There isn’t one day that goes by that I don’t take care of at least one patient with MRSA (methicillin resistant Staphylococcus aureus) infection. I spent the last 3 posts talking about staph infections in general, including why it is that staph is able to cause such bad infections (see here), examples of some of these bad infections (see here), and what makes MRSA a big deal (see here).
MRSA infection tends to freak people out and one of the commonest questions I get asked about it (often from loved ones of those suffering from infection) is, how can I prevent this infection? I’ll dive right into the 8 strategies I recommend for preventing MRSA infection (they also apply to the prevention of MSSA – methicillin sensitive Staphylococcus aureus):
1- Wash your hands. As I said here, hand washing remains the cornerstone of infection prevention. Wash with soap and water, or clean your hands with an alcohol based sanitizer after visiting any public place. Be particularly vigilant in sanitizing hands after visiting a hospital or other healthcare facility as one would expected there to be a higher concentration of MRSA in environments where there are more sick people
2- Take a shower after being out and about (and put the clothes you were wearing in the soiled laundry basket). I recommend doing this especially after a prolonged visit to a healthcare facility. This is also highly recommended after a workout at the gym. Yes the gym! Gyms are well known to be colonized with MRSA. Every now and then in the media there are reports of sports people coming down with bad MRSA infections.
3- Don’t go to gym with freshly shaved legs/body. If so, wear clothing that covers all shaved areas. The thing is, after a fresh shave, there are little nicks and scratches on the skin, some invisible to you, but not too small for bacteria to get through. MRSA laying around on the gym equipment can get into these little nicks and cause skin infections. Infection may not always occur but the MRSA can stay on your skin and in your nostrils (colonizing you). Sometime in the future, it can shift from just being a colonizer to actually causing you an infection.
4- Keep any scratches or wounds clean and covered. Wounds should be cleaned twice per day (can be during a shower) to wash away dead cells/tissue and surface germs so that there is less chance for infection to “brew.” Remember, bacteria like dead tissue.
5- Avoid contact with another person’s wound, especially if it is draining. If you have to assist someone with caring for their wound, wear gloves if possible, and after the wound care, wash hands with soap, under running water.
6- Avoid unnecessary antibiotics. There are some people who are at the doctor’s office almost every month requesting antibiotics for a sinus infection, or a cough, or for urine that “smells bad,” or some other complaint that probably does not warrant antibiotic therapy. The more one takes antibiotics, the more good bacteria in the body are killed. Some of the bacteria that survive are able to do so because they found smart ways to hide from the antibiotics, that is, they became resistant (like MRSA). Because the balance of all the germs/bacteria in the body is thrown off after a course of antibiotics, these resistant bacteria overgrow, because there is less “competition” from the good bacteria…Stick with me here…In other words, pressure from the antibiotics causes the good bacteria to die, and so now, the resistant bacteria such as MRSA are automatically selected for survival. We call this “selective pressure” which gets more pronounced, the more antibiotics a person goes on. And not to mention the frequent contacts with the healthcare system for these antibiotic prescriptions, further increases the chance of getting “contaminated” or colonized with MRSA
7- Bathe or shower with 4% chlorhexidine gluconate (CHG) soap before any surgical procedure. This is pretty much standard of care now, given the high incidence of MRSA infections (in hospitals). CHG kills germs including MRSA, thereby decreasing the overall concentration of germs on the skin going into surgery. The risk of infection of the surgery wound post operatively is therefore decreased. The recommendation is to wash with CHG once a day for 3 days prior to surgery, from neck down (head, face and genitals should be avoided). After first bathing with regular soap, the CHG is applied to the body with a clean washcloth and left on the skin for 3 minutes before washing off. CHG is available from all major pharmacies over the counter.
8- Optimize your immune system. Nothing helps to beat an infection like a solid immune system. Even with all the antibiotics and intensive hospital support we now have available, a strong immune system can mean the difference between life and death sometimes. Optimize your immune system by eating well (more real food and less processed meals), avoiding excess sugar (germs love sugar!), exercising, minimizing stress, and eliminating cigarette smoking.
Sometimes, even after sticking to all the above prevention strategies and more, an MRSA infection still occurs, because…stuff happens. If it happens to you, quickly seek medical attention for the appropriate treatment, and continue to optimize health to prevent serious complications and recurrent infections in the future.