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Suggest Treatment For MRSA

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Posted on Wed, 18 Jun 2014
Question: Hello !!

I would like to ask you question! ( if I need ask this question to other doctor please say me to what specialty doctor should I ask this question )


If I don’t have any other disease I m healthy and I get MRSA infection by bacteria – and I go to doctor early as possible and treat infection it will save me ?
And I will avoid any fatal problem !!

I wrote to much things – but the most important I would like to understand If I get (CA-) MRSA and get for doctor in soon as possible and infection doesn’t spread in body I will avoid any health problems even (CA-) MRSA strain is dangerous.


Because there are two kinds of MRSA





1.     CA-MRSA - community-associated (CA-) MRSA

They say that 75 are treated effective – does other 25 % are very dangerous ? Or you can not say that ? you can still treat these 25 % and important to star early treatment! Is it so ??


Please read this part !!

About 75 percent of community-associated (CA-) MRSA infections are localized to skin and soft tissue and usually can be treated effectively.[5] Some CA-MRSA strains display enhancedvirulence, spreading more rapidly and causing illness much more severe than traditional healthcare-associated (HA-) MRSA infections, and they can affect vital organs and lead to widespread infection (sepsis), toxic shock syndrome, and necrotizing ("flesh-eating") pneumonia. This is thought to be due to toxins carried by CA-MRSA strains, such as PVL and PSM, though PVL was recently found not to be a factor in a study by the National Institute of Allergy and Infectious Diseases(NIAID) at the National Institutes of Health. (NIH) It is not known why some healthy people develop CA-MRSA skin infections that are treatable while others infected with the same strain develop severe infections or die.[6]
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus







2.They explain how you can get CA-MRSA and what are first symptoms, and how you get it !!



CA-MRSA tends to occur under conditions where people are in prolonged physical proximity, such as in childcare and long-term care facilities, and in soldiers, prisoners, athletes involved in skin-to-skin contact sports such as wrestling, and in individuals sharing personal items such as towels. Unlike HA-MRSA, the source of infection for CA-MRSA is often difficult to identify.
CA-MRSA usually enters the body though a cut or scrape. The first sign of infection is commonly described as resembling a spider bite – a spot on the skin that is red, swollen, and painful. The site may produce pus. Infrequently, CA-MRSA infection can progress to a more serious disease, such as bloodstream infection or pneumonia. CA-MRSA can, in rare cases, lead to death. Highly publicized accounts of the deaths of at least three students from CA-MRSA in late 2007 prompted concern among students, parents, and school officials. The best defense against MRSA is to maintain good hygiene, including frequent and thorough hand washing, and to avoid the sharing of personal care items.
https://www.bcm.edu/departments/molecular-virology-and-microbiology/index.cfm?pmid=16508


3. And this publication strongly say that CA-MRSA should be diagnose and treat as soon as possible - so infection doesn’t spread to body !


If CA-MRSA is detected early, it can usually be treated effectively with antibiotics other than methicillin. It is important that individuals who think they might have a CA-MRSAinfection seek advice from a healthcare professional quickly so that the infection can be properly diagnosed and treated effectively. With skin infections caused by CA-MRSA, antibiotics are rarely needed. Once the wound is open and drained of pus, it will normally heal on its own. Early diagnosis also ensures that appropriate measures can be taken to limit the spread of the infection.
http://www.phac-aspc.gc.ca/id-mi/camrsa-eng.php


4. And they say – infection could be deadly if it spread to body!!
So the most important thing is not to allow infection to spread – treat as soon as possible – even Some CA-MRSA strains display enhanced virulence, spreading more rapidly and causing illness much more severe than traditional healthcare-associated (HA-) MRSA infections, and they can affect vital organs and lead to widespread infection (sepsis), toxic shock syndrome, and necrotizing ("flesh-eating") pneumonia



5.So if I catch infection in time it will no spread to body and cause health problems. It is so ??


