Disease: Staph Infection

What Is a Staph Infection?

Billions of people worldwide carry the Staphylococcus aureus bacteria, but most are unaffected by it.

There are more than 30 different types of bacteria that are classified as Staphylococcus; the most common is Staphylococcus aureus.

You don’t have to be sick to be a carrier of the staph bacteria. This germ lives on the skin and in the nose of many healthy people, and most will never be affected by it.

But for some — especially those with compromised immune systems — the bacteria can cause an infection that ranges from a mild skin rash to potentially life-threatening blood poisoning.

There are many different forms of staph infections. The most common are:

Skin Infections: These staph-related conditions include boils, cellulitis, and impetigo.

Boils are hair follicles or oil glands that have become infected and are often filled with pus. The boil may be raised, swollen, red, and painful to the touch. Boils most often occur in areas with a lot of friction, including under the arms, in the groin, and on the buttocks.

Cellulitis is an infection of the deeper layers of skin that causes your skin to swell, turn red, and become warm and tender. Oozing sores (ulcers) may also develop. Cellulitis most often occurs in the lower legs and feet.

Impetigo is a highly contagious skin rash most commonly seen in children. An infected person will have blisters that ooze and crust over after a few days.

Food poisoning: Eating food that has been contaminated by staph bacteria is one of the most common causes of food poisoning. Symptoms occur suddenly and include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Dehydration
  • Low blood pressure

Toxic shock syndrome: Also known as TSS, this potentially deadly condition results from toxins that are produced by some strains of staph bacteria.

TSS has been associated with the use of certain types of tampons, skin wounds, and surgery. Symptoms appear suddenly and include:

  • High fever
  • Nausea and vomiting
  • Confusion
  • A rash on your palms and soles that resembles sunburn
  • Muscle aches
  • Diarrhea
  • Abdominal pain

Septic Arthritis: Staph infection is a common cause of septic arthritis. The knees are most often affected, but the bacteria can target other joints including your ankle, hip, wrist, elbow, shoulder, or spine. Symptoms include:

  • Joint swelling
  • Severe pain in the affected joint
  • Fever

Bacteremia: Also known as blood poisoning, bacteremia is a more serious result of staph infection.

As the name suggests, it occurs when staph bacteria enter a person's bloodstream; symptoms include a fever and low blood pressure. Bacteremia can affect:

  • Bones
  • Muscles
  • Lungs
  • Brain
  • Heart
  • Surgically implanted devices, such as artificial joints or cardiac pacemakers
  • Kidneys

Diagnosing a Staph Infection

If you suspect you have any form of a staph infection, it’s important to see your doctor.

To diagnose a staph infection, your doctor will examine any sores or cuts you may have. Cellulitis and impetigo both have predictable patterns and telltale lesions, and both can generally be diagnosed visually.

Your doctor may also collect a tissue sample. Staph infections are diagnosed by analyzing a tissue sample or nasal secretions for the bacteria.

Treating a Staph Infection

Depending on the type of staph infection you have, your doctor may:

  • Drain the wound. If you have a skin infection, such as a boil, your doctor will likely lance the sore to drain fluid and pus.
  • Prescribe an antibiotic ointment. Impetigo is easily treated with antibiotic creams. In more advanced cases, your doctor may also prescribe an oral antibiotic.
  • Oral antibiotics. Depending on the type of staph bacteria you have, your doctor may prescribe an antibiotic. Those most commonly prescribed are certain cephalosporins, nafcillin or related antibiotics, or sulfa drugs.

If an oral antibiotic is ineffective, it may be because the strain of staph bacteria is resistant to most antibiotics. This type of staph is known as methicillin-resistant Staphylococcus aureus, or MRSA.

In the event of a MRSA infection, an intravenous antibiotic, such as vancomycin (Vancocin) or dalbavancin (Dalvance), may need to be administered.

Sources:

  • Staph Infections (Mayo Clinic).
  • Staphylococcal Infections (NIM.NIH.gov).

Symptoms of Staph Infection

Do you know the signs of a potentially dangerous Staphylococcus infection?

Staph infection is a general term for any infection caused by Staphylococcus, a type of bacteria.

