How To Stop MRSA Recurrences

Comment: Stopping MRSA recurrences requires complete treatment of the original MRSA infection, limiting/avoiding re-exposure to MRSA, and ridding one’s body of colonized MRSA. Re-colonization and re-infection can occur if someone is re-exposed to MRSA bacteria, but an ongoing maintenance program can significantly limit this risk.   

Kirk Bortel M.D.  

Definition

MRSA colonization is when bacteria reside on an individual, but there are no signs or evidence of infection. These individuals are called carriers.

Carriers are at personal risk for a MRSA infection, and have the potential to transfer MRSA to others.

Understanding MRSA Colonization

MRSA colonization is in constant flux. Someone colonized today will not necessarily be colonized next month or next year. But please note, individuals can remain colonized for years!

• The risk for MRSA colonization is directly related to the use of antibiotics: 
  • Everyone is colonized with a variety of bacteria. This is called bacterial flora and is a normal part of our physiology.
  • Antibiotics tend to kill off our normal bacteria flora allowing the invasion of more resistant bacteria, including MRSA.
• Antibiotics have limited effectiveness against MRSA colonization. Reasons include:
  • Antibiotics travel throughout our body via the bloodstream. Tissues rich in blood supply receive a high concentration of antibiotics; whereas, areas with limited blood supply receive a minimal amount of antibiotics. Such areas include the nasal cavity and the skin surface, both of which are common areas for MRSA colonization.
  • Colonized MRSA bacteria are in a semi-dormant state, which means they are not actively multiplying. Therefore, they have limited uptake from their environment, including uptake of antibiotics.
• Antibiotic treatment of a non-infection increases the risk for further antibiotic resistance (colonization is not an infection). This is because:
  • Colonized MRSA bacteria reside on the skin surface or in the nasal cavity where the level of antibiotics is low to nonexistent. A low concentration of antibiotics allows bacteria that have partial resistance to survive, and develop increased or complete resistance.   

Screening for MRSA Colonization

Comment: We rarely screen for MRSA colonization in the outpatient setting; however, it does play a more significant role in the inpatient setting – see below for details.   
Kirk Bortel M.D.

Screening for MRSA colonization may be considered in select patients. Nasal swabs are the screening test of choice, because the nose is the most common site to harbor MRSA bacteria. But note, nasal screening alone can miss up to one third of patients colonized with MRSA!¹

• Nasal swabs may be performed prior to decolonization to verify the presence of MRSA bacteria. 
• Nasal swabs may be performed after decolonization to verify success of treatment. 

Outpatient MRSA Screening

Screening for MRSA colonization in the outpatient setting is not routinely recommended. However, one may consider screening household contacts when:

• A patient has a history of multiple MRSA infections. 
• A patient has a history of a severe MRSA infection.
• Multiple persons in the household are infected with MRSA.

Inpatient MRSA Screening

Screening for MRSA colonization is more common in the inpatient setting; these patients are at higher risk for a serious MRSA infection. Many facilities have screening protocols for MRSA colonization. Screening protocols are based on risk and acuity (level of illness). High-risk situations include:

• Preoperative and postoperative setting.
• Critically ill patients: including patients on ventilators, and/or in the ICU.
• Patients with history of prior MRSA infection or known to be colonized.
• Facility or community with a high incidence or prevalence of MRSA.

Patients found positive for MRSA colonization are subsequently treated per facility protocols.  

MRSA Decolonization

• Decolonization is ridding one’s body of MRSA that is not currently the cause of an infection. The goal is to prevent colonized or dormant MRSA bacteria from developing into an active MRSA infection.
• Despite best efforts patients develop recurrences. These are often the result of patient’s harboring MRSA; however, an ongoing maintenance program can significantly limit this risk.   

How We Can Help You

We specialize in the treatment and prevention of MRSA skin infections. Over the years we’ve successfully helped our patients defeat MRSA. 

Yet, we frequently encounter new patients frustrated over the lack of accurate and useful information available to treat/prevent their MRSA skin infections. Recognition of this unmet need prompted us to put into writing all that works for our patients and make it available to you. MRSA MD Insider’s Guide reveals how we successfully treat and prevent MRSA skin infections.

Included you’ll find:

• How To Treat MRSA Skin Infections.
• Which Antibiotics Work? What are the Side Affects?
• How To Care for MRSA Wounds.
• How To Minimize Pain Lancing an Abscess.
• How To Prevent the Spread of MRSA.
• How To Rid Your House of MRSA.
• How To Stop Recurrences and Stop Harboring MRSA.

 

 Click Here – for more information on how this guide can help you! 

We’ve treated countless MRSA skin infections and we bring that wisdom to you!

 

1 A study published in the June 2012 online edition of the Archives of Pediatrics & Adolescent Medicine titled “Staphylococcus aureus Colonization in Children With Community-Associated Staphylococcus aureus Skin Infections and Their Household Contacts” found nasal cultures alone would have missed 32% of the colonized Staph.