On rare occasions, a CA-MRSA infection can result in life-threatening illness or death. However, most cases are limited to the skin and can be successfully treated.

http://www.phac-aspc.gc.ca/id-mi/camrsa-eng.php



And week immune system will have more chance to get infection


Having a weakened immune system. People with weakened immune systems, including those living with HIV/AIDS, are more likely to have severe CA-MRSA infections
http://www.utexas.edu/safety/ehs/bulletin/staph.html




6.As I understand 1 – 2 % carries MSRA, and I get it on skin in my small wound I can get MRSA infection, And if I get very treatment will it help me to avoid rare fatality ? As CA-MRSA is more virulent (as I understand more dangers) – early diagnose can help to treat it ?? is it so ??
And are CA-MRSA more dangerous than HA-MRSA in some case ? How to avoid this danger ?

Community-acquired MRSA (CA-MRSA) is more easily treated and more virulent than hospital-acquired MRSA (HA-MRSA)
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus



7.As they say that MRSA death rate could be high !! As I understand it is MRSA from hospitals – because they say that MRSA is influenced by other diseases !! Is it so ??
(Except for the presence of comorbidities……..)


Staphylococcus aureus bacteremia (SAB) is an important infection with an incidence rate ranging from 20 to 50 cases/100,000 population per year. Between 10% and 30% of these patients will die from SAB. Comparatively, this accounts for a greater number of deaths than for AIDS, tuberculosis, and viral hepatitis combined. Multiple factors influence outcomes for SAB patients. The most consistent predictor of mortality is age, with older patients being twice as likely to die. Except for the presence of comorbidities, the impacts of other host factors, including gender, ethnicity, socioeconomic status, and immune status, are unclear. Pathogen-host interactions, especially the presence of shock and the source of SAB, are strong predictors of outcomes. Although antibiotic resistance may be associated with increased mortality, questions remain as to whether this reflects pathogen-specific factors or poorer responses to antibiotic therapy, namely, vancomycin. Optimal management relies on starting appropriate antibiotics in a timely fashion, resulting in improved outcomes for certain patient subgroups. The roles of surgery and infectious disease consultations require further study. Although the rate of mortality from SAB is declining, it remains high. Future international collaborative studies are required to tease out the relative contributions of various factors to mortality, which would enable the optimization of SAB management and patient outcomes.
http://cmr.asm.org/content/25/2/362.full




8.They say that the diagnose is done 48 h after you have got infection – so it means – it could be start treatment to avoid any fatal problems !!
I thin it is so !!! So it is important to start treatment as soon as possible !!


Setting of BacteremiaThe setting of SAB onset has traditionally been divided into two categories, health care associated (formerly nosocomial) and community acquired, when subsequent positive S. aureus blood culture bottles are obtained ≥48 h and within 48 h of hospital admission, respectively (102). With changes in the complexity of modern health care, community-onset infections are now further divided into episodes with health care contact (e.g., health care-associated outpatient) and those without (253). The setting of SAB assisted clinicians in predicting the infecting S. aureus clonal type and, consequently, antibiotic choice. However, with the advent of community-acquired MRSA (CA-MRSA) (defined by the antibiotic resistance pattern and/or staphylococcal cassette chromosome mec [SCCmec] type) strains entering the hospital, causing cross infections and replacing common hospital clones, these definitions are becoming less helpful (229).
http://cmr.asm.org/content/25/2/362.full



9.And they say that CA-MRSA has more drugs for treatment – so it would help to treat is easily if do it in time !!!