The symptoms of a particular staph infection will vary by the type of infection. The most common are:

Skin Infection Symptoms

A boil (or “furuncle”) is an infected hair follicle or oil gland. Symptoms of boils are:

  • A red, swollen bump that is painful to the touch that starts out small, about the size of a pimple. They are common around areas of friction, including your underarms, groin, and buttocks.
  • The bump may fill with pus and grow in size to a hard lump over a few days. Untreated, it may get as big as a baseball.
  • The bump may develop a yellow-white tip that eventually bursts and pus may ooze out.
  • A cluster of boils may become interconnected underneath the skin forming a carbuncle. Carbuncles may cause fever and chills.

Impetigo is a contagious skin infection that most commonly occurs in children, ages 2-5 (most commonly). Symptoms of impetigo are:

  • Red blisters that appear around the nose, mouth, neck, and hands. The blisters may show up on other parts of the body as the infection progresses.
  • After a few days, the sore will ooze and form a brownish-yellow crust.
  • The sores may be itchy, but aren’t typically painful.

Cellulitis is a common skin infection. Symptoms of cellulitis are:

  • Swollen red areas of skin that feel hot and tender to the touch. It most commonly affects shins and calves, but can appear anywhere on your body.
  • Fever
  • Small red spots may appear on the reddened skin
  • Small blisters may form and burst

Food Poisoning Symptoms

When you eat food contaminated with staph bacteria, you may develop food poisoning. Symptoms of food poisoning caused by staph often occur rapidly (30 minutes to six hours after eating) and include:

  • Nausea
  • Vomiting
  • Stomach cramps
  • Diarrhea.
  • Symptoms that usually don’t last longer than a day, but can last up to three.

Symptoms of Toxic Shock Syndrome

Toxic shock syndrome, or TSS, is a potentially deadly infection. Symptoms of TSS include:

  • A high fever that occurs suddenly
  • Fatigue, malaise
  • Confusion
  • Diarrhea
  • Low blood pressure
  • Vomiting
  • General aches and pains
  • Red eyes, mouth, and throat
  • A rash on the palms and soles of the feet

Symptoms of Septic Arthritis

Septic arthritis is when bacteria spread to a joint. It can occur at any age — in children it typically affects those less than 3 years old. Symptoms of septic arthritis in children include:

  • Crying when infected joint is moved
  • Fever
  • Inability to move the arm or leg with the infected joint
  • Crankiness

Symptoms in adults include:

  • Fever
  • Joint swelling and redness
  • Joint pain
  • Inability to move the arm or leg with the infected joint

Symptoms of Bacteremia

Anyone who stays in the hospital, those who have a catheter, has a weakened immune system, or is elderly is at higher risk for bacteremia, also known as blood poisoning or sepsis. Symptoms of bacteremia include:

  • Fever
  • Low blood pressure
  • Organ damage, especially to the heart and kidneys

Sources:

  • Diseases and Conditions: Carbuncles and Boils (Mayo Clinic).
  • Diseases and Conditions: Cellulitis (Mayo Clinic).
  • Diseases and Conditions: Impetigo (Mayo Clinic).
  • Septic Arthritis (Medline Plus).
  • Staphylococcal Food Poisoning (Center for Disease Control).
  • Toxic Shock Syndrome (Medline Plus).

What Causes Staph Infection?

Take steps to prevent an infection by the Staphylococcus aureus bacterium.

Staph infections are caused by Staphylococcus bacteria that live on your skin, in your mouth, and in your nasal secretions.

There are more than 30 different bacteria that are classified as Staphylococcus; Staphylococcus aureus is the most common one. You can be a carrier of staph bacteria and never get sick.

But for those with open sores or cuts, compromised immune systems, or who have recently had surgery, staph bacteria can cause an infection that ranges from mild to severe to life threatening.

Is a Staph Infection Contagious?

Certain types of staph infections, including boils and impetigo (a skin rash), are contagious.

Other types of staph infections, including cellulitis, food poisoning, toxic shock syndrome, bacteremia, osteomyelitis, and septic arthritis are not contagious.

