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Super clean: The antidote to the "super bug"

You eat right, get plenty of rest, and exercise at least five days a week. Who would have thought this could make you sick? On Friday, you lifted weights and swam. On Saturday, you rode your bike. And on Sunday, you raced the kids across the monkey bars at the park and won, your trophy an angry blister pulsing in the palm of your hand. On Monday, you climbed on the treadmill at the gym, gingerly took hold of the handrails, and went for a run.

By Wednesday, your blistered hand hadn’t healed. In fact, it festered and became swollen. Ultimately, you went to the doctor, who prescribed an antibiotic to treat the infection. But it still didn’t get better.

Just your luck, a wily little germ called methicillin-resistant Staphylococcus aureus (MRSA) has taken up residence in your wound and is wreaking havoc with your healing process. Known among the lay community as a "super germ" or "smart bug," it is neither super nor smart; but it has become resistant to some of the more frequently used antibiotics.

There’s a chance you picked it up on the treadmill.

"MRSA is basically acquired by someone who has an open wound that comes into contact with someone else’s open wound," says Dr. Rita Koshinski, medical director of infection control at Community Hospital. "The biggest incidence we see is in the sports community, where there is a lot of contact. We see it with wrestlers and people who go to gyms, where the equipment is not cleaned every time it’s used. We get it not by being in the same room as someone who has a cough but from direct contact with someone who has an open, draining wound."

Just thinking about it will make you want to wash your hands. And it should.

Many years ago, Staphylococcus aureus was treated with penicillin. By the 1980s, after a lot of exposure to penicillin, it became increasingly resistant to the drug. Penicillin was replaced by methicillin, to which the germ has also become resistant.

"The fact that it is resistant to certain antibiotics," Koshinski says, "doesn’t make it any worse than any other bacteria. It means we have to use other antibiotics to treat it. And we do have other options, particularly for the community-acquired strains, which are easier to treat than those acquired in hospitals."

Nationally, the majority of MRSA infections occur among patients in hospitals or other healthcare settings, but they are becoming increasingly prevalent in community settings.

"At Community Hospital," she says, "we are mostly seeing community-acquired strains of MRSA, which have developed their own resistance patterns different from what we see in the hospital setting. Generally speaking, the community-acquired virulence factors seem to make people sicker and abscesses uglier, but they are more treatable."

MRSA is a staph bug that usually shows up on the skin. The infection normally won’t progress to pneumonia unless its host is already sick or otherwise compromised, such as by a depressed immune system. While these more susceptible patients can become very sick and even go into shock, Koshinski says it is very rare. The highest incidence, she says, is among young, healthy people who have acquired it in the community.

"The usual treatment for MRSA is to open up and drain the abscess," she says. "If there is a lot of surrounding infection or a low-grade fever, it should be treated with oral antibiotics for a short period of time until the skin lesion is better. The patient should keep the abscess covered so it doesn’t spread to other parts of the body or to others."

Even better would be to avoid acquiring MRSA in the first place. Prevention comes in the form of basic hygiene, especially good, old-fashioned hand-washing. Community Hospital has dispensers with alcohol hand-rub inside every patient room. Free bottles of hand sanitizer also are available throughout the hospital. Patients are encouraged to ask healthcare workers if they have washed their hands, and guests are asked to clean their hands before visiting patients.

When using soap, Koshinski recommends sticking with the basics — non-antibacterial soaps that are pH-balanced. And by all means, wipe down the machines at the gym, before and after use, and wash up at work, at play, and at home.

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