Methicillin-resistant Staphylococcus Aureus (MRSA) Infection

Causative agent

Staphylococcus aureus (S. aureus) is a bacterium that can be found in the nasal cavity and on the skin of some healthy people. These healthy individuals carry the bacteria without signs or symptoms of infection. Yet, the bacteria may sometimes cause diseases such as infection of skin, wound, urinary tract, lung, bloodstream and food poisoning.

Most S. aureus infections can be treated by antibiotics effectively. However, methicillin-resistant S. aureus (MRSA) is a strain of S. aureus that is resistant to antibiotics including methicillin and other commonly used antibiotics such as oxacillin, penicillin, amoxicillin and cephalosporins. Improper use of antibiotics is widely recognised as a contributing factor to antibiotic resistance.

Anyone can carry or get infected with MRSA, the risk increases with crowded environment and activities with frequent skin to skin contact. Most MRSA infections occur in people who have been hospitalised, live in residential care homes or have received antibiotic treatment/ invasive procedures in health care settings such as dialysis centres.

Clinical features

MRSA usually causes skin and soft tissue infections such as pimples, boils, abscesses or wound infections. The infected area may be red, swollen and painful or it may produce pus. Sometimes, more serious sequelae such as bloodstream infections, lung infections or necrotising fasciitis may occur.

Mode of transmission

The main mode of transmission of MRSA infections is through direct contact with wounds, discharge and soiled areas, or indirect contact with contaminated environment or equipment. Other risk factors include close contact, breaks in the skin due to wounds or indwelling catheters, poor personal hygiene and living in crowded conditions.

Management

Individuals with wound infection should seek advice from healthcare professional quickly so that the infection can be properly diagnosed and effectively treated. Boils or abscesses may require incision and drainage while antibiotics may be prescribed if indicated.

Prevention

1. Maintain good personal hygiene

• Perform hand hygiene frequently, especially before touching one’s mouth, nose or eyes; before eating; after using the toilet; or after touching public installations such as handrails or doorknobs.

• Wash hands with liquid soap and water, and rub for at least 20 seconds. Then rinse with water and dry with a disposable paper towel or hand dryer. If hand washing facilities are not available, or when hands are not visibly soiled, hand hygiene with 70 to 80% alcohol-based handrub is an effective alternative.

• Wear gloves when handling soiled objects, and perform hand hygiene thoroughly afterwards.
• Avoid sharing personal items such as towels, bed linens, clothing or uniforms, razors or nail-clippers.

2. Proper wound management

• Avoid direct contact with wounds or objects soiled by wound discharge.
• Clean wound immediately and cover properly with waterproof adhesive dressings until healed.
• Perform hand hygiene before and after touching wounds.
• Consult doctor promptly if symptoms of infection develop.
• Avoid contact sports or visiting public bathrooms if you have an open wound.

3. Proper use of antibiotics

• Do not demand antibiotics from your doctor.
• Follow your doctor’s advice when taking antibiotics.
• Do not stop taking antibiotics by yourself even if you are feeling better.
• Do not take leftover antibiotics.
• Do not share your antibiotics with others.
• Do not self-purchase antibiotics without a doctor’s prescription.
• Enhance personal hygiene while you are taking antibiotics to protect the health of you and your family:
  • Practise frequent hand hygiene.
  • Eat or drink only thoroughly cooked and boiled items.
  • Disinfect and cover all wounds.
  • Wear a surgical mask if you have respiratory symptoms like cough, sneeze, runny nose or sore throat.
  • Young children with symptoms of infections should minimise contact with other children.

4. Maintain good environmental hygiene

• Keep the environment clean; shared items (e.g. athletic equipment and mats) in public places such as sports centres and public bathrooms should be cleaned and disinfected regularly.
• MRSA can be spread through contact with contaminated objects and surfaces. Therefore, high-touch objects (e.g. furniture, toilet seat, doorknobs, and other commonly shared items) should be cleaned frequently and disinfected with diluted household bleach regularly. For more information on the use of bleach, please visit the following webpage: https://www.chp.gov.hk/files/pdf/the_use_of_bleach.pdf

Other languages

Methicillin-resistant Staphylococcus Aureus (MRSA) Infection and Community-associated MRSA Infection (Pamphlet):

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