. They also must follow strict hand hygiene procedures.
For example, health care workers can help prevent HA-MRSA by washing their hands with soap and water or using hand sanitizer before and after each clinical appointment. Hospital rooms, surfaces and equipment, as well as laundry items, need to be properly disinfected and cleaned regularly. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version.
Overview Methicillin-resistant Staphylococcus aureus MRSA infection is caused by a type of staph bacteria that's become resistant to many of the antibiotics used to treat ordinary staph infections. Staph infection Open pop-up dialog box Close. Staph infection MRSA infections start out as small red bumps that can quickly turn into deep, painful abscesses. If the child is stable without ongoing bacteremia or intravascular infection, empiric therapy with clindamycin 10 to 13 mg per kg intravenously every six to eight hours for a total of 40 mg per kg per day is an option if the resistance rate is less than 10 percent.
If the strain is susceptible, transition to oral therapy is advised. Linezolid may be considered as an alternative mg orally or intravenously twice per day for children 12 years and older; 10 mg per kg orally or intravenously every eight hours for children younger than 12 years. Physicians should provide instructions on personal hygiene and wound care for patients with skin and soft-tissue infections.
Patients should cover draining wounds with clean, dry bandages. Regular bathing is advised, as well as hand washing with soap and water or an alcohol-based hand gel, especially after touching infected skin or an item that has been in contact with a draining wound. Patients should also avoid reusing or sharing items that that have touched infected skin e. Commercially available cleaners or detergents should be used to clean high-touch surfaces e.
Decolonization may be considered if a patient develops a recurrent infection despite good personal hygiene and wound care, or if other household members develop infections. Strategies for decolonization include nasal decolonization with mupirocin twice per day for five to 10 days, or nasal decolonization with mupirocin twice per day for five to 10 days plus topical body decolonization with a skin antiseptic solution e. Dilute bleach baths can be made with 1 teaspoon of bleach per 1 gallon of water or one-fourth cup per one-fourth bathtub or 13 gallons of water and are given for 15 minutes twice per week for three months.
Oral antimicrobial therapy is recommended only for treating active infection and is not routinely recommended for decolonization. An oral agent in combination with rifampin, if the strain is susceptible, may be considered if infections recur despite these measures. If household or interpersonal transmission is suspected, patients and contacts should be instructed to practice personal and environmental hygiene measures.
In symptomatic contacts, nasal and topical body decolonization strategies may be considered after treating the active infection. Decolonization strategies also may be considered in asymptomatic household contacts.
The role of cultures in managing recurrent skin and soft-tissue infections is limited. Screening cultures before decolonization are not routinely recommended if at least one of the previous infections was caused by MRSA.
Surveillance cultures after a decolonization regimen are not routinely recommended if there is no active infection. Uncomplicated bacteremia is defined as positive blood culture results and the following: exclusion of endocarditis; no implanted prostheses; follow-up blood cultures performed on specimens obtained two to four days after the initial set that do not grow MRSA; defervescence within 72 hours of initiating effective therapy; and no evidence of metastatic sites of infection.
Recommended treatment for adults with uncomplicated bacteremia includes vancomycin or daptomycin at a dosage of 6 mg per kg intravenously once per day for at least two weeks. For adults with complicated bacteremia positive blood culture results without meeting criteria for uncomplicated bacteremia , four to six weeks of therapy is recommended, depending on the extent of infection.
Some experts recommend higher dosages of daptomycin 8 to 10 mg per kg intravenously once per day. For adults with infective endocarditis, intravenous vancomycin or daptomycin 6 mg per kg intravenously once per day for six weeks is recommended. Adding gentamicin or rifampin to vancomycin is not recommended in patients with bacteremia or native valve infective endocarditis.
Additional blood cultures two to four days after initial positive cultures and as needed thereafter are recommended to document clearance of bacteremia.
Echocardiography is recommended for all adults with bacteremia. Transesophageal echocardiography is preferred over transthoracic echocardiography. Evaluation for valve replacement surgery is recommended if any of the following are present: large vegetation greater than 10 mm in diameter , occurrence of one or more embolic events during the first two weeks of therapy, severe valvular insufficiency, valvular perforation or dehiscence, decompensated heart failure, perivalvular or myocardial abscess, new heart block, or persistent fevers or bacteremia.
Patients with infective endocarditis and a prosthetic valve should be treated with intravenous vancomycin and rifampin mg orally or intravenously every eight hours for at least six weeks , plus gentamicin 1 mg per kg intravenously every eight hours for two weeks.
Early evaluation for valve replacement surgery is recommended. In children, intravenous vancomycin 15 mg per kg every six hours is recommended for treating bacteremia and infective endocarditis. The duration of therapy may range from two to six weeks depending on the source, the presence of endovascular infection, and metastatic foci of infection.
Data regarding the safety and effectiveness of alternative agents in children are limited, although daptomycin 6 to 10 mg per kg intravenously once per day may be an option. Clindamycin and linezolid should not be used if there is concern of infective endocarditis or an endovascular source of infection, although they may be considered in children with bacteremia that rapidly clears and is not related to an endovascular focus.
Data are insufficient to support the routine use of combination therapy with rifampin or gentamicin in children with bacteremia or infective endocarditis. The decision to use combination therapy should be individualized.
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