Minor Foot Problems Seeing More MRSA Infections

Skin care professionals, and particular those that offer pedicures and other foot-related treatments, should be aware of the rise in MRSA infections being seen.

More Americans are developing drug-resistant staph infections, known as MRSA, from common, relatively minor foot problems such as cuts, cracks in the skin, athlete’s foot and ingrown toenails, according to the American College of Foot and Ankle Surgeons (ACFAS). Foot and ankle surgeons are noting an increase in community-associated MRSA, or methicillin-resistant Staphylococcus aureus.

MRSA linked to athlete’s foot, ingrown toenails

“If you have a cut or a scrape that gets infected and it’s not healing in a timely fashion, don’t hesitate to get it checked out,” said Karl Collins, DPM, FACFAS, a foot and ankle surgeon in St. Louis. Dr. Collins said he’s diagnosed community-associated MRSA infections in patients with athlete’s foot, and even a six-year-old who stubbed his toe.

Brandi Johnson, DPM, AACFAS, estimates treating 20 patients for community-associated MRSA last year. The Brandon, Florida foot and ankle surgeon says half of those patients had infected ingrown toenails. Puncture wounds, pedicures and cuts from glass and seashells caused the rest of the infections.

One of Johnson’s patients was a teenage boy. He waited months before seeing a doctor for an infected ingrown toenail. After the boy’s primary care doctor referred him to Johnson, she ran several tests. Results showed a community-associated MRSA infection. Even worse, it had spread to bone in the teen’s big toe. He recovered after six weeks of intravenous antibiotics. “I’ve had several high schoolers come in with ingrown toenails recently,” Dr. Johnson said. “Their pediatricians started them on antibiotics and sent them to my office. Lab results showed they all had MRSA.”

Preventing infection

Staph bacteria such as MRSA are common. One in three people carry them. The bacteria live on the skin and in the nose and are spread through skin contact. Even minor tears in the skin’s surface open the door to bacteria and infection.

Skin conditions such as athlete’s foot, calluses, corns, eczema and psoriasis can create breaks in the skin. Walking barefoot increases the risk of cuts and puncture wounds. Foot and ankle surgeons say simple steps can prevent community-associated MRSA infections:

  • Wash and bandage cuts.
  • See a doctor within 24 hours for any puncture wound.
  • Never perform “bathroom surgeries” to cut or dig out an ingrown toenail.
  • Keep feet clean and dry to prevent fungal infections such as athlete’s foot.

MRSA becomes a community problem

According to a study by the Centers for Disease Control and Prevention, 14% of MRSA cases are community-associated and 85% are health care-associated. Health care-associated MRSA has existed for decades in settings such as hospitals and nursing homes. But within the past decade, community-associated MRSA has emerged as a threat, as outbreaks occur in schools, sports teams, prisons and other places in the community with populations that are generally healthy.

Adapted from materials provided by American College of Foot and Ankle Surgeons.

ScienceDaily, May 25, 2009

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