CA-MRSA has a greater spectrum of antimicrobial susceptibility, including to sulfa drugs (like co-trimoxazole/trimethoprim-sulfamethoxazole), tetracyclines (like doxycycline and minocycline) andclindamycin (for osteomyelitis), but the drug of choice for treating CA-MRSA is now believed to be vancomycin, according to a XXXXXXX Ford Hospital Study. HA-MRSA is resistant even to these antibiotics and often is susceptible only to vancomycin. Newer drugs, such as linezolid (belonging to the newer oxazolidinones class) anddaptomycin, are effective against both CA-MRSA and HA-MRSA. The Infectious Disease Society of XXXXXXX recommends vancomycin, linezolid, or clindamycin (if susceptible) for treating patients with MRSA pneumonia.[96] Ceftaroline, a fifth generation cephalosporin, is the first beta-lactam antibiotic approved in the US to treat MRSA infections (skin and soft tissue or community acquired pneumonia only).[97]

http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus















10. They say that CA-MRSA are rare fatal


The place of SAB onset influences outcomes, with community-onset episodes having a lower mortality rate than health care-acquired episodes (0.6% and 3.9%, respectively) (71), probably secondary to the predominance of skin and soft tissue infections and bone and joint infections in community-onset episodes.
http://cmr.asm.org/content/25/2/362.full



11.But they say some cases CA-MRSA could be fatal !!


Infective endocarditis, although rare in children, is associated with an increased 1-year mortality rate (40%, versus 12% for children with no IE) (297). Both IE (patients 0 to 10 years old) and pulmonary infections (patients <1 and 11 to 20 years old) were independent predictors of mortality (71). Although small case series have documented high mortality rates associated with pvl-positive and CA-MRSA infections (27, 83, 84), a lack of comparative data and the small sample size limit drawing conclusions about the impact of these factors on outcomes.
http://cmr.asm.org/content/25/2/362.full








12.And in other publication explain more details – and they say that diagnose in these case are very important, so children should examine their body to find out their source of infection to avoid infection to develop (Mortality appears to be high, and children may benefit from a search of their soft tissues and joints to identify the source of infection to prevent embolic dissemination.) So it is important to find out MRSA infection soon as possible and to start treatment – to avoid fatal end !!




We observed a number of cases of sepsis from bacteremia in children from community-associated methicillin-resistant Staphylococcus aureus (MRSA), which led us to study its patterns of infection and outcome. A retrospective review identifying children admitted to our institution with blood culture-proven community-associated MRSA sepsis over a 2-year period was performed. The inclusion criteria were younger than 19 years old, two or more blood cultures for MRSA within 48 hours of admission, evidence of systemic inflammatory response syndrome, and no prior hospital admissions within 6 months. Eight patients were included; seven required mechanical ventilation. Vasopressors were required in seven patients. Four patients required extracorporeal membrane oxygenation. Four patients had culture-proven septic arthritis or thrombophlebitis and three of these patients developed bilateral necrotizing pneumonia. Bilateral necrotizing pneumonia was identified in the other four patients, but the primary source of infection was never identified. The overall intact neurologic survival was 50 per cent. Children with severe community-associated MRSA sepsis can rapidly progress to cardiorespiratory failure. Mortality appears to be high, and children may benefit from a search of their soft tissues and joints to identify the source of infection to prevent embolic dissemination.
http://www.ncbi.nlm.nih.gov/pubmed/0000?dopt=Abstract









- And other risk factor. Is here

A report of CA-MRSA bacteremia in neonates from XXXXXXX (94) noted a high mortality rate of 38%. However, comparative data with other SAB clonal episodes were not documented. In a neonatal intensive care unit study by Kuint et al. (149), of 11 CA-MRSA (pvl-negative), 20 multidrug-resistant MRSA, and 12 MSSA bacteremic episodes, mortality (9%) was not dependent on the S. aureus subtype despite CA-MRSA episodes occurring in younger neonates.
doctor
Answered by Dr. Sumit Bhatti (5 hours later)
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for your query. I find that you are too worried than you should be about MRSA. Let me tell you MRSA is virulent but not as dangerous as you think. With your readings and research I could understand that you are sleeping and living with its fear. It is still treatable. Let me also assure you that healthy people like you would not die because of MRSA. You are underestimating the immunity levels of a healthy person, it can break open any bug. A person in worry loses immunity faster so be strong and keep up your body defense.

