Travelers Medical Guide

M E T H I CI LLI N -RE S I STAN T STAPHYLOC OC CUS AUREUS Methicillin-resistant Staphylococcus aureus (MRSA) is a type of Staphylococcus bacteria that is resistant to many antibiotics used to treat ordinary staph infections. In the United States, about 33 percent of the population carry ordinary staph that is still sensitive to usual antibiotics — known as methicillin-sensitive Staphylococcus aureus (MSSA) — while 2 percent carry MRSA without showing symptoms.40 When the surface of the skin gets damaged, however, the bacteria cause an infection.

Hospital-acquired MRSA (HA-MRSA): In hospital settings, about 5 percent of patients carry MRSA on their skin or nose without showing signs of the disease. It may cause severe infections in patients who have had surgeries, artificial joints or intravenous tubings, such as patients on dialysis or life support. The most dangerous situation is when MRSA staph enters the bloodstream (bacteremia), causes sepsis and possibly affects many organs. The incidence of MRSA infections in hospitals worldwide varies, but it is present in any world region. In 2017 there were nearly 120,000 cases of invasive MRSA infections in the U.S., and 20,000 resulted in the patient’s death.41 MRSA is also a significant problem in Europe, with a higher incidence in southern European countries than in northern ones. The problem is also widespread in Asia, but the incidence is unknown.

Community-associated MRSA (CA-MRSA): These MRSA infections occur outside of health care facilities and in the broader community among healthy people. The condition often begins as a painful skin infection spread by skin-to-skin contact or by contact with contaminated objects such as towels, floor mats or beach sand. At-risk populations for CA-MRSA include athletes in contact sports, childcare workers and people living in crowded conditions. Staph bacteria, including MRSA, have been found in seawater and sand.

Livestock-animals MRSA (LA-MRSA): MRSA can also be present among animals and may cause severe damage to the livestock industry.

Contact with infected animals is a potential source of infection. Avoid contact with domestic and wild animals, especially when traveling.

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