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MRSA Methicillin Resistant Staph Aureus.

This is a staph germ that has increased in frequency over the last 15 yrs. The news media loves to scare you about it so they can get viewers. Here is my take on it.

Once just in Hospitals it is now in most public areas. The last study found it in 100% of planes, trains, and busses. So it is out there and not just in locker rooms of sports teams. It is probably on most grocery cart handles and I have advised cleaning those handles for years. I have been seeing one case about every 3-4 weeks which is more common than in the past and it is definitely increasing. Do not be paranoid about it but use precautions. Bathe children every night and bring them in to the doctor if a pimple becomes bigger than a dime.

It is aggressive and causes a large boil nickel to quarter size real quick. Then it is dark and almost black in appearance. Most parents think it is a spider bite rather than an infection. It occurs most in the area between the waist and knees, but can occur anywhere on the body. Usually it likes sweaty areas with friction to get into the pours and start an abscess. It needs to be treated early so that it does not become dangerous. Most people that have died from it waited until it was huge, or were small infants below 6 months, had immune deficiency, or the elderly.

It can be treated with two antibiotics so far until they become resistant to them. The most important and the main treatment is to drain the pus out of the abscess. That is not the fun part of my job.

Then I treat it with Keflex and Septra for 10 days.

But then the parent needs to do the big jog. We need to sterilize the patient and the house every evening for 4-5 days. If it recurs then treat it 4 days initially and once a week for 4 weeks.

1.     Person: Pour 1 cup of Bleach into the bath tub that is filled with water.  Bath the child for 10 minutes but not the hair unless you want them blond.  Then rinse off before drying off.  Then apply antibiotic ointment (the best is Bactroban Rx) in the nasal entrance.

2.     House and Car: Then you take dish towels, soak them in the bath water after the child gets out, and wipe down (not scrub hard) every surface in the house and car that is not cloth. Every surface….. doorknobs, counters, kitchen, chairs, handle of refrigerator, sports equipment, bicycles, dresser drawers, toys, electronic games, car door handles, car seats, ……. EVERYTHING!!! You do not have to wipe things that are never touched by hands like pictures on the wall or the floor.

3.     Then change their clothes, and bed linen.

 

What we are trying to do is remove the germ from the close environment.

But MRSA is out there and you are not to be paranoid but just cautious. You should be cleaning the grocery cart handle and high chairs since there are even worse germs out there. We scrub down every chair and surface in our clinic before the well checkups come in during the morning and afternoon sessions.

Roger Knapp MD

Addendum Spring 09:

"The late Tom Anderson, the family doctor in this little farm town in northwestern Indiana, at first was puzzled, then frightened. MRSA (methicillin resistant Staphylococcus aureus) sometimes arouses terrifying headlines as a ‘superbug' or 'flesh‑eating bacteria.' The best‑known strain is found in hospitals, where it has been seen regularly since the 1990s, but more recently different strains also have been passed among high school and college athletes. Dr Anderson at first couldn't figure out why he was seeing patient after patient with MRSA in a small Indiana town. And then he began to wonder about all the hog farms outside of town. Could the pigs be incubating and spreading the disease? One of the first clues that pigs could infect people with MRSA came in the Netherlands in 2004, when a young woman tested positive for a new strain of MRSA, called ST398. The family lived on a farm, so public health authorities swept in‑and found that 3 family members, 3 co‑workers and 8 of 10 pigs tested all carried MRSA. Since then, that strain of MRSA has spread rapidly through the Netherlands‑ especially in swine producing areas. A small Dutch study found pig farmers there were 760 times more likely than the general population to carry MRSA (without necessarily showing symptoms), and Scientific American reports that this strain of MRSA has turned up in 12% of Dutch retail pork samples. Now this same strain of MRSA has also been found in the United States. A new study by Tara Smith, a University of Iowa epidemiologist, found that 45% of pig farmers she sampled carried MRSA, as did 49% of the hogs tested."

Kristof MD. New York Times. March 12,2009