Dental Report Condition and Prognosis R M & Co Solicitors RMC/123/2010 1st January 2010 Dr B DAVID COHEN PhD, MSc, BDS, MFGDP, LDSRCS, CUEW, MEWI Specialist in Endodontics Accredited Expert Witness the MALT HOUSE Specialist Dental Treatment Centre Deva Centre Trinity Way Manchester M3 7BD Tel: 0161 834 8824 Fax: 0161 838 5353 Email: firstname.lastname@example.org __________________________
Mrsa community acquired vsMRSA Fact Sheet
1. What is Staphylococcus aureus? - Staphylococcus aureus, often referred to simply as
"staph," are bacteria commonly carried on the skin or in the nose of healthy people. Approximately 25% to 30% of the population is colonized (when bacteria are present, but not causing an infection) in the nose with staph bacteria. Sometimes, staph can also cause an infection. Staph bacteria are one of the most common causes of skin infections in the United States. Most of these skin infections are minor (such as pimples and boils) and can be treated without antibiotics. However, staph bacteria also can cause serious infections (such as surgical wound infections, bloodstream infections, and pneumonia).
2. What is methicillin-resistant Staphylococcus aureus (MRSA)? - Some staph bacteria
develop resistance to antibiotics. MRSA is a sub-group of Staph that is resistant to beta-lactam antibioticss. Beta-lactam antibiotics include methicillin and other more commonly used antibiotics such as oxacillin, penicillin and amoxicillin. While 25% to 30% of the human population is colonized with staph, approximately 1% is colonized with MRSA.
3. Who gets staph and/or MRSA infections? - Staph infections, including MRSA, occur most
frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems.
4. What is community-associated MRSA (CA-MRSA)? - Staph and MRSA can also cause
illness in persons outside of hospitals and healthcare facilities. MRSA infections that are
acquired by persons who have not been recently (within the past year) hospitalized or had a
medical procedure (such as dialysis, surgery, catheters) are known as CA-MRSA infections.
Staph or MRSA infections in a community are usually manifested as skin infections, such as
pimples and boils, and occur in otherwise healthy people.
5. How common are staph and MRSA infections? - Staph bacteria are one of the most
common causes of skin infection in the United States and are a common cause of pneumonia, surgical wound infections, and bloodstream infections. The majority of MRSA infections occur among patients in hospitals or other healthcare settings; however, it is becoming more common in the community setting. Data from a prospective study in 2003, suggests that 12% of clinical MRSA infections are community-associated, but this varies by geographic region and population.
6. What does a staph or MRSA infection look like? - Staph bacteria, including MRSA, can
cause skin infections that may look like a pimple or boil and can be red, swollen, painful, or have pus or other drainage. More serious infections may cause pneumonia, bloodstream infections, or surgical wound infections.
7. Are certain people at increased risk for CA-MRSA infections? – The Centers for Disease
Control and Prevention (CDC) has investigated clusters of CA-MRSA skin infections among athletes, military recruits, children, Pacific Islanders, Alaskan Natives, Native Americans, men who have sex with men, and prisoners. Factors that have been associated with the spread of CA-MRSA skin infections include: close skin-to-skin contact, openings in the skin such as cuts or abrasions, contaminated items and surfaces, crowded living conditions, and poor hygiene.
8. How can I prevent staph or MRSA skin infections? Practice good hygiene:
a. Keep your hands clean by washing thoroughly with soap and water or using an alcohol- b. Keep cuts and scrapes clean and covered with a bandage until healed. c. Avoid contact with other people’s wounds or bandages. d. Avoid sharing personal items such as towels or razors.
9. Are people who are positive for the human immune deficiency virus (HIV) at increased
risk for MRSA? Should they be taking special precautions? - People with weakened
immune systems, which include some patients with HIV infection, may be at risk for more
severe illness if they get infected with MRSA. People with HIV should follow the same
prevention measures as those without HIV to prevent Staph infections, including practice
good hygiene, cover wounds (e.g., cuts or abrasions) with clean dry bandages, avoid sharing
personal items such as towels and razors, and contact their doctor if they think they have an
10. Can I get a staph or MRSA infection at my health club? - The environment usually does
not play a significant role in the transmission of MRSA. MRSA is transmitted most frequently by direct skin-to-skin contact. You can protect yourself from infections by practicing good hygiene (e.g., keeping your hands clean by washing with soap and water or using an alcohol-based hand rub and showering after working out); covering any open skin area such as abrasions or cuts with a clean dry bandage; avoiding sharing personal items such as towels or razors; using a barrier (e.g., clothing or a towel) between your skin and shared equipment; and wiping surfaces of equipment before and after use.
11. What should I do if I think I have a staph or MRSA infection? - See your healthcare
12. How is MRSA diagnosed? The only way to diagnose MRSA is to take a swab sample and
examine it in the laboratory. There are rapid tests to diagnose MRSA and staph bacteria can be cultured. MRSA cannot be reliably diagnosed based on appearance or clinical symptoms.
13. Are staph and MRSA infections treatable? - Yes. Most staph and MRSA infections are
treatable with good wound care and, if needed, with appropriate antibiotics. a. If you are given an antibiotic, take all of the doses, even if the infection is getting better, unless your doctor tells you to stop taking it. Do not share antibiotics with other people or save unfinished antibiotics to use at another time. b. Many Staph skin infections may be treated by draining the abscess or boil and may not require antibiotics. Drainage of skin boils or abscesses should only be done by a healthcare provider. c. If after visiting your healthcare provider the infection is not getting better after a few days, contact them again. If other people you know or live with get the same infection tell them to go to their healthcare provider.
14. If I have a staph, or MRSA skin infection, what can I do to prevent others from getting
infected? - You can prevent spreading staph or MRSA skin infections to others by following
a. Cover your wound. Keep wounds that are draining or have pus covered with clean, dry
bandages. Follow your healthcare provider’s instructions on proper care of the wound. Pus from infected wounds can contain staph and MRSA, so keeping the infection covered will help prevent the spread to others. Bandages or tape can be discarded with the regular trash.
b. Clean your hands. You, your family, and others in close contact should wash their hands
frequently with soap and warm water or use an alcohol-based hand sanitizer, especially after changing the bandage or touching the infected wound. c. Do not share personal items. Avoid sharing personal items such as towels, washcloths,
razors, clothing, or uniforms that may have had contact with the infected wound or bandage. Wash sheets, towels, and clothes that become soiled with water and laundry detergent. Drying clothes in a hot dryer, rather than air-drying, also helps kill bacteria in clothes. d. Talk to your doctor. Tell any healthcare providers who treat you that you have or had a
15. Is it possible that my staph or MRSA skin infection will come back after it is cured? -
Yes. It is possible to have a staph or MRSA skin infection come back (recur) after it is cured. To prevent this from happening, follow your healthcare provider’s directions while you have the infection, and follow the prevention steps above until the infection is gone.
16. What should I do if someone I know has a staph or MRSA infection? - If you know
someone that has a staph or MRSA infection you should follow the above prevention steps.
For more information about staph or MRSA:
This fact sheet provides general information. Please contact your physician for specific clinical information related to you.
Scandinavian Journal of Gastroenterology, 2006; 41: 131 Á/137Laryngeal examination is superior to endoscopy in the diagnosis ofthe laryngopharyngeal form of gastroesophageal reflux diseaseLAIMAS JONAITIS1, RUTA PRIBUISIENE2, LIMAS KUPCINSKAS1 &VIRGILIJUS ULOZA21Department of Gastroenterology, Kaunas University of Medicine, Kaunas, Lithuania, and 2Department of Otolaryngology,Kaunas Univers