Risk Factors for Staph Infections

You are at higher risk for a staph infection if:

  • You have a skin condition such as eczema that may cause skin irritation or damage.
  • You play a contact sport, like wrestling, that involves skin-to-skin contact.
  • You live in crowded conditions such as a dormitory, prison, or military barracks.
  • You have a compromised immune system from HIV/AIDS, chemotherapy, or medication.
  • You have an invasive device such as a catheter, feeding tube, or breathing tube
  • You have diabetes, particularly if you use insulin or receive dialysis.

How to Prevent Staph Infection

Many staph infections are preventable with proper wound care and good hygiene.

The most important thing you can do to prevent a staph infection is to follow proper wound care procedures. If you have a cut, scrape, or bug bite, wash it with soap and warm water. Allow it to dry, then apply an antibacterial ointment. Cover it with a bandage until it heals.

Don’t scratch bug bites or pick at scabs; dirty fingers and nails can introduce bacteria into a wound. If you have a boil, don’t squeeze it or try to pop it yourself.

At home and in the locker room, don’t share towels, razors, or other personal care items that may be contaminated with bacteria.

And if you know you are a carrier of staph bacteria, let your dentist or doctor know prior to treatment. He or she can prescribe an antibiotic prior to a dental cleaning or any type of surgery.

What Is a ‘Superbug’?

A superbug is any germ — usually a strain of bacteria — that has developed a resistance to antibiotics or other treatments.

Methicillin-resistant Staphylococcus aureus, or MRSA, is an increasingly common strain of staph bacteria that’s resistant to methicillin and other antibiotics commonly prescribed to treat staph infections.

Hospital patients, nursing home residents, and those who attend healthcare centers (including dialysis centers) are at a greater risk for MRSA.

It’s important that you only take antibiotics only when necessary (not for viral infections like the flu or colds) and when they are prescribed to you by a doctor.

Also, it’s critical that people always finish their full course of antibiotics, even if their symptoms have subsided, to prevent the development of antibiotic-resistant superbugs such as MRSA.

Sources:

  • Disease and Conditions: Staph Infections (Mayo Clinic).
  • Staphylococcal Infections (NIM.NIH.gov).

Treatment for Staph Infection

Today, many antibiotics are ineffective against an infection by Staphylococcus aureus.

The treatment for staph infections will depend both on the strain of staph you are infected with and the way the infection shows up.

Treatment for Skin Infections Caused by Staph Infections

Boils: A boil is an infected hair follicle or oil gland that is red, swollen, and sometimes filled with pus. Treatment for boils include:

  • Warm compresses. Soak a clean washcloth with warm water and apply to your boil for 10 minutes at a time a few times throughout the day. This will help draw the boil to a head and encourage it to burst.
  • Do not attempt to pop the boil yourself by squeezing it, because this could cause an infection.
  • Once the boil has burst, clean it with soap, smear it with antibacterial gel, and cover it with a bandage.

If the boil does not burst on its own, or you have a fever, or it develops red streaks, you should see your doctor, who may decide to lance it. Your doctor may also prescribe an antibiotic if the boil is infected.

Impetigo: Impetigo is a skin infection that causes a rash with pus-filled blisters. It is most common in children. Treatment for impetigo includes:

  • Applying a topical antibiotic cream will to help clear up the infection more quickly. Mupirocin (Bactroban) or retapamulin (Altabax) are the two most commonly prescribed.
  • In a more advanced or widespread case of impetigo, your doctor may also prescribe an oral antibiotic.

Cellulitis: Cellulitis is a skin infection that causes swollen, hot, red patches on the shins and calves. Treatments for cellulitis include:

  • Elevating the infected area.
  • Oral antibiotics. Your doctor will determine the best one based on your symptoms and overall health.
  • If your infection does not respond within three days after starting the antibiotic, let your doctor know. You may need to receive an intravenous (IV) antibiotic.
  • If you have fever with cellulitis initially, you may need at least one dose of IV antibiotics.

Treatment of Food Poisoning Caused by Staph Infections

Unfortunately, there is no treatment for food poisoning that is caused by staph infections. On the plus side, the symptoms typically resolve themselves in 24 hours.