1. MRSA is only one of the many 'superbugs' encountered in routine medical treatment of patients.

2. I treat many patients of MRSA under my care. Simple hygiene methods are all that are required to avoid infection. There is no doubt that MRSA is more virulent than MSSA (Methicilin Sensitive Staph Aureus).

3. Currently, antibiotics such as Linezolid and Tigecycline cure even Vancomycin resistant strains (VRSA/VISA).

4. A deep nasal swab is used to rule out carrier status. Simple skin infections may require no treatment. Some may require only pus drainage. The severe infections mentioned by you are rare and would require hospitalization.

5. Staph Aureus is also normally present in our respiratory tract as a commensal. Since you are healthy, there is no cause for worry.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (1 hour later)
Thank you very much for your help !!

from your answer

in statment from you -

I find that you are too worried than you should be about MRSA

- so you say i should not be to woried about that !!

An the other qestion - it is very important to find out as early as posible MRSA in
your body and to treat it - to stop it spreading in your body - to avoid any health problems - becaouse it is said in all publication what i read !!!
So it will protect me from MRSA posible damige to your body !!!


I tking if you agre with my statment - i will take stress out from me and keep good imune sitem.
Sory i would like to add one more gestion

From this publication it is said that -

Summary: Staphylococcus aureus bacteremia (SAB) is an important infection with an incidence rate ranging from 20 to 50 cases/100,000 population per year. Between 10% and 30% of these patients will die from SAB. Comparatively, this accounts for a greater number of deaths than for AIDS, tuberculosis, and viral hepatitis combined. Multiple factors influence outcomes for SAB patients

http://cmr.asm.org/content/25/2/362.full


But as i understan thes letal case in in people in hospitals - people who have some health problem, and MRSA worese thes problems !! Health people are not in this group

And not in all contries MRSA is so widespread - and do so much damage


I m not in this riks group - if i get MRSA treatmen very early (it doesnt spred to my body) i will avoid any problem !!

Thank you very much


Thank you for your help !!
doctor
Answered by Dr. Sumit Bhatti (10 hours later)
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. Yes, you are correct. I always swab and culture any infection in the patient. If MRSA is identified, treatment is started immediately, before the infection can spread any further.

2. It is true that many patients already have pre-existing diseases and immune weakness before they pick up the MRSA infection. Primary cases are less common.

3. A healthy person like yourself should have no cause for worry.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sumit Bhatti (3 hours later)


Thank you very much – you help me a lot, I m thankful

I know that I must stop reading – and relax !

In one publication it was said that


In 2005 the 94 360 reported cases of CA –MRSA resulted in 18 650 death

http://www.trepubs.com/play-book/WEMVSK%20-%20E2.pdf

And I understand it is mistake – huge mistake, because I in official CDC web page it is said that these death rates is not from community-associated MRSA, because it is said that CA –MRSA is rare fatal.



the Centers for Disease Control and Prevention (CDC) released a study indicating that on anannual basis; approximately 94,000 patients develop serious MRSA infections resulting in 18,650 deaths
http://www.academia.edu/0000/COMMUNITY_ACQUIRED_MRSA








1.And one more question – is MRSA strain USA600 it is dangerous – it is very rare because there has been only 16 cases for 3 years !! And all patients where older than 60 years – As understand this strain is not in community as CA –MRSA, and I should not be worried about that because so few cases and they all was older than 60.

From 2005 through 2008, the investigators evaluated 16 consecutive cases of USA600
http://www.medpagetoday.com/MeetingCoverage/IDSA/16781


2.As I understand CA – MRSA could be spread more easy – but it is rare fatal.

