Keep it clean, to prevent infection

Dennis Schoch had not set foot in a hospital since the 70’s. Therefore, when he was diagnosed with MRSA (Methicillin-Resistant Staphylococcus Aureus) in his ears last year, he began to wonder how he got it.

A common misperception is that indivduals can only contract MRSA through exposure in a health care setting, which Schoch, 60, found out was not the case.

Over the years, Schoch has been treated several times for pseudomonas infections in his ears. It has become common for him since scuba diving in south Florida 40 years ago, being susceptible to swimmer’s ear infections.

Schoch sought treatment for his ear infection thinking it would be the same as before, take the prescribed medications and it will clear up.

“I tested positive for MRSA, and began a tiring regimen for 6 weeks receiving five bags of IV antibiotics a day,” said Schoch, “I had to go in to the hospital three times in one day, starting at six o’clock in the morning, and sometimes lasting past midnight.”

Feeling frustrated, Schoch found himself researching MRSA and how he could have acquired the infection. His conclusion came from his chronic ear infections leaving him vulnerable to exposure to MRSA in the community.

Undergoing treatment for two infections, Schoch was tested again for MRSA, and the result was positive even when the other infection was showing signs of drying out.

In hopes that there may be an additional or alternative option for him, the treating physician, Dr. Naresh Menezes, board certified in infectious diseases and internal medicine, referred Schoch to Shands HealthCare in Gainesville and an ENT (otorhinolaryngologist) for further treatment for his chronic ear infections.

Schoch explained that his family had concerns; going on a family vacation and being in proximity could lead to other family members acquiring MRSA. However, following recommendations and precautions in dealing with MRSA made it less scary.

Menezes said most individuals view MRSA like leprosy and also consider it deadly. This is not always the case, as most MRSA conditions are mild and treatable. However, in certain individuals MRSA infections can lead to more severe and deadly consequences.

Following simple hygiene principles are all that are required to reduce your risks and prevent infections, he added.

Menezes recommends simple hygiene procedures, such as removing your shoes before entering your home, washing hands after being in the garden or shopping, as well as regular showering or bathing.

“I am thankful for this ordeal,” said Schoch, “if it wasn’t for the MRSA, I would not have had an MRI and a CT scan done, which discovered a growth on my thyroid, a small carcinoma, cancer was found and removed.”

What is pseudomonas?
Pseudomonas can cause illnesses such as skin rashes (folliculitis), ear infections (swimmer’s ear), urinary tract infections, pneumonia and corneal ulcers (keratitis). It is the most commonly isolated bacteria from skin rashes and ear infections associated with recreational waters, advises the Centers for Disease Control.

Pseudomonas, discovered in the late 1800s, is a commonly found bacteria developing in moist environments and have been found in soil, water, plants and animals. Pseudomonas are normally found in low quantities in the throat, skin and mucous membranes of normal healthy persons, according to the CDC.

The bacteria thrive in wet or moist areas, particularly pools and hot tubs and surrounding carpeted areas. Any recreational waters which have multiple users, such as pools, are a possible source of the bacteria. Also, inside the home, hand towels and sink traps, explains the CDC.

The CDC advises pseudomonas is an opportunistic germ, often causing hospital-acquired (nosocomial) infections. In addition to causing serious, often life-threatening diseases, it can be resistant to many antibiotics and can develop new resistance after exposure to anti-microbial agents.

This bacterium is a concern for health care facilities, since it has been indicated in secondary infections.

Swimmer’s ear is an example of a pseudomonas infection, occurring when the ear canal is moist (usually from swimming) allowing the bacteria the opportunity to breed. Pseudomonas can ‘colonize’ in the ear canal, causing extreme discomfort, redness and swelling.

Workplaces where cuts and abrasions are common, crowded living and working spaces like fishing boats, jails and prisons, and sports settings where athletes have frequent physical contact and share equipment can all have the potential for contamination.

MRSA – Community Associated
MRSA, or Methicillin-Resistant Staphylococcus Aureus, is a type of staph bacterial infection found on the skin and in the nose that is extremely resistant to antibiotics.

Community-Associated MRSA infections occur in people who have no health care environment exposure.

Michelle Perez R.N., an infection preventionist at Oak Hill Hospital advises that “CA-MRSA is not new in our community, it has been around since 2000. Many people harbor the organism without symptoms and the infections may be from the organisms they were already carrying and we cannot identify a source patient for most cases.

“With people that are carriers of MRSA,” said Menezes, “contact with a carrier person to an open wound is an example of how someone contracts a MRSA infection.”

“Once an individual has a colonized state of MRSA, for these individuals there is a 20 percent chance of not developing another infection, a 40 percent chance that it will remain and be considered a carrier, and a 40 percent chance that the individual will experience continued MRSA infections every few months or so,” Menezes added.

CA-MRSA is like other staph bacteria, causing a skin infection such as pimples, rashes, abscesses, boils or what can look like a spider bite. These infections are usually warm, painful, red or swollen, Perez advises.

CA-MRSA is spreading more commonly in the community, especially among healthy people, advised the CDC. “In fact, almost 90 percent of physicians confirm that the prevalence of Community-Associated MRSA infections is increasing.”

According to the CDC, CA-MRSA can spread in public settings such as gyms, locker rooms, households, schools, daycares and places where children gather (lunch rooms and locker rooms).
The CDC advises that the most common presentation is a patient complaint of a spider/insect bite.

Recently, there has been an increase in the number of news reports regarding bacterial skin infections. MRSA infections are occurring more frequently in both hospital and community settings.

However, MRSA is not a disease that primarily affects children or the school system, and outbreaks of MRSA in schools are rare except among athletic teams where close person-to-person contact may occur, according to the Florida Department of Health.

If you think that you or anyone in your family may have a MRSA infection, contact a licensed health care professional, especially if the infection is large, painful, warm to the touch, or does not heal by itself.

Anna Lamy is the Health and Fitness Content Coordinator for Hernando Today. She can be contacted at [email protected].