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February 12, 2012 at 8:51 PMComments: 6 Faves: 0

MRSA and The Flesh Eating Bacteria - Should We Worry?

By Jeffrey VanWingen M.D. More Blogs by This Author

This week I watched the movie Contagion. 

In the movie, a new virus emerges and spreads rampantly, killing en mass. This movie capitalizes on our fears of being vulnerable to an infectious illness. In past years we have seen HIV, Ebola Zaire, Swine Flu and Bird Flu emerge from seemingly nowhere. Two recent players on the scene infect the skin—MRSA (called “MUR-SA”) and necrotizing fasciitis caused by “flesh-eating bacteria" conjure up grotesque images and fear in the hearts of many. 

Are these fears justified? 

How much of a threat do these diseases ACTUALLY pose? 

This blog will examine MRSA and necrotizing fasciitis in regards to their presentation, treatment, prevention and potential threat to health in the community.

What is MRSA?

MRSA stands for Methicillin-Resistant Staphylococcus Aureus.  The staphylococcus family is ever-present and found virtually everywhere.  In fact, one strain, Staphylococcus Epidermidis inhabits our skin on a normal basis.

MRSA and Penicillin

Aureus has always been around causing infections, but the methicillin-resistant variety is a more recent development which can actually be traced back to the advent of antibiotics. You see, Methicillin is an antibiotic in the penicillin family, which started being used on a large scale in the 1940’s.

Since then, their use has grown exponentially and has become so common-place in medicine, problems are now occurring because of penicillin's over-use. MRSA is just one example of such a consequence. With frequent antibiotic experience, some bacteria has learned to overcome the defense we created and led to the emergence of MRSA. Some refer to MRSA as a “smart” or “super” bacteria. 

MRSA - Sores That Will Not Heal

MRSA infection typically appears on the skin as a boil or a sore that does not heal.  If left alone, it can extend into the deeper tissue and form an abscess.  More serious MRSA infections involve the joints, bones, blood, lungs, and heart valves.

How Do You Catch MRSA?

MRSA is a big problem in hospitals and other health facilities. It is spread from one surface to another, surface-to-skin or skin-to skin. In hospitalized patients and institutionalized people, MRSA can spread readily and cause more serious infections. Open wounds and portals into the body such as IV lines or catheters can increase a person’s susceptibility. If undisciplined or unsanitary, healthcare personnel can bring exposure as they travel from patient to patient giving care.

Among healthy people in the community, contact sports (especially wrestling) seem to be the biggest risk factor in transmission.  It is estimated that around 1% of individuals harbor MRSA, most often in the nares of the nose and/or on the skin. 

Why Are People So Worried About MRSA?

MRSA infections are relatively common in hospitals and in the community. Prevention measures are showing success in prevention. While people can die from MRSA, this is quite unusual in healthy individuals. MRSA is difficult, but not impossible to treat.

Other drugs besides penicillins are effective. The worry is what happens when we run out of options, that the bacteria might learn to outsmart those other treatments as well.

The way we prevent this is by limiting antibiotic use.

We are in a different era when it comes to sores on the skin. If you have a sore that does not heal within a reasonable time,  it's a good idea to see your doctor and be tested for MRSA.

Why are People So Worried about Necrotizing Fasciitis or Flesh Eating Bacteria?

Necrotizing fasciitis is quite serious. Unfortunately, it is often fatal if it is not caught early. It is treated by surgically cutting away tissue until the infection is removed. The infection enters the body through the skin and travels readily along the planes of muscles and other tissues and often involve more than one type of bacteria.

The positive side of all this, however, is that the infection is quite rare.  Annually there are only about 600 cases in the US. Contagion is not typical and victims are most often susceptible due to a weakened immune systems.

Though uncommon, cases get press in the community due to the seriousness, the speed and the disfigurement of the infection. Contrary to its nickname, the bacteria does not “eat” the flesh.  Rather, it produces a toxin that causes breakdown of tissue giving the impression of being eaten away.

The bottom line on necrotizing fasciitis is that it is serious.  It’s lethality and virulence give good reason to be feared.  It’s prevalence, however, at least in the present time, is quite small.

The Prognosis?

To sum it up, the world of infectious disease is ever evolving.  And as bacteria evolve, there will always be a nemesis to be fought.  Though common, MRSA is treatable in its minor stages on the skin.  Early detection and preventative measures are important for the best outcomes.  Necrotizing fasciitis is serious and often fatal, but quite rare.  In the present time, we are doing a reasonable job against the microbial world but movies like Contagion give us a healthy reminder that we are ever susceptible.

Photo Credit: splityarn

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6 Comments

  • Thanks for posting this, Dr. V. What sorts of prevention measures do you suggest we take to help avoid MRSA?

    My husband had MRSA a long time ago before I met him. I am not sure how he got it, but he had to drop from 16 credits to 9 credits that semester in college and he could barely do much but just go to those classes and sleep. But he did get over it and is very healthy now.

  • Bri, the best way to prevent MRSA is hand washing or use of hand sanitizer. Using a body soap with antibacterial properties also helps when bathing or showering. Use particular caution when in a hospital or nursing home.

  • Thank-you for helping to spread awareness of both MRSA and the flesh-eating bacteria... I was recently made aware of the latter when my Aunt entered the hospital for a bladder infection. The bacteria had already spread and the doctors were unable to keep up with it. Within a few short days, she had already left us to be with her husband in Heaven...

    This bacteria is very serious. This and other hospital induced infections are something we must all be aware of...

  • Dr. V, do you mean to use the antibacterial soaps and hand sanitizer when you're around potential MRSA exposure? Wouldn't avoiding antibacterial products the rest of the time keep your own microflora strong?

  • Great question! Hand washing or hand sanitizer are recommended as a "universal precaution." By this I mean that they are recommended routinely. It is good practice for a healthcare professional to wash hands or use sanitizer before and after touching any patient. In the same way it is recommended that we wash our hands or use sanitizer before touching food that will enter our mouths. As far as hand washing vs. hand sanitizer, this has been studied extensively by hospitals. The results show time and again that the sanitizer is the same in eradicating bad bacteria from our hands. There are some controversies in this with issues arising from frequent hand washing and eradicating normal skin bacteria from our hands. Overall, though, hand washing/sanitizer use greatly outweighs not using them.

  • Interesting article - my husband recently was in the hospital for knee replacement for several days and they had the hand sanitizers everywhere.

    I was a little skeptical using the sanitizer so much - I would rather wash my hands with soap and water. He came out with no MRSA yeah!

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