CA-MRSA strains may spread more easily from person to person or cause more skin disease than HA-MRSA. At least three different strains of staph that cause CA-MRSA infections have been identified in the United States. Scientists are working towards understanding the differences between these strains and determining why certain people become infected and seriously ill
https://www.bcm.edu/departments/molecular-virology-and-microbiology/index.cfm?pmid=16508


3.And is it true that some strains of CA – MRSA is more dangerous than
HA-MRSA than because they spread in body more rapidly and can cause serious problems and it is very important to diagnose in this case soon as possible to start treatment.
____________________
Some CA-MRSA strains display enhancedvirulence, spreading more rapidly and causing illness much more severe than traditional healthcare-associated (HA-) MRSA infections, and they can affect vital organs and lead to widespread infection (sepsis), toxic shock syndrome, and necrotizing ("flesh-eating") pneumonia.
It is not known why some healthy people develop CA-MRSA skin infections that are treatable while others infected with the same strain develop severe infections or die.
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus










4.But they say infection progress rapidly so it is important to diagnose it soon as possible – because after 72 h it could become resistant to treatment, So if see that my small child has CA-MRSA symptoms I should get him to hospital as soon as possible to avoid spread infection in body and cause serious problems. Is it so ??
___________________________
MRSA may progress substantially within 24–48 hours of initial topical symptoms. After 72 hours, MRSA can take hold in human tissues and eventually become resistant to treatment. The initial presentation of MRSA is small red bumps that resemble pimples, spider bites, or boils; they may be accompanied by fever and, occasionally, rashes. Within a few days, the bumps become larger and more painful; they eventually open into deep
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus



Thank you very much for your help !!!

You help me very much !!

Good health to you !!!
doctor
Answered by Dr. Sumit Bhatti (19 hours later)
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. The ST45:USA600 and similar strains are extremely rare and hence you are unlikely to ever encounter an infection.

2. CA-MRSA is less likely to cause life threatening infections compared to HA-MRSA strains. Hospital acquired infections are usually more resistant.

3. CA-MRSA does not commonly cause severe infections. Only some patients with other illnesses are susceptible.

4. Yes, you should get your child examined if yu suspect MRSA. It can be highly virulent and spread quickly in children. At the same time, early treatment prevents a severe infection.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (3 hours later)
Thank you for your help the last qestion !!!

Is it true that somes strains of CA MRSA is more dengersos becose they spread more rapidy and could cause problems ! In this case it is very importat to diagnose and to treat them soon as posible ??

Some CA-MRSA strains display enhanced virulence, spreading more rapidly and causing illness much more severe than traditional healthcare-associated (HA-) MRSA infections
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus

Thank you very much !!!
doctor
Answered by Dr. Sumit Bhatti (23 hours later)
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. These strains of CA-MRSA are more likely to spread rapidly in very young, old or patients with weak immune systems. Patients with good immunity are unlikely to have fulminant infection if diagnosed and treated early.

2. HA-MRSA will be more resistant to antibiotics than CA-MRSA. A fulminant CA-MRSA is a likely possibility in a patient who is diagnosed late or not treated early.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sumit Bhatti (5 hours later)
Thank you the last

More a read less i understand !!!


It is said XXXXXXX
- whereas the ST1:USA400 strain results in necrotizing pneumonia and pulmonary sepsis
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus

Is it somus study it is said that it in number 63 % of cases
- is these all cases as pneumonia - or it is in some subtype only

CA-MRSA isolates are most often classified as PFT USA300 or USA400. In Minnesota, the predominant CA-MRSA PFT has changed dramatically over time. In 2000, 63% of CA-MRSA isolates were USA400 and 4% were USA300. In 2005, only 14% of CA-MRS












Europe ST80 strains, which carry SCCmec type IV, predominate but it is

well treated ?
and not so dangeros ??

Becouse SCCmec genotypes - Conversely, CA-MRSA is associated with types IV and V, which are smaller and lack resistance genes other than mecA
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus#cite_note-51

It means that is more asy treatable ?



