BODY & MIND
MRSA: Skip the Rumors, Learn the Facts
By Elizabeth Boskey, Ph.D. M.P.H. C.H.E.S.
The so-called "MRSA epidemic" has struck fear in the hearts and heads of many people. However, calling it an epidemic is premature. The recent research study that has gotten so much media attention has simply found that a bacteria previously thought to primarily be problematic in hospitalized patients has also managed to take hold in certain parts of the general population—more specifically in gay men.
This is not to say that the fact that MRSA infections may be sexually transmitted is not a serious problem. It is. Although a reasonable proportion of the population carries at least one strain of Staphylococcus aureus on their skin, and the presence of the bacteria isn't inherently a big deal, serious problems can come about when the bacteria gets into a cut or other open wound. Whereas a normal staph infection is unpleasant, but easily treatable, a MRSA infection can often only be treated with expensive intravenous antibiotics, because the bacteria have become resistant to treatment with ordinary drugs.
What is MRSA?
MRSA is the acronym for methicillin-resistant Staphylococcus aureus. In other words it is a description for a type of bacteria (Staphylococcus aureus) that has become resistant to a particular class of antibiotics. In practice, most MRSA strains are actually multi-drug resistant, which means that there are very few options for treatment. Not all Staphylococcus infections are MRSA infections. Staph infections are actually one of the most common form of skin infection in the United States, although most infections are minor—simply pimples or boils—and can be treated without antibiotics. Staph can, however, cause more serious infections such as surgical wound infections, blood infections, and pneumonia.
Understanding MRSA
MRSA is mostly a problem in hospitals. It is primarily transmitted between providers, staff, and patients, and until recently has only been seen rarely in the community. The Centers for Disease Control statistics state that only around 12 percent of MRSA infections occur outside of a healthcare setting. The people at greatest risk of a MRSA infection are those with a recent hospitalization and those who have impaired immune systems because of HIV, old age, or other health conditions.
Is it normal to have Staphylococcus on your skin?
Approximately 25 to 30 percent of people have Staphylococcus bacteria living in their noses, and it is thought that similar numbers have it present on their skin. However, only approximately 1 percent of people are colonized with MRSA. Colonization is different than infection. It is possible to carry the bacteria on your skin without it ever causing problems.
How can you reduce the likelihood of MRSA becoming a problem?
If you have a scrape or cut that seems to be infected, or that's warm to the touch, red, swollen, draining pus, or streaky in appearance, you should bring it to the attention of a health care professional.
What do recent studies say about MRSA in gay men?
There is evidence that gay men are at a higher risk of contracting MRSA:
MRSA infection is a real problem for gay men, particularly in Boston, San Francisco, and New York, but it is by no means untreatable or a plague. It is also not only a problem for gay men. MRSA is still, and will probably continue to be, most common in health care settings, with only a relatively small number of community acquired infections. That having been said, the fact that MRSA appears to potentially be sexually transmitted is something that people need to be informed about. Remembering to shower with soap and water after sex, as well as after any form of skin-to-skin contact, is a good idea for everyone, as is practicing good hygiene with equipment at the gym.
MRSA is not a "gay disease." It is a disease of opportunity. Basic hygiene and some common sense are your main weapons against giving it one. Even in hospitals, scientists have found that one of the best ways to reduce the transmission of MRSA is simply to encourage everyone to wash their hands.
Sources
This is not to say that the fact that MRSA infections may be sexually transmitted is not a serious problem. It is. Although a reasonable proportion of the population carries at least one strain of Staphylococcus aureus on their skin, and the presence of the bacteria isn't inherently a big deal, serious problems can come about when the bacteria gets into a cut or other open wound. Whereas a normal staph infection is unpleasant, but easily treatable, a MRSA infection can often only be treated with expensive intravenous antibiotics, because the bacteria have become resistant to treatment with ordinary drugs.
What is MRSA?
MRSA is the acronym for methicillin-resistant Staphylococcus aureus. In other words it is a description for a type of bacteria (Staphylococcus aureus) that has become resistant to a particular class of antibiotics. In practice, most MRSA strains are actually multi-drug resistant, which means that there are very few options for treatment. Not all Staphylococcus infections are MRSA infections. Staph infections are actually one of the most common form of skin infection in the United States, although most infections are minor—simply pimples or boils—and can be treated without antibiotics. Staph can, however, cause more serious infections such as surgical wound infections, blood infections, and pneumonia.
