Living with MRSA: Nearly Ten Years On

I have MRSA – to be specific I have HA-MRSA.  MRSA is a superbug – its full is name methicillin-resistant Staphylococcus aureus bacteria – the HA denotes I contracted it in hospital – if I had contracted it outside of hospital it would be denoted CA-MRSA – community acquired MRSA.

Superbugs are a group of microorganisms that are resistant to at least one or more commonly used antibiotics.  The commonly accepted list of superbugs is as follows:

MRSA  – (Staphylococcus aureus strains resistant to multiple antibiotics) , VRE (Enterococcus species resistant to vancomycin), PRSP (Streptococcus pneumoniae strains resistant to penicillin), ESBLs (Escherichia coli and other Gram-negative bacteria resistant to antibiotics such as cephalosporins and monobactams) and multiple drug-resistant Clostridium difficile.

MRSA thrives in warm environments – inside the nose, in the groin and armpits and in your cleavage if you are a woman.  In medical speak it likes the “dirty” areas where sweat gathers.  It particularly likes hospital environments which are warm and where there are a lot of people who have weakened immune systems and who have open wounds and who are unable to be bathed or showered every day.

Living with MRSA has been relatively easy for me me over the years once the initial infection had been cleared up.  I have a huge red flag on my health records which immediately warns health professionals of the risks both to my health and theirs if appropriate hygiene and treatment is not followed. One advantage – if one can call in that – is that I should be nursed in isolation if I am hospitalized and that doctors and nurses should take appropriate precautions – such as one use gloves, anti-bacterial agents and scrupulous hand washing.

I use antibacterial everything at home, soaps, disinfectants and gels.  Those that live with me should do the same.

Until this year I had no problems at all with my MRSA – but this year has seen it rear its ugly head twice.  Once with my abscess (in a dirty area) and again in the last couple of weeks with a mosquito bite that became infected.  I had already noticed that mosquito bites present themselves slightly differently on my body than they do on others. I was not allergic to them as such but I got much more of a reaction to them than other people usually do.

They always got redder and more inflamed than others and they nearly always appeared to actually have a black sting – similar to a wasp or a bee and would not start to heal until that had been removed. Oh and they itch like mad – I have woken up in the night scratching my leg to bits – to discover I have been bitten while asleep.

Looking to find images for this post has all of a sudden put my reactions to mosquito bites into context – each and every one is a chance for the dreaded MRSA to take hold – in spite of all my efforts to bolster my immune system by diet and supplements such as Echinacea and multivitamins. I tend to rest the Echinacea in the summer months – needless to say I have started to take them again.  I have also started another course of antibiotics to get rid of the infected bite.

I just hope that I have not developed a resistance to them and have to step up a level and find others that work.  The Center for Disease Dynamics, Economics and Policy has published a paper that reports that staph skin infections and resulting that community acquired MRSA peaks in the summer months – when it is warmer, people are wearing less clothing, doing more sport and getting bitten more!

In the UK, the MRSA figures appear to have stabilized – mostly in relation to new hygiene regimes being implemented. The same appears to be happening in the United States – but the last full years statistics I could find were for 2010.

Tackling the problem long term is a huge problem – it is a problem with multiple causes.

Firstly, approximately a third of the population “carry” Staphylococcus aureus in their nose and throats and on their skin without any symptoms or harm to themselves.  These people are everywhere, they are you, the postman, the doctor, the nurse, the porter, the bus driver and the kid next door. They are in the swimming pool, the gym, the bus, the train and in your favorite restaurant and bar.

It is thought that one percent of the population are carrying MRSA without any infection or affect on their health – they do however, carry a higher risk of becoming infected.

At some time or another these people will visit a hospital, partake of sports, get skin abrasions, even break an arm or a leg and be admitted to hospital – or even share the same air as a carrier and this is where the risks and the outbreaks start.

Hygiene routines in hospitals has changed over the years.  All working uniforms used to be sterilized and starched on the premises and made available to staff on a daily basis – now they travel to and from work in their uniforms.  I am going to quote Janna here – from an email via David .

“Janna was just talking about this the other day — how dentists and hospital workers all wear their scrubs in public on the way to work and bring the filth of their homes and public transit and everything else into the workplace.

We live near a hospital and several specialists and dentists and all the employees all run around to Dunkin Donuts and the sandwich shop in their work clothes and go right back to treating patients.

As Janna said, “They bring the outside inside their patients” — and it really is fascinating that is even allowed.  They should be sterilized going in and out of the hospital and they should change from street clothes to work clothes AT WORK!”

The other major and long term issue that needs to be addressed is societies use of antibiotics.  The more you use antibiotics the more you lose your resistance to them and they cease to work as effectively as they should – requiring the use of stronger antibiotics.  Over-prescription of antibiotics has been a problem for many years.

There are cases where nothing but the correct antibiotic will do the trick – but there are other times when a good diet and a good immune system and over the counter medicine – coupled with a few days rest will cure the problem.   You will see the problem immediately in that sentence  – good diet and a few days rest – how many of us have the luxury of “time” enough to take time off from work – often at a loss of salary to get well – especially when we are persuaded we can carry on working with a dose of penicillin?

All in all, we have a lot of work to do personally and as a community to reverse the march of the superbugs. We have to take responsibility for our diet, our personal hygiene, laundry and our home environment. Our hospitals have to take responsibility for maintaining the highest standards of care – both in nursing and cleaning procedures and we all have to accept that when it comes to antibiotics – less is more.

WARNING  –  if you have a skin infection characterized by a bite that will not heal, boils, infected hair follicles, an abscess, skin rash or impetigo go to your doctor. One major problem with MRSA (and occasionally with other Staph infections) is that occasionally the skin infection can spread to almost any other organ in the body. When this happens, more severe symptoms develop. MRSA that spreads to internal organs can become life threatening. Fever, chills, low blood pressure, joint pains, severe headaches, shortness of breath, and “rash over most of the body” are symptoms that need immediate medical attention, especially when associated with skin infections. Some CA-MRSA and HA-MRSA infections become severe, and complications such as endocarditis, necrotizing fasciitis, osteomyelitis, sepsis, and death may occur.