MRSA and CAMRSA: What You Need to Know

Methicillin Resistant Staphylococcus Aureus (MRSA) is a type of bacteria that occurs naturally in approximately 1 in 4 healthy individuals. In the general population, Staph. Aureus is harmless. It stays mostly in a person's nasal passages or on their skin. Occasionally the bacteria becomes exceptionally resistant to the antibiotics that would normally work well to stem the tide of infection. When this happens, MRSA becomes increasingly resistant to a particular family of antibiotics called "beta-lactams."

MRSA is spread when someone with an active staph infection comes into direct contact with someone who is immuno-supressed. Hospitals are often to blame when a patient contracts MRSA In the cystic fibrosis community, the MRSA may be acquired through indirect contact with CF patients who are colonized with MRSA. For example, their bedding, curtains, doctors' coats, nurses scrubs, etc. The good news about MRSA is that patients who are colonized do not exhibit deterioration in lung function as a result. Patients who are MRSA-positive will more often than not have MRSA in their sputum, even when they're not experiencing an exacerbation due to infection.

Recently, a frighteningly newer, stronger, more resistant strain of Staphaureus has been identified by the Centers for Disease Control, (CDC) CA-MRSA or "Community Acquired" MRSA is a huge public health threat. The recent edition of Readers Digest cites CA-MRSA as being second only to AIDs.

How Worried Should I Be?

Some people can culture CA-MRSA without ever presenting an infection. This is because staph is occurs naturally in the body. The CDC reports that only 1% of the population is infected with CA-MRSA. According to the 2005 Cystic Fibrosis Patient Registry Report, the overall percentage of patients with MRSA is 17%. CF patients between the ages of 11 and 17 had the highest number of occurrences of the infection. A likely explanation is that people in that particular demographic are not as fastidious about personal hygiene.

Taking reasonable precautions to prevent infection is always in the best interest of a person with cystic fibrosis. The easiest ways to protect yourself from CA-MRSA are as follows:

1. Keep your hands clean by washing thoroughly with soap and water or using an alcohol-based hand sanitizer.
2. Keep cuts and scrapes clean and covered with a bandage until healed.
3. Avoid contact with other people's wounds or bandages.
4 .Avoid sharing personal items such as towels or razors.

Adhering to a strict cross-infection control plan when in the presence of other cystic fibrosis patients is also encouraged. When sitting in the waiting room for a clinic appointment, keep a minimum distance of 3 feet between yourself and others. Always cover your mouth when coughing, or wear gloves and a mask.

The effects of CA-MRSA can be devastating within a short period of time. It has the potential to destroy healthy tissue very rapidly. Cystic fibrosis patients especially should be careful to steer clear of people who are coughing or sneezing repeatedly. It's important not to ignore symptoms that may indicate infection.

Symptoms of CA-MRSA

1. Absesses at the site of broken skin
2. Pustules or other pockets of pus that resemble boils or pimples
3. Redness, pain and swelling at the site of presumed infection

In severe cases, CA-MRSA can manifest as serious infections such as:

1. Pneumonia
2. difficulty breathing
3. fever or chills

CA-MRSA at School

Younger children should be instructed in the importance of hand-washing. Teach them to wash with warm water and soap. Singing the alphabet song while rinsing is a good way for them to remember how long they should rinse. Be sure to tell your CFer to keep his or her hands to herself on the school bus. Cuts, scrapes, "Boo-boos" and "owies" should be covered with a bandage, and not picked at.

Gym class is where CA-MRSA is most likely to raise its ugly head. Locker rooms and showers are warm, moist environments where bacteria like to thrive. College students who live in crowded dorms should also be careful to limit their exposure to areas where staph may like to grow.

In the world not-restricted by the walls of a classroom, there are other ways to lower your risk of contracting CA-MRSA. Use your knuckles instead of your fingertip when pressing elevator or ATM buttons. Keep a small bottle of hand sanitizer or disinfectant wipes in your purse, briefcase or glove compartment, and use whenever necessary.

How is it Treated?

Although CA-MRSA and MRSA are difficult to eradicate one a person has become infected, a combination of drugs has demonstrated effectiveness. Vancomycin, or a similar medication can be prescribed. The is some evidence that preventive therapy with flucloxacillin is useful. Additionally Chloramphenicol and clindamycin tend to have activity against CA-MRSA.