An Apple A Day

"An Apple A Day"

Orcas Family
Health Center
A Washington State and IRS 501 (c) (3) charitable non -profit corporation

"Apple A Day Articles"

ADULT “CHECK-UPS”

AN APPLE A DAY...FOR WOMEN

COMMUNICATION BASICS

FDA LICENSES NEWVACCINE FOR PREVENTION OF CERVICAL CANCER

GETTING THERE FROM HERE

LEMONS AND LYMES

NO MERCY FROM MRSA

ONE FLU OVER THE CUCKOO'S NEST

PROSTATE CANCER SCREENING

TO ERR IS HUMAN

NO MERCY FROM MRSA

In our last column we alluded to some of the non-epidemics that are making the news such as bird fl u and SARS. This column is devoted to an infection that has already created havoc in hospitals for many years and now seems to have spread beyond hospital walls and threatens to infiltrate the community. That infection is MRSA (pronounced mur-sa) which stands for methicillin-resistant Staphylococcus aureus.

Three weeks ago Time Magazine featured an article on this threat. Our focus will be on the growing community presence of MRSA. To review the importance of this first we must dissect the letters of this tongue twister.

M = methicillin is an antibiotic that is related to penicillin that was first manufactured in the early 60s when many bacteria, including Staph, started becoming resistant (here’s the R) to penicillin. Since then, methicillin and similar antibiotics have been effective in treating resistant Staph infections. That is no longer the case. MRSA is resistant to methicillin as well as a host of other antibiotics introduced over the past 50 years specifically to treat the growing number of antibiotic-resistant bacteria.

SA = Staphylococcus aureus is a very common bacteria normally found on human skin, in nasal and oral areas. Usually Staph causes no problems. However, in the right conditions it can produce myriad infections from simple skin infections to sinus infections to pneumonia and life threatening sepsis. The specific strain of S. aureus, MRSA, h

as been confined to hospitals for several years causing the infectious disease doctors untold headaches trying to find an antibiotic to control these infections. Now this bacteria has graduated from the hospital and become a common problem in communities. (By the way, this is NOT the notorious “flesh eating bacteria”.)

Think you have a spider bite? Think again. Think you have a splinter? Think again. These could be MRSA. The initial presentation for MRSA is not much different from any other skin infection. It appears as a red, tender area often without any known cause. Over time the redness and tenderness may increase to the point when a patient is seen in the office for evaluation. Without a culture (which is not always necessary) it is impossible to distinguish MRSA from other more common Staph infections. Unfortunately, antibiotics that treat MRSA do not work well to treat other Staph and vice versa. So, while it is often appropriate to initially treat the infection with the usual anti-Staph antibiotics (cephalexin, erythromycin, etc.) it may be necessary to switch to the MRSA antibiotics (sulfa, doxycycline, etc.) if the infection does not respond.

Outside the hospital, MRSA infections are more an annoyance than life threatening. Initial treatment can be the same as for any other superficial skin infection, i.e. frequent hot soaks. The message is if you have an enlarging red tender area that you cannot explain and does not respond to conservative measures, consider being seen and treated with an antibiotic.

If you have questions about this or any of our other “Apple A Day” columns, please give us a call.