Treatment of Toxic Shock Syndrome

Toxic shock syndrome, or TSS, is a potentially deadly infection that starts with fever and confusion and can lead to kidney and liver failure. Treatment for toxic shock syndrome includes:

  • Removal of any foreign materials including tampons and gauze
  • Drainage of any infected surgical wounds
  • Oral or intravenous antibiotics
  • Intravenous fluids
  • Blood pressure control medication
  • Dialysis (in the case of kidney failure)
  • Intravenous gamma globulin in severe cases

Treatment of Septic Arthritis

Septic arthritis is a result of bacteria that has spreads through your blood to a joint, causing pain and swelling. Treatment of septic arthritis includes:

  • Resting, raising, and immobilizing the affected joint
  • Applying cool compresses to the joint to relieve pain
  • Oral or intravenous antibiotics
  • Fluid may need to be drained from the infected joint. In very severe cases, you may need surgery to drain the infected joint fluid.

Treatment of Bacteremia

Bacteremia, also known as blood poisoning or sepsis, can cause high fevers and low blood pressure. Treatment includes:

  • Removal of foreign devices such as catheters
  • Oral or intravenous antibiotics

’Superbugs’ and MRSA Treatment

Because staph bacteria are very adaptable, only about 10 percent of staph infections respond to treatment with penicillin and other older types of antibiotics.

An increase in antibiotic-resistant strains of staph bacteria, including methicillin-resistant Staphylococcus aureus or MRSA, has led to the use of alternative antibiotics that have the potential for more serious side effects.

In severe cases of MRSA, you may need to be hospitalized to receive an intravenous antibiotic, such as vancomycin (Vancocin) or dalbavancin (Dalvance).

Sources:

  • Blood Poisoning: When to See a Doctor (Mayo Clinic).
  • Diseases and Conditions: Carbuncles and Boils (Mayo Clinic).
  • Diseases and Conditions Cellulitis (MayoClinic).
  • Diseases and Conditions: MRSA Infection (Mayo Clinic).
  • Impetigo Beyond the Basics, Larry M. Badour, MD, FIDSA (UptoDate).
  • Septic Arthritis (Medline Plus).

What Is MRSA?

This 'superbug' is causing concern among many medical experts.

MRSA stands for methicillin-resistant Staphylococcus aureus, a type of staph infection caused by a so-called “superbug” staph bacteria that’s resistant to the antibiotic drugs usually used to treat common staph infections.

An estimated 2 percent of the population carries the MSRA type of staph bacteria, according to the Centers for Disease Control and Prevention (CDC).

MRSA has become more common in recent years as a result of the over-prescribing of antibiotics — including prescribing antibiotics for viral infections such as colds and flu. Antibiotics are useless at treating infections caused by viruses.

Many other bacteria, such as tuberculosis, Clostridium difficile (C. difficile), and gonorrhea, are also becoming more resistant to antibiotics and are now increasingly challenging to treat.

There are two types of MRSA, hospital-acquired MRSA, known as HA-MRSA, and community-acquired MRSA, or CA-MRSA.

HA-MRSA occurs most often in people who have been in healthcare settings including hospitals, nursing homes, or dialysis centers.

CA-MRSA is spread by skin-to-skin contact or in crowded conditions. High school and college wrestlers, and those who live in dormitories, prisons, or military barracks, are at higher risk of MRSA infection.

Causes of MRSA

MRSA is a type of bacteria that lives on most everyone’s body. You can be a carrier of the bacteria and have no symptoms.

Risk factors for HA-MRSA include:

  • Being hospitalized: MRSA preys on those with weakened immune systems, including older adults and those recovering from surgery or an illness.
  • Having an invasive medical device: Medical tubing, such as intravenous (IV) lines or urinary catheters, can provide an easy way for MRSA to get into your body.
  • Residing in a long-term care facility: Another place MRSA is common is in nursing homes, where the bacteria can spread from those who carry MRSA to the infirm, even if they're not sick themselves. The bacteria can live on door knobs, bedding, and other places, so proper hygiene in hospitals and nursing homes is imperative.

Risk factors for CA-MRSA include:

  • Playing contact sports. MRSA spreads easily through cuts during skin-to-skin contact, such as occurs in wrestling, football and other activities.
  • Living in crowded or unsanitary conditions. MRSA may occur in child care centers, college dorms, military training camps, and prisons.
  • Homosexual behavior. Men who have sex with men have a higher risk of developing MRSA infections.

Symptoms of MRSA

A large percentage of people who carry the MRSA strain of staph bacteria will never develop serious symptoms.

