MRSA, a type of flesh-eating bacteria, has emerged as a significant health threat in the last two decades.

What is MRSA?

MRSA stands for methicillin-resistant staph aureus, and is pronounced MER-sa by doctors. It’s a special strain of staph infection that spreads easily and is especially difficult to treat, since it is resistant to most antibiotics. It is what is known as a “community acquired infection,” because it can be obtained from anything you touch. The first reports of MRSA infections emerged in the late 1990s from day care centers and high school wrestling teams. It has gone on to become one of the most prevalent and dangerous pathogens out there.

How people get infected with MRSA
MRSA is spread through touch, either by direct contact with others or through touching something that someone infected has touched, such as a doorknob, gym equipment or playground structures.

Antibiotic-resistant strains of MRSA can lurk in ocean water and perhaps in the sand, along with rivers and ponds. Many children and teens have been infected after cutting themselves while swimming. Researcher Lisa Plano had beachgoers in Southern Florida wade into the ocean, dunk themselves underwater 3 times, and then collect a sample of surrounding seawater in a clean jug. The samples revealed that of 1,303 adult bathers, 37% came into contact with the usually harmless staphylococcus aureus microbe. A small percentage of those samples proved to be MRSA. Follow up interviewers showed no links between exposure and subsequent infections (which would be expected, since the bacteria would need to be introduced to the skin through a sufficient cut), but it’s an example of how people can be exposed just about anywhere. (Sanders, 2009)

How many people are infected with MRSA?
One out of every 3 Americans is now infected with staph aureus, most without knowing they have it or where they got it. Staph aureus is a common microbe that includes many strains, and not all of them are the more dangerous MRSA. However, as immunity to antibiotics grows, the number of semi- or fully-resistant strains continues to rise.

How an MRSA infection starts & spreads
Normally, MRSA will live harmlessly on a person’s skin or in their nasal passages. The problem arises when the bacteria is able to enter the bloodstream, typically through some sort of cut or abrasion. Once this happens, a person is said to have become infected. Since so many people have the bacteria living on their skin, something so simple as a skinned knee can allow it to enter the bloodstream, causing a potentially life-threatening MRSA infection.

MRSA often begins as a pimple or boil on the skin. It can spread to other parts of the body, including the lungs, where it can cause pneumonia. Once it’s inside you, an MRSA infection can move through the body within a matter of a few days, causing serious damage that includes septic shock, heart and kidney failure, bone infection, and if not controlled, eventually death. More than 2 million Americans have been “colonized” with MRSA like this, and once colonized, it’s virtually impossible to get rid of. In this way, MRSA is very similar to HIV: it’s great at finding places to hide inside the body and can lay dormant, waiting to show its ugly face.

“Staph aureus is a sneaky bug that likes to hide, and it’s hard to kill,” says Vance Fowler, an infectious disease specialist at Duke University. “Whenever you have staph aureus in your bloodstream, the question is not just how to kill it, but where else did it go? What other tissue did it seed? This is why in some of the really desperate situations, we’re talking about lifelong suppression by antibiotics. The patient has to be on antibiotics forever, just to keep the bacteria from recurring.” (Taubes, 2009)

One man acquired the infection while swimming in a pond with his children. He suspects a fish nibbled at the infection site. It swelled, and he ended up in the hospital with a golf ball sized infection. In the 3-years since this original infection, he’s had one more outbreak, and each of his two children have had them. His daughter’s second infection occurred in her hip joint after taking what her father called “a ‘few whacks’ on her side during a gymnastics class. She needed intravenous antibiotics for 4 weeks. His son then had a skin infection, and his daughter came down with one more infection in the same place. (ibid)

MRSA mutates quickly by altering at least one DNA letter in its genome about every 6 weeks, which means it can quickly adapt to what doctors throw at it. One study found more of those mutations occur in genes involved in antibiotic resistance than would be expected by chance, “illustrating that there is an immense selective pressure from antibiotic use worldwide,” says Simon Harris of the Welcome Trust Sanger Institute in Hinxton, England. (Hesman-Saey, xxxx) Today, 70% of infections are impervious to at least one antibiotic, which prompts many clinicians to prescribe multiple drugs, which leads to even more resistance to newer and higher level drugs. (Svoboda, 2009)

How dangerous is MRSA?

MRSA now routinely kills about 20,000 Americans each year, more than those killed by HIV/AIDS (which averages around 18,000 deaths a year and is steadily declining). In 2005, nearly 280,000 Americans were hospitalized for MRSA infections, many suffering serious complications.

Children infected with MRSA
More disturbingly, the number of children hospitalized with MRSA surged tenfold in recent years, according to a study in the May 17, 2010 Pediatrics, going from 2 cases per 1,000 to 21 cases per 1,000 between 1999 and 2008. It also appears that hospital-transmitted cases may be in decline while community-acquired infections are on the rise. (USA Today, 5-18-2010)

Protecting Your Family from MRSA
The bacteria itself can be found on countertops, kitchen sinks, doorknobs, playground equipment…you name it, it’s likely to be there. It can be spread when you shake hands, give someone a high-five, or when kids wrestle and roughhouse on the playground. Organized sports such as soccer, wrestling, swimming, gymnastics, and martial arts can spread it. So absent living in a bubble, there’s not much you can do to keep your family from being exposed. However, there are a few precautions you can take to lower the risk.

How to prevent MRSA infections

• Have children wear water shoes when swimming in an outdoor body of water to protect against cuts that might introduce the bacteria.

• Families can shower with soap after a beach visit, or after their children engage in contact sports, which can reduce the chance that a resistant form will colonize their skin.

• Be proactive if you or a loved one has to go to the hospital, which is one of the main places it spreads. One study of 74,000 ICU hospital patients found that “decolonization” of people by bathing them with antimicrobial soap and water and dabbing their nasal cavities twice a day with antibiotic ointment prior to entering the ICU reduced MRSA infections better than did the standard approach, which generally involves swabbing a patient’s skin and testing for the bug before they go for surgery. (Seppa, 2013) So politely encourage hospital staff to take this approach.