"Staph" is short for Staphylococcus aureus, one of many bacteria that are plentiful and ubiquitous in our environment. Staph is very common on skin surfaces, in the bowel, and in the nose of healthy people, and usually does not cause any trouble there, unless it ends up in a place it does not belong like the middle ear, sinuses, lungs, or in a wound on broken skin. Then it can cause an infection, ranging from a pimple to a rapidly progressive, invasive infection.
In the old days, all strains of staph could be treated with methicillin, an antibiotic similar to plain penicillin. Over time, increasing numbers of these bacteria became resistant to methicillin—thus the name, MRSA, or Methicillin Resistant Staphylococcus Aureus. The original MRSA is no more dangerous than plain staph, just more difficult to treat. Most staph that cause diseases today are of the MRSA variety.
An additional complication is that some strains of MRSA are now making a toxin called PVL which is capable of killing white cells, a part of the immune system that would otherwise keep the infection from going out of control. Infections caused by MRSA with PVL are more dangerous and quicker to progress than plain old MRSA—in particular, MRSA-PVL pneumonia is a very severe and sometimes fatal infection.
What can parents do to minimize the risk of their children getting infections?
Handwashing is absolutely the most important preventive measure: before, after, and during school, meals, trips to bathroom, playing with friends, visiting other homes (especially ones where someone is sick), and public areas. Hand sanitizers with viscous alcohol also kill harmful bacteria on contact.
Keeping the environment clean is nearly as important—bacteria can live on surfaces, especially surfaces in contact with food.
The last measure is unique to staph: An ointment called mupirocin (or bactroban) can eradicate staph from the nose if it is applied directly deep into the nostrils. This is most useful for families in which one or more members have recurrent staph infections: Most commonly, the reservoir of the infection is in the otherwise perfectly healthy nose.
Dr. Anatoly Belilovsky, a New York City-based board-certified pediatrician with a specialty in urgent care medicine, is the medical director of Belilovsky Pediatrics, with locations in Brooklyn and on Staten Island. He is a Princeton graduate, a former clinical instructor at Cornell University, and recipient of the Americhoice Quality Care Award for his groundbreaking work with pediatric asthma patients.
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