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JAMA Patient Page
October 26, 2011

MRSA Infections

JAMA. 2011;306(16):1818. doi:10.1001/jama.306.16.1818

Staphylococcus aureus (S aureus) is a type of bacterium. Like other kinds of bacteria, S aureus frequently lives on the skin and in the nose without causing health problems. Staphylococcus aureus becomes a problem when it is a source of infection in the skin, lungs, or blood. These bacteria can be spread from one person to another through casual contact or through sharing contaminated objects. Methicillin-resistantStaphylococcus aureus (MRSA) bacteria are resistant to commonly used antibiotics, the medicines used to treat bacterial infections. Because of this, MRSA infections are more difficult to treat than ordinary S aureus infections. MRSA that is acquired in a hospital is called hospital-associated MRSA (HA-MRSA). MRSA infections are now becoming more common in healthy, nonhospitalized persons. These infections can occur among young people with cuts or wounds who have close contact with each other, such as members of sports teams. This type of MRSA is called community-acquired MRSA (CA-MRSA). This Patient Page is based on one originally published in the October 17, 2007, issue of JAMA.

CAUSES OF MRSA INFECTIONS

Leading causes of antibiotic resistance include

  • Bacterial mutation—bacteria that survive treatment with one antibiotic may develop resistance to the effects of that drug and similar medicines.

  • Unnecessary antibiotic use—for decades, antibiotics have been prescribed for colds, flu, and other viral infections that do not require or respond to antibiotics.

  • Antibiotics in food—antibiotics are commonly given to cattle, pigs, and chickens.

RISK FACTORS

Risk factors for HA-MRSA include

  • Current or recent hospitalization

  • Residence in a long-term care facility

  • Invasive procedures such as urinary catheters, intra-arterial lines, or central venous lines

  • Recent or long-term antibiotic use

  • Family members or close contacts who are health care workers

  • Chronic renal dialysis

Risk factors for CA-MRSA include

  • Participation in contact sports

  • Sharing towels or athletic equipment

  • Having a weakened immune system, such as in persons with HIV/AIDS

  • Living in crowded or unsanitary conditions, such as prisons

TREATMENT AND PREVENTION

Both HA-MRSA and CA-MRSA still respond to certain medications. Doctors usually treat suspected and confirmed infections with vancomycin, but resistance to vancomycin can also occur. Few other drugs are available. Current research is directed toward development of new antibiotics.

To prevent the spread of MRSA:

  • Ask hospital staff to wash their hands before touching you.

  • Wash your own hands frequently and avoid sharing personal items like razors or towels.

  • Follow hospitals' isolation procedures for gowns, gloves, and masks.

  • Wipe down shared equipment at gyms before and after using them.

  • Athletes should participate in sports only if any open wounds can be kept covered during participation.

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at www.jama.com. Many are available in English and Spanish.

Sources: Centers for Disease Control and Prevention, Mayo Clinic

Topic: INFECTIOUS DISEASES

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

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