But for those with an active MRSA infection, the infection typically begins with small red bumps that look like pimples, boils, or spider bites. These seemingly harmless bumps can develop into deep, painful abscesses that require surgical draining.

The bacteria may stay on the skin, but in some more serious cases, they can bore deep into the body, causing potentially life-threatening infections in surgical wounds, bones, joints, the bloodstream, lungs, and heart valves.

Preventing HA-MRSA

Following proper hygienic procedures is key to preventing the spread of HA-MRSA in the hospital and other health care facilities. Contaminated laundry should be thoroughly washed in hot water and surfaces should be properly disinfected.

Those who are infected with MRSA are often placed in isolation (sometimes called “contact isolation”) to prevent the spread of the bacteria. Nurses, doctors, and other health care workers caring for those in isolation may need to wear protective garments and follow strict hygiene procedures.

Preventing CA-MRSA

  • Wash your hands with soap and warm water after coming into contact with others. Shower after athletic games.
  • Keep any cuts, bites, or sores clean and covered with a bandage.
  • Don’t share personal items such as towels, clothing, athletic equipment, or razors.

Diagnosis of MRSA

Your doctor may take a sample of your nasal secretions or other tissue sample to test for the presence of MRSA bacteria. The results take about one to two days.

Complications of MRSA

As the name suggests, MRSA bacteria is resistant to many antibiotics. If left untreated an infection may become life threatening as it spreads to your:

  • Bones
  • Joints
  • Bloodstream
  • Lungs
  • Heart

Treatment of MRSA

Both forms of MRSA — HA-MRSA and CA-MRSA — respond to certain types of antibiotics. The nasal secretion culture your doctor did will help determine the right type of antibiotic for your case.

In severe cases, you may need to be hospitalized to receive an intravenous antibiotic such as vancomycin (Vancocin) or dalbavancin (Dalvance).

Sources:

  • Disease and Conditions: MRSA Infection (Mayo Clinic).
  • Staphylococcal Infections (NIM.NIH.gov).

Symptoms of MRSA

Methicillin-resistant Staphylococcus aureus is a 'superbug' that's tough to treat.

MRSA stands for methicillin-resistant Staphylococcus aureus, a type of staph bacteria that’s resistant to most antibiotics; for that reason, it’s also known as a “superbug.”

When bacteria are resistant to antibiotics, it’s harder to kill them and it takes longer for you to recover from an infection.

In otherwise healthy people, MRSA can cause skin infections. In hospitals and other healthcare settings, it can lead to more severe infections including bloodstream infections.

Of the more than 30 different bacteria that are classified as Staphylococcus, the most common is Staphylococcus aureus. An estimated 2 percent of the population carries the MSRA strain of staph bacteria, according to the Centers for Disease Control and Prevention (CDC).

You can carry the bacteria and not be sick. However, in some cases, it can lead to a life-threatening illness, especially if you have a weakened immune system or are in a healthcare setting.

Fortunately, MRSA infections have declined significantly over the past decade. A CDC study found that MRSA infections in hospitals declined 54 percent from 2005 to 2011 and there were 9,000 fewer deaths in 2011 than 2005 as a result of MRSA.

Symptoms of MRSA Skin Infections

MRSA skin infections commonly occur where you already have a cut or skin abrasion through which the bacteria can enter your body, and on areas of the body that are covered by hair (e.g., back of neck, groin, buttock, armpit, or beard area of men).

The first sign of a MRSA infection is usually a small pimple that is sometimes mistaken for a spider bite. The bump may be:

  • Red
  • Swollen
  • Painful
  • Warm to the touch
  • Full of pus
  • Accompanied by a fever

If you suspect you have a staph infection or if you have a fever, schedule an appointment with your doctor immediately.

In the interim, cleanse the area thoroughly with soap and warm water and cover with a bandage. Do not try to squeeze out the pus yourself as dirty fingers and nails might only make the infection worse.

Your doctor may need to lance and drain the area of the infection. He or she may also prescribe antibiotics to help clear up the infection.

Symptoms of HA-MRSA Infections

In a hospital, nursing home, or other healthcare setting such as a dialysis center, symptoms tend to be more severe.

