MRSA Infection

Staphylococcus aureus bacteria, often known simply as staph, are bacteria commonly carried in the nose and on the skin of healthy people. Staph often causes no problems, but can sometimes cause infections, usually on the skin. When the bacteria don’t respond to the antibiotic methicillin or others like it, such as oxacillin, penicillin, amoxicillin and cephalexin, it’s called MRSA (methicillin-resistant Staphylococcus aureus).

MRSA infections can be contagious. The bacteria is spread through casual contact with a person who is infected or contact with an object that has been contaminated with MRSA, such as towels, sheets, wound dressings, razors, tubs, sports uniforms and other clothes, workout areas, sports equipment or countertops. They’re not spread by coughing or sneezing. MRSA infections can be hard to treat, and some can be quite serious.

Most MRSA infections are found in older adults and people with weakened immune systems, typically in hospitals and other health care settings, such as nursing homes and dialysis centers. These are called health care-associated infections, or HA-MRSA. These infections may appear in surgical wounds, the urinary tract, bloodstream and the lungs (pneumonia).

More recently, MRSA infections also have begun affecting otherwise healthy people who have not been hospitalized or undergone medical procedures. These are called community-associated infections, or CA-MRSA. At-risk groups include young children, athletes in contact sports such as football and wrestling, or anyone who shares towels or athletic equipment, has a weakened immune system or lives in crowded or unsanitary conditions. MRSA infections can occur anywhere, but the odds of getting an infection are greater when the “5 Cs” are present.

The “5 Cs” are common in schools, dormitories, military barracks, households, correctional facilities and daycare centers.

Unless directed by a physician, students with MRSA infections should not be excluded from attending school. Exclusion from school should be reserved for those with wound drainage that can’t be covered and contained with a clean, dry bandage and for those who can’t maintain good personal hygiene.

CA-MRSA infections usually appear on the skin as pimples or boils. An infection could be mistaken for a spider bite. These infections most often appear around an existing cut or abrasion or on areas of the body covered by hair, such as the back of the neck, groin, buttocks, armpits or in beards. Signs of infection include fever, redness, swelling, warmth and tenderness around the wound, and a yellowish-white fluid or pus draining from the wound.

Because their immune systems aren’t fully developed, CA-MRSA can be quite serious in children. A cut or scrape can turn into a widespread infection. To be on the safe side, keep an eye on any minor skin problem your child may have to make sure there are no signs of infection.

If you’re concerned your son may have a MRSA infection, seek medical care. Ask his doctor to check the infected wound for MRSA. The doctor may rub a cotton swab over the infected area of skin and send it to a lab for further review. The lab also can do a sensitivity test on the bacteria to determine which medicine should be prescribed to fight the infection. This will prevent treatment with an ineffective antibiotic, which could lead to a more serious illness.

If your child develops a MRSA skin or wound infection, his doctor may treat it by draining the infected fluid from the wound or giving a course of antibiotics, or both. Draining a boil or abscess should only be done by your doctor or another qualified health care professional.

Follow instructions carefully if your doctor prescribes an antibiotic for your child to take by mouth or place on his skin. Even if the infection is getting better, give all the prescribed doses, unless your doctor tells you to stop.  Do not save unfinished antibiotics to use at another time. If the infection does not improve or seems to get worse, call your doctor for advice.

The best way to keep your child from developing a MRSA infection is to follow some common-sense personal hygiene practices.

Bronchiolitis Spread via respiratory droplets through sneezing or coughing  2 to 10 days  Onset of cough until 7 to 10 days 
Chickenpox (Varicella) Airborne or via skin contact with lesions  10 to 21 days  2 days before rash appears until all sores have crusted 
Colds Spread via respiratory droplets or direct contact with infected person or object  2 to 4 days  Onset of runny nose until fever is gone

Croup (viral) Spread via respiratory droplets or contact with infected person or object  2 to 6 days  Onset of cough until fever is gone
Diarrhea Contact with feces  Depends on causative agent (bacterial 1 to 7 days; viral 1 to 4 days)  Depends on causative agent; usually until stools are formed. (See specific agents)
Fifth Disease (Parvo virus) Spread via respiratory droplets  Usually 4 to 14 days, but can be as long as 21 days  7 days before rash until rash begins 
Hand-foot-mouth (Coxsackie) Spread via respiratory droplets, fecal/oral contact or fluid from blisters  3 to 6 days  Onset of mouth ulcers until fever is gone (respiratory tract shedding usually 1 week; fecal can be several weeks)
Hepatitis A Fecal contact  15 to 50 days  1 to 2 weeks before jaundice begins until 1 week after onset of jaundice
Hepatitis B Contact with infected blood/body fluids  45 to 160 days  Indefinite period. If Hepatitis e antigen is positive, at risk for transmission 
Herpes Simplex Oral/genital skin contact  2 days to 2 weeks  Initial infection: 1 week to several weeks (oral/genital). Recurrent infection: 3 to 4 days
Impetigo Direct skin contact with lesion and contact with infected objects  7 to 10 days  Onset of sores until 1 day on antibiotics
Influenza Spread via respiratory droplets or contact with infected person or object  1 to 4 days  24 hours before onset of symptoms until fever is gone, about 7 days
Lice Spread via contact with skin or hair  10 to 14 days  Onset of itch until 24 hours after first treatment
Meningococcus Spread via respiratory droplets  1 to 10 days  7 days before symptoms to 24 hours after treatment begins
Mononucleosis Contact with infected saliva  30 to 50 days  Undetermined, but usually 6 weeks
MRSA Spread via contact with infected person, person who is a carrier of the disease, or contaminated surface.  One to 10 days  Varies depending on whether infection is active and if person is seeking treatment 
Pertussis (whooping cough) Spread via respiratory droplets  Five to 21 days  Two weeks after onset of cough or until five days on antibiotics
Pink-eye or Conjunctivitis (bacterial) Spread via contact with eye drainage
2 to 7 days  Onset of pus until symptoms have resolved
Rotavirus Direct or indirect contact with infected people  2 to 4 days  Before onset of diarrhea until 10 to 12 days after onset
Salmonella, Shigella, Campylobacter Fecal contact  Salmonella - 12 to 36 hours
Shigella & Campylobacter - 1 to 7 days 
Contagious until diarrhea is resolved; sometimes with prolonged excretions with salmonella
Scabies Contact with clothing, bedding or skin of infected animal or person  4 to 6 weeks (previous exposure 1 to 4 days)  Onset of itch until one treatment completed
Scarlet fever Spread via airborne respiratory droplets and direct contact  1 to 2 days  Onset of fever or rash until 1 day on antibiotics
Sore throat (viral) Spread via respiratory droplets  2 to 5 days  Onset of sore throat until fever is gone 
Strep throat Spread via respiratory droplets  2 to 5 days  Onset of sore throat until 1 day on antibiotics 

2006 Red Book, Report of the Committee on Infectious Disease, American Academy of Pediatrics

Airborne - droplets nuclei that remain suspended in the air for long periods
Respiratory droplets - droplets propelled for a short distance, such as talking, sneezing, coughing, etc.

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