Staph Infections, including “MRSA” (Methicillin-Resistant Staphylococcus aureus)

What is a staph infection? “Staph” is short for a bacterium known as Staphylococcus aureus. This common germ is carried on the skin and in the nose of one in every three people. Most people who carry Staph remain well and are known as “healthy carriers”. But sometimes the Staph causes an “infection” and makes people ill. The most common infection involves the skin and soft tissues (such as impetigo, boils, wound infections, abscesses) but more serious infections such as cellulitis, pneumonia and infections of the bloodstream can occur. What is MRSA? Antibiotics are often used to treat people who become ill with staph. Some staph (called “methicillin-resistant Staphylococcus aureus”, or “MRSA”) have become “resistant” to the commonly used antibiotics which means that they need special antibiotics to cure the infection. MRSA are sometimes called “super bugs” because of the need for special antibiotics, but the type and severity of MRSA infections are generally not different from other staph infections. Where does staph come from? Staph can be passed by touching someone who carries staph or has a staph infection. In addition, it can be passed by touching things that have been touched by someone who has staph. Activities or places that favor the spread of staph involve crowding, skin-to-skin contact, or sharing of equipment and supplies. This might include sports, daycare, and hospital wards. MRSA is increasing in our community, so we have more and more children and adults who have it and can pass it to someone else. How does a child get a staph infection? Staph infections often start when the bacteria enters an area where the skin is broken, such as a scrape, cut, sore or insect bite. Having a staph infection does not mean there is anything wrong with your child’s immunity – healthy people can get staph infections. What are the signs and symptoms of a staph skin infection? Most staph skin infections, including MRSA, appear as a bump or sore on the skin that may be red, swollen, painful, warm to touch, filled with pus or cloudy fluid, or draining pus or cloudy fluid. The child may also have fever. What should I do if I see these symptoms? If caught early, most staph infections are easy to treat and not a cause for alarm. Cover the area with a bandage and wash your hands after touching the area. Contact your child’s doctor so it can be treated quickly - the infection can become more severe if treatment is delayed. If your child has a skin infection along with fever, chills, severe headache, or rash, he or she needs immediate medical attention. Prompt medical attention should also be sought for infants less than 3 months of age and children with eczema or other skin conditions. Do not try to treat the infection yourself by picking or popping the sore. How is a staph infection treated? Impetigo (a skin infection with yellow crusts or blisters filled with cloudy fluid) is treated with Bactroban, an antibiotic cream or ointment that is applied to the infected skin. Sometimes the doctor must open larger boil or abscess with a needle or small blade to drain the pus. The child then will be given Bactroban or possibly antibiotics by mouth. It is important that the child takes the full course of antibiotics that is prescribed, even if feeling better. Infections that are not completely treated may be more likely to return, and to become resistant to antibiotics. The area should be kept clean and covered while it heals. As soon as new sores begin, apply a warm wash cloth to the area for 10 minutes 3 times each day. If the infected area is large, or has spread throughout the body, the child may need intravenous antibiotics in the hospital. Sometimes surgery is needed to drain pus from infected areas. How can I protect my family from staph infections? Keep cuts, scrapes, and insect bites clean, dry, and covered with a bandage – discourage your child from scratching or picking the scab. Encourage good hygiene, keeping fingernails short, cleaning hands regularly and taking a bath every day. To promote thorough hand washing, teach your child to sing Happy Birthday two times slowly while washing his/her hands. Staph infections can follow certain illnesses caused by viruses, such as influenza and chicken pox. Make sure that your child is up-to-date with his/her influenza and chicken pox vaccinations. If your child or another member of the family has had a MRSA infection, take some extra steps:  Change underwear, towels, washcloths, and sleepwear each day.  Wash bed sheets and pillow cases every week in the hottest water possible, 160 degrees or hotter is best. Dry these using the high heat setting on the dryer.  Avoid sharing of personal items such as towels, washcloths, razors, clothing, brushes, and makeup.  Wipe bathroom surfaces frequently with a bleach-containing cleanser. What if the infection returns? Sometimes children develop repeated staph skin infections. Sometimes a stubborn cycle develops in which staph infections are spread from one family member to another for weeks to months. In these cases, one or more members of the household is usually carrying the staph on the skin, and in the nose and/or rectum and passing it to others. If your doctor suspects that this is the case, he or she may recommend the following:  Bactroban ointment or cream in each nostril (and possibly the rectum) using a cotton- tip swab twice a day for 5 days. Sometimes, the doctor recommends that all members of the household use Bactroban in this way.  Hibiclens soap washes  Diluted bleach baths  Referral to a specialist in pediatric infectious diseases These measures may not be safe or effective for all children and should only be taken under the supervision of your child’s health care provider. Should a child with a staph infection be excluded from day care or educational settings? In general, it is not necessary to keep a child who has a staph infection home if the infected skin can be kept covered with a clean, dry bandage to keep it from touching other children, toys and surfaces in the center, or the child’s hands.