Infections with hospital-acquired MRSA, or HA-MRSA, may be in the bloodstream, heart, lungs, other organs, urine, or in the area of a recent surgery.

Typical symptoms of HA-MRSA may include:

  • Chest pain
  • Cough or shortness of breath
  • Fatigue
  • Fever and chills
  • General malaise
  • Headache
  • Rash
  • Wounds that do not heal

HA-MRSA infections are diagnosed through a culture of your tissues or nasal secretions. Your doctor will prescribe an appropriate oral antibiotic for you to treat the infection.

If you don’t respond to treatment, you may need to receive antibiotics intravenously. The two most commonly prescribed are vancomycin (Vancocin) and dalbavancin (Dalvance).

Sources:

  • Methicillin-resistant Staphylococcus aureus (MRSA) Infections (Centers for Disease Control and Prevention).
  • MRSA (Medline Plus).

MRSA Treatment

Treatment of MRSA may involve the use of very strong — and risky — antibiotics.

Methicillin-resistant Staphylococcus aureus (MRSA), sometimes known as a “superbug,” is caused by a strain of staph bacteria that has become resistant to many antibiotics.

It can be life-threatening and is often found in hospitals, healthcare settings, and in crowded areas like college dorms, military bases, and prisons.

An estimated 2 percent of the U.S. population carries the MSRA strain of staph bacteria, according to the Centers for Disease Control and Prevention (CDC), compared to one-third of the population that carries other forms of the staph bacteria.

You can be a carrier of the bacteria and never get sick, but in some cases it can cause a life-threatening infection.

MRSA infections have declined significantly over the past decade. A CDC study found that there were 9,000 fewer deaths in 2011 than 2005 as a result of MRSA, and 38,000 fewer cases in 2011 than 2005, a 54 percent decline.

MRSA can enter the body through a cut, scratch, or bug bite; in these instances it is most likely to cause a skin infection, soft skin tissue infection, boil, or abscess.

When the infection occurs in a healthcare setting (sometimes called hospital-acquired MRSA or HA-MRSA), symptoms typically include:

  • Fatigue
  • Fever and chills
  • General malaise
  • Headache
  • Rash
  • Wounds that do not heal
  • Chest pain
  • Cough or shortness of breath

Diagnosing MRSA

All forms of staph infection are diagnosed from a culture. Your doctor will test your nasal secretions or take a blood culture or tissue sample to see if they contain the staph bacteria, including MRSA.

The sample is put in a dish of nutrients that encourage bacterial growth. It takes one to two days to get the results of the test.

Treatment of MRSA Skin Infections

If you have a MRSA skin infection, generally from community-acquired MRSA or CA-MRSA, your doctor may need to drain the sore by making a small incision or lancing it.

Do not try to do this yourself as you may introduce more bacteria into the sore through dirty fingers, or you may push the infection deeper into the skin.

It’s vital that the boil or abscess is drained in the appropriate sterile manner so the infection does not get worse or spread to other people. 

Treatment of CA-MRSA may also involve the use of antibiotics other than methicillin, such as doxycycline (Doryx, Monodox), minocycline (Dynacin, Minocin), or trimethoprim/sulfamethoxazole, also called TMP-SMX (Bactrim, Septra). 

Treatment of HA-MRSA Infections

For HA-MRSA infections your doctor will prescribe an antibiotic. Only about 10 percent of staph infections respond to treatment with penicillin, so your doctor will most likely need to give you an alternative drug.

Vancomycin (Vancocin) is a popular alternative, though it may have toxic side effects, including damage to your hearing and kidneys. It is typically given intravenously. Talk to your doctor about its risks and benefits before receiving it.

Dalbavancin (Dalvance) is another drug used to treat MRSA. It received approval from the Food and Drug Administration (FDA) in 2014.

Dalvance is also administered intravenously and has side effects including nausea, headache, and diarrhea. Some patients experience elevated liver enzyme levels after taking Dalvance. Your doctor will ensure you receive the proper dosage level.

Sources:

  • FDA approves Dalvance to treat skin infections (Food and Drug Administration).
  • Methicillin-resistant Staphylococcus aureus (MRSA) Infections (Centers for Disease Control and Prevention).

Staph/MRSA News

Source: http://www.everydayhealth.com

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