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MRSA (methicillin-resistant Staphylococcus aureus)
Published by Bupa's health information team, June 2008.
This factsheet is for people who have MRSA, or who would like information about it.
The full name for MRSA is methicillin-resistant Staphylococcus aureus (S. aureus). These are bacteria resistant to medicines called methicillin-type antibiotics, and are sometimes referred to as 'superbugs'.
S. aureus is a member of the Staphylococcus family of bacteria. S. aureus bacteria are common - it's estimated that one in three healthy people carry this type of bacteria on their skin, in their nose or in their mouth.
Most S. aureus bacteria can be treated with methicillin-type antibiotics. However, certain types of this bacteria are resistant to methicillin-type antibiotics. This means that the bacteria aren't killed off by the antibiotics. This resistant group is called MRSA bacteria.
People carrying the bacteria on their skin are said to be colonised, or carriers of MRSA, but not infected. The bacteria are on the surface of the body and haven't penetrated the body tissues or blood.
Most people who are colonised with S. aureus or MRSA don't go on to develop an infection, so if you stay healthy you may never be aware that you are carrying the bacteria. However, if your immune system becomes weakened or if you have a wound, the bacteria can cause an infection.
MRSA is no more infectious than other types of S. aureus but because of its resistance to many types of antibiotics, it can be more difficult to treat.
Symptoms of MRSA
S. aureus generally infects the skin, causing pimples, boils, abscesses and impetigo. The affected areas may be swollen, painful and red.
If S. aureus gets into a wound it can cause infection. MRSA is difficult to treat because of the antibiotic resistance, so if it gets into an open wound it can take longer to heal or sometimes the wound can fail to heal properly.
If S. aureus enters the bloodstream it can infect almost any part of the body. MRSA causes around 40 percent of all cases of blood poisoning in England.
Causes of MRSA
MRSA has evolved over time. This has occurred because of the overuse of antibiotics and because sometimes a course of antibiotics isn't finished. The surviving bacteria then become more and more resistant to standard antibiotic treatment.
You can become colonised with MRSA (or infected if the bacteria enters your body) by contact with someone carrying MRSA on their skin.
MRSA can be picked up from contact with surfaces or objects that have been touched or used by someone who has MRSA, such as door handles, razors, towels or sheets.
Who is most at risk of developing an MRSA infection?
MRSA usually doesn't cause any problems in people who are healthy and have a good immune system. MRSA infection is most likely to develop in people who have:
- a weakened immune system - for example if you are over 65 or if you already have another infection
- open wounds, burns, cuts or a severe skin condition such as psoriasis
Premature and newborn babies are at risk of developing MRSA infection because their immune system hasn't properly developed yet.
Complications of MRSA
MRSA can cause serious illness if it's not treated quickly. Complications include:
- osteomyelitis - infection of the bone and the bone marrow
- joint problems (septic arthritis)
- heart valve and heart lining infections (endocarditis)
- pneumonia - lung infection
- septicaemia - blood poisoning
- abscesses anywhere in the body
Diagnosis of MRSA
There are various methods used to screen for MRSA. These include:
- swab samples - a cotton bud is lightly rubbed over your skin, in your nose or back of your throat
- blood or urine samples - these are usually only taken if you are in hospital
The samples are sent to a laboratory to be examined. If MRSA is found, sensitivity tests are done to find out which type of medicine the MRSA responds to.
If you have an MRSA infection, your doctor will use the results of these tests to decide which medicines to give to you.
Treatment of MRSA
People who are carriers of MRSA but who are healthy don't need any treatment.
If you are waiting to have surgery, your doctor may prescribe you treatment to get rid of the bacteria to reduce your risk of infection. This may be done by washing your skin and hair with antiseptic lotion and shampoo. You may be given antibiotic cream to apply to your skin, or existing cuts.
MRSA infection can be treated. The resistance of the MRSA bacteria to certain types of antibiotics makes treatment more difficult, but not impossible. If you have an MRSA infection you will be prescribed antibiotics. These may be given as tablets to swallow or through a drip in a vein, depending on the type of antibiotic used and severity of the infection.
Most strains of MRSA can be treated with the following types of antibiotics:
- tetracycline (eg Deteclo)
- clindamycin (eg Dalacin C)
- vancomycin (eg Vancocin)
- daptomycin (eg Cubicin)
- teicoplanin (eg Targocid)
- linezolid (eg Zyvox)
- quinupristin/dalfopristin (eg Synercid)
Various combinations of antibiotics may be used to treat an MRSA infection. In addition, you may be treated with a new antibiotic called dalbavancin, which may be prescribed for you off-label. This means the medicine is being used to treat a condition that it isn't yet licensed for.
Prevention of MRSA
People who are most at risk of MRSA infection are those who are in hospital, over 65 or premature/newborn babies. If you are a nursing mother and have MRSA, some antibiotics can enter breast milk, and you should ask your GP for advice.
There are a number of measures you can take to reduce your risk of MRSA infection and stop it from spreading.
If you are visiting someone in hospital or a care home, always wash your hands before and after meeting the patient. Many hospitals have alcohol gels for hand cleaning at the end of patients' beds or at the entrance to the ward.
If you have damaged skin or a cut, keep it covered with a waterproof dressing. Always wash your hands before and after changing the dressing.
If you are going into hospital, your doctor may suggest you are screened for MRSA before you go into hospital. If you are a MRSA carrier, your doctor may prescribe treatment before you go into hospital.
While you are in hospital there are a number of basic hygiene measures that you can take to reduce your risk of infection.
- Always keep your hands and body clean - take soap, a flannel, moist hand-wipes and your own razor into hospital with you.
- Always wash your hands after using the toilet or commode.
- Always wash your hands or clean them with a hand-wipe immediately before and after eating a meal.
- Don't touch an open wound or damaged skin.
- Make sure that your bed area is cleaned regularly.
- Report any unclean toilet or bathroom facilities to your nurse.
- Don't walk around with bare feet.
Doctors and nurses wash their hands and use alcohol-based hand gels between patients to stop bacteria being transferred from one patient to the next. Hospital wards, corridors and surfaces are regularly cleaned. However if you have any concerns about hygiene, you should speak to your doctor or nurse.
If you develop an MRSA infection, you may be cared for in a private room to help stop the infection from spreading to other patients.
See our answers to common questions about MRSA, including:
See our videos about MRSA:
- A simple guide to MRSA. Department of Health. www.dh.gov.uk, accessed 20 February 2008
- Dancer SJ. Importance of the environment in methicillin-resistant Staphylococcus aureus acquisition: the case for hospital cleaning. Lancet Infect Dis 2008; 8:101-113. www.thelancet.com/journals/laninf
- MRSA Frequently asked questions. Health Protection Agency. www.hpa.org.uk, accessed 20 February 2008
- Herchline T. Staphylococcal infections. eMedicine. www.emedicine.com, accessed 20 February 2008
- Methicillin-resistant Staphylococcus aureus. MRSA Action UK. www.mrsaactionuk.net, accessed 20 February 2008
- Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford, 2007:668
- British National Formulary (BNF). BMJ Publishing Group, 2007. 54:283
- Gemmell CG, Edwards DI, Fraise AP et al. Guidelines for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the UK. J Antimicrob Chemother 2006; 57:589-608. jac.oxfordjournals.org
- Methicillin-resistant Staphylococcus aureus (MRSA). Guidance for nursing staff. Royal College of Nursing recommendations. www.rcn.org.uk, accessed 20 February 2008
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr W H Simpson, MBBS, General Practitioner, and by Bupa doctors. It has also been reviewed by MRSA Action UK. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: June 2008.