Understanding MRSA
MRSA is mostly a problem in hospitals. It is primarily transmitted between providers, staff, and patients, and until recently has only been seen rarely in the community. The Centers for Disease Control statistics state that only around 12 percent of MRSA infections occur outside of a healthcare setting. The people at greatest risk of a MRSA infection are those with a recent hospitalization and those who have impaired immune systems because of HIV, old age, or other health conditions.
Is it normal to have Staphylococcus on your skin?
Approximately 25 to 30 percent of people have Staphylococcus bacteria living in their noses, and it is thought that similar numbers have it present on their skin. However, only approximately 1 percent of people are colonized with MRSA. Colonization is different than infection. It is possible to carry the bacteria on your skin without it ever causing problems.
How can you reduce the likelihood of MRSA becoming a problem?
- Wash with soap and water after sex and other skin-to-skin contact (including sports games, etc.)
- Wash your hands frequently with soap and water, particularly after going to the bathroom, to avoid transferring bacteria from one part of your skin to another.
- Keep your cuts, scrapes, and scratches clean, dry and covered.
- Don't share personal items like towels, razors, or tweezers.
- Clean shared gym equipment, or cover it with towels, before using it.
If you have a scrape or cut that seems to be infected, or that's warm to the touch, red, swollen, draining pus, or streaky in appearance, you should bring it to the attention of a health care professional.
What do recent studies say about MRSA in gay men?
There is evidence that gay men are at a higher risk of contracting MRSA:
- In San Francisco, MRSA cases are more common in zip codes with higher proportions of male-male couples.
- In San Francisco, Boston, and New York, MRSA is more common in men who have sex with other men than in men who do not have sex with men.
- For men, being HIV positive and having sex with men are independentt risk factors for acquisition of MRSA.
- Spread of MRSA among men who have sex with men is associated with high-risk sexual behaviors including "use of methamphetamine and other illicit drugs, sex with multiple partners, participation in a group sex party, use of the internet for sexual contacts, skin-abrading sex, and history of sexually transmitted infections."
MRSA infection is a real problem for gay men, particularly in Boston, San Francisco, and New York, but it is by no means untreatable or a plague. It is also not only a problem for gay men. MRSA is still, and will probably continue to be, most common in health care settings, with only a relatively small number of community acquired infections. That having been said, the fact that MRSA appears to potentially be sexually transmitted is something that people need to be informed about. Remembering to shower with soap and water after sex, as well as after any form of skin-to-skin contact, is a good idea for everyone, as is practicing good hygiene with equipment at the gym.
MRSA is not a "gay disease." It is a disease of opportunity. Basic hygiene and some common sense are your main weapons against giving it one. Even in hospitals, scientists have found that one of the best ways to reduce the transmission of MRSA is simply to encourage everyone to wash their hands.
Sources
- Binh An Diep et al. "Emergence of Multidrug-Resistant, Community-Associated, Methicillin-Resistant Staphylococcus aureus Clone USA300 in Men Who Have Sex with Men" Annals of Internal Medicine 148(4) Epub Ahead of Print. (Accessed 1/22/08)
- CDC Community Associated MRSA Information Page (Accessed 1/22/08)
Kevin82 wrote:
The article states that it is sexually transmitted and to avoid that take a shower after a sexual encounter. Leads me to believe that it's not a sexual fluid disease rather a body contact issue. So why call it sexually transmitted?
Feb 20 7:57 PM
Heshot wrote:
CONTINUED FROM BELOW (part 2)
The Hawaiian government had know about the surge in this "epidemic" since 1998, however covered up and refused to admit the problem, or warn any of the arriving masses that there was anything to be aware of , because they were afraid that it might stop tourism. I have also since found out that almost 48% of the locals, the people working in the hotels, and restaurants and the airport and cabs, are already infected and are forbidden to allow any job or tourist of their condition. Pardon my english, BUT THIS IS SO TOTALLY FUCKED!!!!
So you tell me, fact givers, what does one do now? After going through this for almost 6 years now, my life completely altered, my mind never at ease, the fear that I might never be able to get better, the complete decompiling of my ability to feel good about myself, WHAT DO I DO NOW? It's not an epidemic? Bullshit!!! I'm an almost "anally" clean person when it comes to my health and body, and I haven't had sex for almost 3 years because of the shame, and fear. The fear that someone could ask after seeing me naked, what are those marks or scars from?
You tell me how one copes with this disease that you are telling people not to be too concerned about. Tell me how I'm going to pay for thousands more dollars in Dr. fees hoping that I someday won't have this horrible monster ever again.
