Community acquired Methicillin Resistant Staphylococcal aureus (CA-MRSA) has received a great deal of media attention with the rash of “outbreaks” in several school systems. In the community setting the incidence of CA-MRSA is clearly increasing.

The reality is that MRSA has been increasing in prevalence over the past 5-10 years. Many of these infections begin after contact in the healthcare setting (nursing homes, hospitals, family contacts). It is not increasing just in our school systems. MRSA is being identified in many different non-medical settings such as the workplace, gyms, and any place that large numbers of people congregate.

There is much speculation regarding the increasing visibility of MRSA in the community. Some of the reasons are due to excessive use of broad spectrum antibiotics in our foods, and well as in the medical setting. The fact is that bacteria and viruses have a built in ability to develop resistance to antibiotics if they are exposed long enough and frequently enough.

One common misconception is that these bacteria (MRSA) are resistant to all antibiotics. This is not the case. There are several oral and i.v. antibiotics that work well against this bacteria.

The most effective treatment, as always, is prevention. This means frequent hand washing. Soap and water works as well as the alcohol based lotions. Wiping down gym equipment with a sanitizer before and after use is also helpful. Once a person has been infected by MRSA, there are several things the doctor can recommend to decrease the chance of spreading the infection to others. Talk to your physician about these measures.

Early recognition is the next most important aspect of caring for MRSA and preventing the spread of the infection.

In the community setting, skin infections such as a “boil” (furnuncle), cellulitis, abcess, or “spider bite” are commonly associated “staph” infections. The only way to determine if they are a “staph” infection or MRSA is to send a culture to a laboratory. This is typically done in the physician’s office or the hospital. Treatment for such infections may simply involve local drainage in the doctors office combined with local care in the home. Occasionally oral or iv antibiotics are required. The most important aspect of treating such skin infection is timing. If a simple skin infection is worsening over 2-3 days rather than improving, the wound should be evaluated by your physician. The fact remains that most community acquired skin infections resolve without long term implications.

We must all be vigilant about hand hygiene and maintain our awareness of this ever more common infection.

Additional information can be found by going to the following web sites:

http://www.mayoclinic.com/health/mrsa/DS00735

http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html

http://www.aap.org/new/mrsa.htm