3STAPHStaphylococcus aureus, often referred to simply as “staph,” are bacteria commonly carried on the skin or in the nose of healthy people.Occasionally, staph can cause infection; staph bacteria are one of the most common causes of skin infections in the United States.Most of these skin infections are minor (such as pimples and boils) and can be treated without antibiotics (also known as antimicrobials or antibacterials).However, staph bacteria also can cause serious infections (such as surgical wound infections, bloodstream infections, and pneumonia).
4SYMPTOMS OF STAPH INFECTIONS The symptoms of a staph infection depends on where the infection is. The staph bacteria can cause:Boils – an abscess, bump, or swelling within the skin. Also called a furuncle.
5Cellulitis – a “flat” skin infection which can make the skin red, painful and warm but does not have pustules.
6Folliculitis – an infection of the hair follicles
7Impetigo – pustules (bulbous impetigo) or honey colored crusted lesions on the skin May be caused by staph or other bacteria
8In addition to skin infections, the staph bacteria can cause: Bacteremia – a blood infectionDeep abscesses –an abscess that occurs below the skin surfaceEndocarditis – an infection on the valves of the heartFood poisoning – vomiting or diarrhea caused by a staph toxinLymphadenitis – an infection of a lymph gland, which causes it to be red, swollen and painful
9Lymphangitis – an infection of the lymph channels that drain to lymph glands, causing red streaks in the skinOsteomyelitis – a bone infectionParonychia – an infection of the skin folds of the nailsScalded skin syndromeSeptic arthritis – an infection of a joint, like a hip or a kneeStyes – an infection of the glands on the eyelidToxic shock syndrome
10The Staphylococcus aureus bacteria can also cause less common infections such as pneumonia, ear infections, and sinusitis.However, it is not possible to know whether the infections is caused by staph or another bacteria, like group A Beta-hemolytic streptococcus. And in many cases, it doesn’t matter, as the antibiotic your child has been prescribed will likely treat both bacteria.
11To make a definitive diagnosis, and to confirm that staph is the bacteria causing the infection, a culture can be done.In the past, most serious staph bacterial infections were treated with a type of penicillin class agent such as oxacillin, penicillin, amoxicillin or a cephalosporin.A sample of the infected area is used to grow the staph bacteria in the laboratory.Tests are done to determine which antibiotics are active for treating the infection.A culture of infected skin is especially useful in recurrent, persistent, or severe infections and in cases of antibiotic failure.
12Over the past 50 years, treatment of these infections has become more difficult because staph bacteria have become resistant to various antimicrobial agents, including the commonly used penicillin class antibiotics.These are the usual treatments for staph infections. They may include a topical antibiotic cream for simple impetigo, warm compresses and drainage for abscesses, an oral antibiotic, or an intravenous antibiotic for more serious infections.
13One of those staph bacteria that is resistant to some antibiotics is called MRSA.
15MRSA MRSA stands for Methicillin-Resistant Staphylococcus aureus MRSA are Staph aureus bacteria that have become resistant to this antibiotic.Found in the nose, and sometimes on the skin, but also can grow in wounds and other sites of the bodyMRSA can no longer be killed by this antibiotic
16People may be colonized or infected with staph. Colonization means that the staph is present in or on the body but is not causing illness.Infection means that the staph is present and is causing illness.Signs of illness can include fever, elevated white blood cell count, pus, pneumonia, and inflammation (warmth, redness and swelling).
17Recurrent skin diseases or open wounds In general, healthy people are at low risk of getting sick with MRSA. Some risk factors include:Recurrent skin diseases or open woundsLong-term illness or long-term dialysis patientIllicit injecting drug useSurgeryThose with weakened immune systems from sickness or chronic disease are the most vulnerable.
18Contact with other persons with MRSA infection Been a patient in the hospital or other health care facility within the past yearContact with other persons with MRSA infectionRecent antibiotic useLive in crowded settingsMRSA infections have been reported among persons in prisons, players of close-contact sports, men who have sex with other men, and other populations.
19HOW ARE THESE GERMS SPREAD? MRSA is transmitted primarily by contact with a person who has an infection or is colonized with the bacteria.The germ can be spread by direct person-to-person contact with an infected person, or by contact with objects or surfaces contaminated by MRSA.Staph can also come off infected skin onto shared objects and surfaces and get onto the skin of the person who uses the object or surface next.Examples of shared objects that might spread staph include personal hygiene objects (i.e. towels, soap, wound dressings, bandages, etc.), sheets, clothes, benches in saunas or hot tubs, and athletic equipment.In other words, anything that could have touched the skin of a staph-infected person can carry the bacteria to the skin of another person.
20How can I protect myself from becoming infected?
21If no visible dirt, use alcohol-based hand sanitizer WASH YOUR HANDSIf no visible dirt, use alcohol-based hand sanitizerKeep cuts and abrasions coveredAvoid contact with other people’s woundsAvoid skin-to-skin contact with infected personsDo not share personal itemsClean objects and other shared surfaces before you use themKeep your hands clean by washing thoroughly with soap and water.If there is no visible dirt on the skin, you can use an alcohol-based hand sanitizer.Keep cuts and abrasions clean and covered with a clean bandage until healed.Avoid contact with other people’s wounds or material and surfaces contaminated from wounds.Avoid skin-to-skin contact with persons who have skin infections.Do not share personal items with other personsClean objects and surfaces that are shared with other persons, such as athletic equipment, before you use them.
22HOW TO KEEP IT FROM SPREADING TO OTHERS Keep infected areas coveredFollow doctor’s instructionsWash handsPut disposable waste in a separate trash bag and close tightly before throwing it outWear glovesKeep infected areas covered with a clean, dry bandageFollow doctor’s instructions on proper care of woundWash handsPut disposable waste in a separate trash bag and close tightly before throwing it outUse gloves to change bandages and then wash your hands afterwards
23Do not share personal items Disinfect all non-clothing and non-disposable itemsWash linens and clothes that become soiledWash utensils and dishes in the usual mannerAvoid participating in contact sportsIf you have a MRSA infection, be sure to tell any health care provider that you have this infectionDo not share personal items.Disinfect all non-clothing (and non-disposable items) that come into contact with the wound with a solution of one tablespoon of household bleach mixed with one quart of water (must be prepared fresh daily), or a phenol-containing store-bought cleaning product.Wash linens and clothes that become soiled with hot water and laundry detergent, and then dry clothes in a dryer.Drying clothes in a hot dryer, rather than air-drying , helps kill bacteria in clothes.Wash dishes like you normally would, or in a home dishwasher.Avoid participating in sports with skin-to-skin contact until your infection has healed.
24And now, let’s look at what MRSA really looks like…
25MRSA/Staph is often misdiagnosed as spider or insect bites. • MRSA/Staph spreads by infected skin to healthy skin contact as well as infected objectsto healthy skin. It can enter healthy, clean, undamaged skin through such contact.• Washing your hands with soap and warm water can prevent the spread of MRSA/Staph.• MRSA/Staph lives on skin and survives on objects, such as towels and exercise equipment for 24 hours or longer.• If you think you may have MRSA/Staph, consult your doctor or healthcare provider.• For all skin infections, dispose of bandages properly and wash your hands frequently to avoid spreading germs to others.
34AcknowledgementThe Infectious Disease Control Unit of the Department of State Health Services thanksGinger Shields, RNEmergency Preparedness SpecialistTexarkana-Bowie County Health Departmentfor the creation and use of this presentation.