Skin infections & Quinolones -2

How can people prevent MRSA infection?
Not making direct contact with skin, clothing, and any items that come in contact with either MRSA patients or MRSA carriers is the best way to avoid MRSA infection.
In many instances, this situation is simply not practical because such infected individuals or carriers are not immediately identifiable.
What people can do is to treat and cover (for example, antiseptic cream and a Band-Aid) any skin breaks and use excellent hygiene practices (for example, hand washing with soap after personal contact or toilet use, washing clothes potentially in contact with MRSA patients or carriers, using disposable items when treating MRSA patients).
Using Antiseptic solutions and wipes to both clean hands and surfaces that may contact MRSA.
Pregnant individuals need to consult with their doctors if they are infected or are carriers of MRSA.
Although MRSA is not transmitted to infants by breastfeeding, there are a few reports that infants can be infected by their mothers who have MRSA, but this seems to be an infrequent situation. Some pregnant MRSA carriers have been successfully treated with the antibiotic mupirocin cream.

If MRSA is so resistant to many antibiotics, how is it treated or cured?
Fortunately, most MRSA still can be treated by certain specific antibiotics (for example, vancomycin (Vancocin), linezolid (Zyvox), and others). For MRSA carriers, mupirocin antibiotic cream can potentially eliminate MRSA from mucous membrane colonization.
A good medical practice is to determine, by microbiological techniques done in a lab, which antibiotic(s) can kill the MRSA and use it alone or, more often, in combination with additional antibiotics to treat the infected patient.
Since resistance can change quickly, antibiotic treatments may need to change also. Many people think they are "cured" after a few antibiotic doses and stop taking the medicine. This is a bad decision because the MRSA may still be viable in or on the person and reinfect the person.
Also, the surviving MRSA may be exposed to low antibiotic doses when the medicine is stopped too soon; this low dose may allow MRSA enough time to become resistant to the medicine. Consequently, MRSA patients (in fact, all patients) treated with appropriate antibiotics should take the entire course of the antibiotic as directed by their doctor. A note of caution is that, in the last few years, there are reports that a new strain of MRSA has evolved that is resistant to vancomycin (VRSA or vancomycin resistant S. aureus) and other antibiotics. Currently, VRSA is not widespread, but it could be the next "superbug."

Types of Skin Infections

  • Cellulitis
  • Cellulitis is a bacterial infection of the deeper layers of the skin, the dermis and the subcutaneous tissue.
    In adults and children, cellulitis is most often caused by Streptococcus and Staphylococcus Aureus bacteria.
    Sometimes Haemophilus influenzae type B can cause cellulitis in children younger than 3, but this has become less common since we've been vaccinating against this bacteria. Knowing the type of bacteria that commonly cause cellulitis helps doctors determine the best antibiotic to treat the infection.

How Someone Gets Cellulitis?
Bacteria are able to cause an infection if they can get into the skin through a break in the skin barrier. This can happen with cuts, scrapes, ulcers, and surgical wounds.
Unfortunately, cellulitis can also develop in skin that appears perfectly normal.
Repeated infections often happen in areas where there is damage to the blood or lymph vessels that circulate fluid throughout the body. This damage can be caused by prior cellulitis infections, surgical removal of lymph nodes, removal of veins for vein grafts somewhere else in the body, and radiation to the area.

Cellulitis Appearance
Before skin changes occur, someone with cellulitis can have fever, chills, and fatigue. The skin infection is usually red, swollen, warm to touch, and painful. It's often difficult to tell exactly where the border is between normal and infected skin. Red streaks coming out of the area and swollen lymph nodes can sometimes occur. Children often get cellulitis on the head and neck, and adults often get cellulitis on the arms or legs.

How Cellulitis Is Diagnosed?
"A cellulitis infection doesn't have pus that could be cultured to see what bacteria are involved."
  • Cellulitis is usually diagnosed based on its typical appearance.
  • Sometimes doctors check a blood count to see if the white blood cells are elevated, meaning the immune system is fighting off an infection. Many times we don't see an elevated white blood cell count even though the immune system is busy fighting the infection.
  • In people who are very sick, blood cultures might be done to see if bacteria have gotten into the blood stream.
  • Sometimes a doctor might do an "
    Asiprate'To suction (a body part or growth, for example) for the removal of a liquid or a gas'
    " which involves injecting sterile fluid into the infected tissue and drawing it back out, hoping that some of the bacteria get washed into the fluid. This fluid is then cultured to see what bacteria grow. An aspirate is usually done in unusual situations where there is a high chance that the infection is caused by a different bacteria than expected.

How Cellulitis is treated?
Cellulitis is treated with antibiotics; the most suitable . Most cellulitis infections require 10 days
of an oral antibiotic. If the infection is on an arm or especially a leg, elevating the extremity often speeds healing.

IV antibiotics might be used in more severe cases such as:
  • Cellulitis of the face
  • Someone who is seriously ill
  • Infections in people who are immuno-compromised
  • Infections that didn't improve or got worse with oral antibiotics
Preventing Cellulitis
The best prevention of cellulitis is taking good care of any break in the skin. This can be done by:
  • Washing the wound daily with soap and water
  • Applying a topical antibiotic to the wound
  • Keeping it covered with a bandage to keep it clean
  • Changing the bandage every day or more often if the bandage gets dirty or wet.

When to See the Doctor?
It's time to have your doctor take a look if you're taking care of a wound as above and you notice that the wound is getting red, more painful, warm to touch, or is draining. If you have diabetes, poor circulation, or are taking immune-suppressing medications, you should consider seeing your doctor as soon as you notice a wound. If not, you should go at the very first signs of infection. Don't try to wait it out and see if it will get better on its own.