Becaouse it was said in text

There were no differences in demographic data, underlying diseases, invasive procedures or outcomes between the SCCmec II/III and IV/V groups, except that patients with SCCmec II/III genotypes tended to have more HCA risk factors (3.1 vs. 2.4; P=0.008). Multivariate logistic regression analysis revealed that having at least four HCA risk factors was independently associated with SCCmec II/III. The sensitivity of recovering SCCmec IV/V genotypes from patients with less than four HCA risk factors was 89.3%. This study revealed the emergence of SCCmec IV/V genotypes in CO-MRSA infections. Although the clinical characteristic boundaries between SCCmec II/III and IV/V diminished, having at least four HCA risk factors made the presence of SCCmec IV/V genotypes less likely in patients with CO-MRSA infections.

http://www.ijaaonline.com/article/S0924-8579(11)00359-1/abstract

So it means it is morea easy treatable CA MRSA - than HA MRSA

I would liek to stop reading - but im doing all the time-
i mus undestand - if these types are so offen - why there are fewer cases of pneimonia or even death with CA MRSA, but more skin infection !!

And how can ia recognaize that is its CAM - MRSA pneimonina - if i dont have skin problems ??(as i understand in this case )


And in this table ther is so musc for example the dengeros USA 600
and so much usa 400
- but in real world there ar more skin infections - how to understand these results ??



Relationship of molecularly characterized MSSA isolates to MRSA epidemic strain types*
MRSA PFGE epidemic types (MLST) No. (%) related MSSA isolates PVL positive Predominant spa type†
CMRSA1/USA600 (ST45) 38 (13.3) 0 t065 (n = 23)
CMRSA2/USA100/800 (ST5) 77 (26.9) 0 t311 (n = 46)
CMRSA4/USA200 (ST36) 30 (10.5) 0 t012 (n = 12)
CMRSA7/USA400 (ST1) 12 (4.2) 12 t128 (n = 8)
CMRSA10/USA300 (ST8) 3 (1.1) 2 t008 (n = 2)
USA700 (ST72) 1(0.4) 0 t148 (n = 1)
ST97 18 (6.3) 0 t2728 (n = 11)
USA1000 (ST59) 33 (11.5) 1 t163 (n = 27)
USA1100 (ST30) 1 (0.4) 0 t122 (n = 1)
*n = 286 MSSA isolates. MSSA, methicilin-susceptible Staphylococcus aureus; MRSA, methicillin-resistant S. aureus; PVL, Panton-Valentine leukocidin; PFGE, pulsed-field gel electrophoresis; MLST, multilocus sequence typing; ST, sequence type.
http://wwwnc.cdc.gov/eid/article/17/4/10-0482-t2.htm

doctor
Answered by Dr. Sumit Bhatti (5 hours later)
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. Any bacteria, fungus virus or other infective agent can cause septicemia if it is very virulent, resistant or if the host immune defense is ineffective.

2. Entrust the diagnosis to the physicians, depending upon the symptoms.

3. You may consult an Infectious Diseases Specialist.

4. You chances of a fatal MRSA infection in your lifetime is virtually nil.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Suggest Treatment For MRSA

Brief Answer: As below: Detailed Answer: Hi, Thank you for your query. I find that you are too worried than you should be about MRSA. Let me tell you MRSA is virulent but not as dangerous as you think. With your readings and research I could understand that you are sleeping and living with its fear. It is still treatable. Let me also assure you that healthy people like you would not die because of MRSA. You are underestimating the immunity levels of a healthy person, it can break open any bug. A person in worry loses immunity faster so be strong and keep up your body defense. 1. MRSA is only one of the many 'superbugs' encountered in routine medical treatment of patients. 2. I treat many patients of MRSA under my care. Simple hygiene methods are all that are required to avoid infection. There is no doubt that MRSA is more virulent than MSSA (Methicilin Sensitive Staph Aureus). 3. Currently, antibiotics such as Linezolid and Tigecycline cure even Vancomycin resistant strains (VRSA/VISA). 4. A deep nasal swab is used to rule out carrier status. Simple skin infections may require no treatment. Some may require only pus drainage. The severe infections mentioned by you are rare and would require hospitalization. 5. Staph Aureus is also normally present in our respiratory tract as a commensal. Since you are healthy, there is no cause for worry. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.