Waiting in vein
-Too Late
Feb 04 12:35 AM
Heshot wrote:
I would just like state that I was infected with MRSA sometime in 2001 while living in Hawaii. My home prior to the islands was San Francisco. I only showed signs of something wrong after leaving the islands. After starting to realize that something was obviously wrong with my skin, I, of course, went right away to SF General, and 4 more major hospitals following. For over 4 years, I was mistreated and misdiagnosed by "knowledgeable" physicians. This problem, which is still part of every 24 hours of my life, destroyed everything for me. I lost friends because they were, like me, scared of the unknown. I then, 2 years after returning from the islands back to SF, was "let go" from my job because of repeated doctor app. with no confirmed diagnosis. Because you can't live in SF without a good job, I then lost my aprtmnt. because I couldn't pay my rent. I couldn't even get another job because of the way my skin, face, neck, hands, everything, looked. People moved away from me on the bus. Service people would all of the sudden be busy with something else when it was my turn in line, or to order food. Even though I found an amazing Dr. in Oregon whom finally was able to tell me what was wrong with me, I, to this day, have to deal with aftermath. It did permanent damage to my psychy (self doubt, self loathing, fear of public, horrible insecurities, shame) It also did permanent damage to my nervous system. I'm no longer the cocky, confidant, live free guy that I used to be for 28 years. To any of you who have said that there isn't "Too Much" reason for concern, try talking to the already struck instead of your paperwork. My life will never be the same, and I did not contract this from sex, or dirty hands. It was heavily transferable in Hawaii through surfing everyday, walking home wet, constant exposure to sand with a million feet a day stomping through it, and to one HUGE factor that has since been discovered.......
Feb 04 12:34 AM
Heshot wrote:
I would just like state that I was infected with MRSA sometime in 2001 while living in Hawaii. My home prior to the islands was San Francisco. I only showed signs of something wrong after leaving the islands. After starting to realize that something was obviously wrong with my skin, I, of course, went right away to SF General, and 4 more major hospitals following. For over 4 years, I was mistreated and misdiagnosed by "knowledgeable" physicians. This problem, which is still part of every 24 hours of my life, destroyed everything for me. I lost friends because they were, like me, scared of the unknown. I then, 2 years after returning from the islands back to SF, was "let go" from my job because of repeated doctor app. with no confirmed diagnosis. Because you can't live in SF with a good job, I then lost my aprtmnt. because I couldn't pay my rent. I couldn't even get another job because of the way my skin, face, neck, hands, everything, looked. People moved away from me on the bus. Service people would all of the sudden be busy with something else when it was my turn in line, or to order food. Even though I found an amazing Dr. in Oregon whom finally was able to tell me what was wrong with me, I, to this day, have to deal with aftermath. It did permanent damage to my psychy (self doubt, self loathing, fear of public, horrible insecurities, shame) It also did permanent damage to my nervous system. I'm no longer the cocky, confidant, live free guy that I used to be for 28 years. To any of you who have said that there isn't "Too Much" reason for concern, try talking to the already struck instead of your paperwork. My life will never be the same, and I did not contract this from sex, or dirty hands. It was heavily transferable in Hawaii through surfing everyday, walking home wet, constant exposure to sand with a million feet a day stomping through it, and to one HUGE factor that has since been discovered....... The Hawaiian government had
Feb 04 12:30 AM
pivot1973 wrote:
MRSA has been the bread and butter in my Infectious Diseases practice since I started seeing patients. Old patients, young patients, straight and gay patients. This organism is not to be messed with, but not to panic about . . . in my opinion.
Wash your hands at the gym!
Wash your hands period!
It is the best way to protect yourself!
Feb 01 8:56 PM
Em3ns wrote:
In the hospital during my nursing clinical I had to gown and mask up, with gloves of course which are standard procedure, in order to provide any treatment to the patient in isolation. MRSA is taken very seriously in the health care setting, especially in hospitals where nosocomial infections are on the rise.
Jan 30 5:31 PM
dancerjack wrote:
we've been covering mrsa in our lgbt newspaper here in charlotte, nc for the past few issues, in order to dispel any panic. thanks for posting this - i'll be damned if i'm going to let the religious right turn this into a 1981 hiv scenario...
Jan 30 5:56 AM
kryptonianadrian wrote:
great write-up. it's concise and dispels that notion of a gay disease rearing its ugly head.
Jan 29 5:51 AM