Outsmart This Scary Germ: Staphylococcus Aureus
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Outsmart This Scary Germ: Staphylococcus Aureus

A deadly disease is stalking women, infecting nearly 60 percent of people who go to the ER for skin or soft-tissue infections. Here's what you need to know to protect yourself from a staph infection.

Staph Infection

When 42-year-old Peg McQueary cut her ankle shaving two years ago, she didn't think anything of it. But about a week later, the mother of two in Sacramento, California, noticed that the area around the nick had turned red. She also felt nauseous and achy and had a slight fever. "I thought I had a flu," she says. Within two days, however, her entire leg began to swell from ankle to hip. By the time she was finally able to get an appointment to see her doctor a day and a half later, her leg had ballooned to twice its normal size. "My husband and I were completely freaked out," she says. "We were wondering, 'What is this?'"

McQueary went to her doctor, who took a look and told her to go immediately to the ER. Her husband rushed her to the hospital, where she spent the next six days receiving a morphine drip and hooked up to an IV that pumped vancomycin, a strong antibiotic often used as a last resort, directly into an artery of her heart. Two days after McQueary was admitted, a skin culture showed that she was infected with a potentially deadly strain of staph bacteria called community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). She was in a fight for her life as the staph invaded her blood, causing uncontrollable shaking, a fever of 105 degrees, and delirium. "I didn't know where I was or what was happening," she says. "On a scale of 1 to 10, the pain was a definite 10," she says.

After a week, McQueary's condition stabilized. She recovered from the infection at home but needed daily antibiotic infusions for more than a year and a half because the germ became resistant to one drug after another. It was finally brought under control, but tests show that CA-MRSA is still in her body. "It has turned my life upside down," she says.

Cases like McQueary's are on the rise. A few years ago, hardly anyone had even heard of CA-MRSA. Today, it has become an epidemic, infecting nearly 60 percent of people who go to the ER for skin or soft-tissue infections, according to studies published in the New England Journal of Medicine. "We've seen a big change," says Henry Blumberg, MD, a professor of medicine in the division of infectious diseases at Emory University School of Medicine. "While skin and soft tissue infections have always been common, now CA-MRSA has become the predominant cause of them." The good news is that the crucial preventive measures are basic and easy. The best way to protect yourself is to know where the germ lurks, what to ask your doctor, and who is most at risk. On these pages, you'll get that information -- plus everything else you need to stay safe.

Anatomy of an Infection

Like other staph germs, CA-MRSA can slip into your body through a cut, crack, or abrasion and attack underlying layers of skin, muscle, and membranes, causing boils, pain, swelling, and abscesses. If not treated properly, it can spread through the blood and carry germs to the heart, brain, lungs, liver, and spleen. This can potentially lead to pneumonia, infections of the heart, stroke, and even organ failure.

CA-MRSA is aggressive. While its closest relative, MRSA, is a common cause of infections in hospitals, where it tends to strike patients whose immune systems are weak, "CA-MRSA can affect otherwise healthy people," says Neil Fishman, MD, an associate professor of medicine and infectious diseases at the University of Pennsylvania School of Medicine and chair of the antimicrobial resistance working group at the Infectious Diseases Society of America. The superbug produces toxic enzymes that attack the body's cells. It can spread within days -- usually forming pus-filled abscesses that allow it to cause deep infection of the skin and underlying tissues -- and CA-MRSA is resistant to a number of antibiotics.

Where the Bug Lurks

You can come into contact with the germ almost anyplace, but it spreads most easily in crowded places like gyms and locker rooms. You can pick it up from weight equipment, mats and, especially, shared items like towels, bars of soap, and razors. Shaving -- even with your own razor -- is a risk factor because it causes tiny abrasions that the germs can enter. "There have been outbreaks of CA-MRSA associated with body shaving. The bacteria like to hide on the legs and especially in areas with folds and crevices such as the underarms and groin," says Dr. Fishman. The bug can also be sexually transmitted, according to a new study.

What to Ask Your Doctor

Because CA-MRSA is such a new threat, some MDs still don't know what to look for. "I had several doctors misdiagnose me because I was young and otherwise healthy," says Jessica Leeb, a 25-year-old medical student at Emory University, who was told she had a herpes infection when CA-MRSA caused a lesion on her lip. A skin culture will identify the bug -- but you may need to ask for it. See your physician if you have a spot that's soft if you press on it, red, swollen and warm, which are signs of infection. "If you also develop a fever, go to the doctor -- or the ER -- immediately," says Dr. Blumberg.

How the Infection Is Treated

Once you're diagnosed with CA-MRSA, the physician will probably put you on antibiotics right away (drug effectiveness varies, but clindamycin, trimethoprim-sulfamethoxazole, and tetracycline are often prescribed). Make sure the doctor also drains any pus from the infection. "If you have an abscess, antibiotics alone aren't enough to fight it off," explains Dr. Blumberg. Finally, you'll also need to go through a stringent cleansing process called decolonization to wipe out any remaining traces of CA-MRSA. This means washing for three to five days with a surgical scrub and using an antibacterial nasal ointment (staph typically hides in the nose).

Protect-Yourself Tips

Now for the good news (yes, there is some!): Experts say a few simple strategies will squash CA-MRSA before it has a chance to strike. Here are the most important things you can do to stay germ-free:

  • Shower immediately after a workout. Your home bathroom may seem safer, but if you've come into contact with CA-MRSA at the gym, you should wash it off as soon as possible, says Dr. Fishman. "You don't need a special antibacterial soap -- just make sure to use your own bar (no sharing!) or liquid soap, and wash every fold and crevice," he says.
  • Wash your hands thoroughly. After you use the bathroom or if you're exposed to someone who's sick, scrub your hands for 15 to 20 seconds.
  • Carry alcohol-based wipes or liquid hand sanitizer in your bag. "Alcohol is actually more effective against microorganisms than soap, and you can use it anywhere," says Dr. Fishman.
  • Choose nail salons carefully. Tubs and dishes used to soak nails for manicures and pedicures are rife with bacteria, says Betsy McCaughey, PhD, chair of the Committee to Reduce Infection Deaths (RID), a nationwide organization devoted to improving hospital hygiene. "Containers should be drenched in detergent and water for three minutes between users, but they seldom are," she says. "Insist that they're cleaned well, or bring your own -- as well as your own cutting tools and files."
  • Wash up after playing with your pet. "There are cases where dogs appear to have been the source of infection," says Dr. Fishman. If you see dry, red patches on your pooch's skin, he may have CA-MRSA. Take him to the vet right away to be examined.

3 Ways to Stay Healthy

A strong immune system can help protect you from CA-MRSA. Here are three crucial steps to take right now to help keep your body in fighting shape.

  1. Pile your plate with fruits and veggies. Foods such as spinach, broccoli, and sweet potatoes contain vitamins A, C, E, and other antioxidants that studies show may prevent damage to immune-system cells.
  2. Don't let germ phobia keep you off the treadmill. Regular, moderate workouts help the body fight infection, research shows. But pace yourself: Exercising vigorously for more than 90 minutes can wear down your defenses.
  3. Get plenty of shut-eye. "Studies find that on-going stress weakens your infection-fighting hormones and cells," says Dr. Fishman. One simple fix: Get more rest, which helps your immune system recharge.

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Originally published in FITNESS magazine, September 2007.