Doctor's Notes: Staph Infections

By: Dr. Alan Xenakis Email
By: Dr. Alan Xenakis Email

Staph Infection and Cellulitis

What Is a Staph Infection?
A staph infection is caused by a Staphylococcus (or "staph") bacteria. Actually, about 25% of people normally carry staph in the nose, mouth, genitals, and anal area. The foot is also very prone to pick up bacteria from the floor. The infection often begins with a little cut, which gets infected with bacteria.

These staph infections range from a simple boil to antibiotic-resistant infections to flesh-eating infections. The difference between all these is the strength of the infection, how deep it goes, how fast it spreads, and how treatable it is with antibiotics. The antibiotic-resistant infections are more common in North America, because of our overuse of antibiotics.

One type of staph infection that involves
skin is called cellulitis and affects the skin's deeper layers. It is treatable with antibiotics.

This type of infection is very common in the general population -- and more common and more severe in people with weak immune systems. People who have
diabetes or weakened immunity are particularly prone to developing cellulitis.

What Are the Symptoms of Staph Infection?

Staph cellulitis usually begins as a small area of tenderness, swelling, and redness. Sometimes it begins with an open sore. Other times, there is no break in the skin at all -- and it's anyone's guess where the bacteria came from.

The signs of cellulitis are those of any inflammation -- redness, warmth, swelling, and
pain. Any skin sore or ulcer that has these signs may be developing cellulitis. If the staph infection spreads, the person may develop a fever, sometimes with chills and sweats, as well as swelling in the area.

What's the Treatment for a Staph Infection?
Antibiotics are used to treat staph infections. But there's been a gradual change in how well these antibiotics work. While most staph infections used to be treatable with
penicillin, that changed in the 1980s and stronger antibiotics are now used.

In about 50% of cases, however, resistance is seen to even these stronger antibiotics. These cases are not just happening in hospitals -- as once was true -- but now are occurring in the general community. That's been a problem. Many doctors are accustomed to using certain antibiotics, but those then fail because of antibiotic resistance. There are several more potent antibiotics now, but doctors need to know when to use them.
There's another treatment sometimes used with staph infections. If the infection goes so deep that it involves muscles or fibers that enclose muscles, it needs to be surgically cleaned.

Can Staph Infections Be Prevented?
You can take steps to help prevent staph infections. Any time you have a cut or skin breakdown, wash it with soap and water, keep it clean and dry, use antiseptic ointment, and keep it covered. A couple of recent outbreaks among football players began when one team member had a boil, and the infection was spread to other team members.

A staph infection is contagious if the wound is weeping or draining, and if people share towels or other items that are contaminated. Wearing foot coverings in locker rooms and other commonly used areas can help prevent contamination.

If the sore becomes unusually painful or red, get prompt medical attention. If red lines develop, that's a sign the infection is spreading and needs immediate medical attention.

Most common spread skin-to-skin contact rather than skin-to-surface contact in the community Study appearing in March 28 issue: Archives of Internal Medicine Enhanced cleaning of hospital intensive care units reduces the risk of methicillin-resistant staphylococcus aureus (MRSA) infection for patients placed in a room previously occupied by someone with MRSA, a new study finds.

MRSA is a a type of staph infection resistant to all first-line antibiotics.
Researchers compared MRSA rates among patients admitted to 10 ICUs at a 750-bed academic medical center before and after implementation of an enhanced cleaning program.

The program included inspections of cleaning efforts and feedback to staff, changing how the disinfectant was applied (from pouring from bottles onto cleaning cloths to immersing cloths in buckets), and educating staff about the importance of repeatedly immersing the cloths in buckets during cleaning.

The rate of MRSA infections among patients in rooms previously occupied by patients with MRSA decreased from 3 percent (305 of 10,151) to 1.5 percent (182 of 11,849) after introduction of the enhanced cleaning program.

In addition, rates of vancomycin-resistant enterococci (VRE) infection decreased from 3 percent (314 of 10,349) to 2.2 percent (256 of 11,871).

"Environmental contamination with multidrug-resistant organisms may facilitate the spread of health care-associated infections," the report noted, adding that this is particularly important in ICUs, in which patients are at high risk of infection due to co-exisiting illnesses, wounds and the use of medical devices.

"Whereas enhanced ICU cleaning appears to be effective in decreasing MRSA and VRE transmission, it may be more effective in reducing transmission of MRSA compared with VRE. Reasons for this difference may include the generally higher burden of VRE contamination and evidence that room contamination may be a major factor in VRE transmission," wrote Rupak Datta, of the University of California Irvine School of Medicine, and colleagues, in a university news release.


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