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CA-MRSA

 
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CA-MRSA - October 16, 2006 1:04:00 PM   
Dr.Wagner


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Everybody should read this and be very aware of this entity. While not typically dangerous, it can be found in abundance in your setting. One of my best friends (a PT) has had this 3 times.

http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html

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Re: CA-MRSA - October 16, 2006 9:17:00 PM   
jma

 

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Yes, we do see this in the hospital setting.. Not only just MRSA but ORSA as well. An excellent reference post for all to read and to be aware of.

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Re: CA-MRSA - October 17, 2006 12:54:00 AM   
Dr.Wagner


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ORSA is the same as MRSA (methacillin and oxacillin are both in the PCN class, just that when the sensitivities are used in the culture results, one test uses methacillin and the other uses oxacillin...it means the same).

As long as everyone understands the difference between CA-MRSA and HA-MRSA/nosocomial MRSA

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Re: CA-MRSA - October 17, 2006 6:32:00 AM   
KAK

 

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The only difference is where one picks up the bug (hospital vs. community). Correct?

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Re: CA-MRSA - October 17, 2006 9:18:00 AM   
Dr.Wagner


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Not really, though that is a key component. The difference is that BOTH bugs are resistent to Penicillins and in turn cephalosporins. These are the most common antibiotics. BUT...CA-MRSA (which is found in school gyms, nursing home furniture, locker rooms and is the primary cause of boils in healthy young people) is suseptible to alot of "old school" antibiotics (sulfa drugs like bactrim or septra).
CA-MRSA usually doesn't cause many problems except stubborn boils.

Nosocomial MRSA, the dreaded hospital MRSA, is usually found in immunocompromised individuals...especially those on Ventilators. It has VERY high morbidity and mortality. It is usually treated with Vancomycin.

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Re: CA-MRSA - October 27, 2006 8:20:00 PM   
bonmar

 

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I got a staph infection from going into a hot tub....yuck!!! At first, the MD thought it was shingles but the boils were all over my trunk (not just one sided). When I mentioned I had been in a hot tub two days prior, she immediatley knew what it was. I was on antibiotics for 4 weeks; the first round of antibiotics did not get rid of it. The scars from the boils lasted over 3 months.

I just thank God I did not dunk my head!!!

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Re: CA-MRSA - October 29, 2006 9:13:00 AM   
Dr.Wagner


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OOOOOH
That is a LITTLE different, you had "Hot Tub Foliculitis"

Notorius for Psuedomonas infection.

Unless the boils were cultured, I would bet it was Psuedomonas.

Psuedomonas creates a "slime layer" which can be found in the drains of bath tubs and showers. This is a protecting coating to prevent HEAT destruction.

Staph Foliculitis is common and it caused by YOUR OWN staphlococcal bacteria found on your skin (ie 'ingrown hair')...
But your case is CLASSIC for psuedomonas.

I would bet the first round of antibiotics (likely a PCN or Cephalosporin), simply didn't work because they do NOT cover for Psuedomonas! The next drug, quite possibly Levaquin or Cipro or Oxacillan are all Psuedomonal killers!

I would bet my credit card that is the real issue. I would bet at the very least you had a MIXED disease...you killed the staph initially but never the Psuedomonas until the next round!

Here is a great article

http://www.emedicine.com/derm/topic356.htm

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Re: CA-MRSA - October 29, 2006 10:03:00 AM   
srcase

 

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That is nasty.....yet another reason to never get into a cesspool....I mean a hot tub.

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Re: CA-MRSA - October 29, 2006 1:39:00 PM   
bonmar

 

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I don't remember what meds I was prescribed...this happened a few years ago. However, it was just NASTY!! I would never go into a hot tub/cesspool (you are right, Sarah) again.

Interestingly enough, my children were the only people out of 14 that did not become symptomatic. Why would that be? (Not all 14 people were in the hot tub at the same time)

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Re: CA-MRSA - October 29, 2006 2:26:00 PM   
Dr.Wagner


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Perhaps the size and amount of hair follicles in the adult vs. child.

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Re: CA-MRSA - November 11, 2006 11:22:00 AM   
Dr.Wagner


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I was watching "The Ultimate Fighting CHampionships" series on Spike TV and saw that all of the wrestlers got CA-MRSA folicullitis.

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