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CDC Director Dr. Tom Frieden On MRSA

Hi, I'm Dr. Hansa Bhargava from WebMD and I'm joined today by Dr. Tom Frieden, director of the CDC. Thank you for being here, Dr. Frieden. Let's talk about MRSA infections. They are hard to treat. And more and more parents are worried about the prevention of these. Especially those who have kids in sports where there is close contact. What would you tell these parents?

Tom Frieden, MD

MRSA, methicillin-resistant Staph aureus, is an organism that became resistant in health care facilities and spread to the community. That's exactly what we need to stop from happening with other organisms, by improving detection and control of resistant organisms in our hospitals. In terms of MRSA in the community, there are commonsense, simple, low-cost things that people can do to avoid it. Wash your hands regularly. Shower after having vigorous physical activity. Don't share towels and combs and other things that kids may share and may carry germs on them. These simple things can really reduce the risk. You know sometimes we're looking for the latest, greatest thing and something as simple as hand washing will make the most difference.

Hansa Bhargava, MD

So just back to basics. Simple hand washing. And for parents who do think that their child might have a MRSA skin infection, how can they distinguish the difference between a regular skin infection vs. MRSA?

Tom Frieden, MD

Well, if it doesn't heal, that's a big hint. You want to make sure that if they're cuts or scrapes, they're washed promptly with soap and water. Cover them during the day time at least, so that they don't get more dirt and dirty things in them. Then if you have a fever or nausea or vomiting, you should be assessed and assessed carefully.

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Hansa Bhargava, MD

Hi, I'm Dr. Hansa Bhargava from WebMD and I'm joined today by Dr. Tom Frieden, director of the CDC. Thank you for being here, Dr. Frieden. Let's talk about MRSA infections. They are hard to treat. And more and more parents are worried about the prevention of these. Especially those who have kids in sports where there is close contact. What would you tell these parents?

Tom Frieden, MD

MRSA, methicillin-resistant Staph aureus, is an organism that became resistant in health care facilities and spread to the community. That's exactly what we need to stop from happening with other organisms, by improving detection and control of resistant organisms in our hospitals. In terms of MRSA in the community, there are commonsense, simple, low-cost things that people can do to avoid it. Wash your hands regularly. Shower after having vigorous physical activity. Don't share towels and combs and other things that kids may share and may carry germs on them. These simple things can really reduce the risk. You know sometimes we're looking for the latest, greatest thing and something as simple as hand washing will make the most difference.

Hansa Bhargava, MD

So just back to basics. Simple hand washing. And for parents who do think that their child might have a MRSA skin infection, how can they distinguish the difference between a regular skin infection vs. MRSA?

Tom Frieden, MD

Well, if it doesn't heal, that's a big hint. You want to make sure that if they're cuts or scrapes, they're washed promptly with soap and water. Cover them during the day time at least, so that they don't get more dirt and dirty things in them. Then if you have a fever or nausea or vomiting, you should be assessed and assessed carefully.

Pharmacist Says Skin Change 'silent Messenger' Of Serious Problems

A pharmacist has warned people not to overlook changes to their skin because they could be vital clues to a life-threatening condition. From a subtle discolouration to a change in texture or feel, skin can serve as a silent messenger that can be the first signs of an underlying health condition.

George Sandhu, Deputy Pharmacy Superintendent from independent pharmacist Well Pharmacy said: "Whether you're curious about a pimple, dry patch or discolouration, your skin can act as a barometer for your general wellbeing. Skin is a major organ, capable of revealing not just cosmetic but also potentially life-threatening conditions – it's not something to take lightly.

"Through observation, we can identify changes that may signify deeper health issues."

10 of the most well-known skin conditions, that could indicate concerns:

SHINGLES

Red blotchy skin, which turns into itchy blisters, that ooze fluid.

  • Is it contagious? YES
  • Could it be life-threatening? NO
  • Shingles is an infection that causes a painful rash. First signs can include tingling or a painful feeling in an area of skin, headaches and feeling generally unwell.

    A rash will usually appear a few days later. In rare cases shingles can cause pain without a rash. Usually, the shingles rash occurs on the chest and belly, but it can appear anywhere on your body including on your face, eyes and genitals.

    You cannot spread shingles to others. But people could catch chickenpox from you if they have not had chickenpox before or have not had the chickenpox vaccine.

    The NHS suggests avoiding pregnant mothers who have not had chickenpox before and people with a weakened immune system – like someone having chemotherapy and newborn babies. If symptoms of shingles occur, the new service Pharmacy First allows pharmacists to provide advice and treatment.

    IMPETIGO

    Starts itchy, red and sore. Once healed a crusty, yellow or "honey-coloured" scab forms over the sore

  • Is it Contagious? YES
  • Could it be life-threatening? NO
  • Impetigo is a very contagious skin infection, but not usually serious. It often gets better in seven to 10 days if you get treatment.

    Conditions start with red sores or blisters, which quickly burst and leave crusty golden-brown patches. The NHS says the patches can look like cornflakes stuck to the skin and can be painful. Impetigo can easily spread to other parts of your body or to other people until it stops being contagious.

    The condition generally stops being contagious 48 hours after the infected person starts using prescribed hydrogen peroxide cream or antibiotics or when the patches dry out and crust over. Pharmacy First allows pharmacists in England to provide advice and treatments for Impetigo.

    ATOPIC ECZEMA

    Red, weepy, crusty, itchy, flaky patches, like oval or circular-shaped areas on the skin.

  • Is it contagious? NO
  • Could it be life-threatening? NO
  • Atopic eczema, sometimes called Atopic dermatitis, is one of the most common forms of eczema, a condition that causes the skin to become itchy, dry and cracked. The skin condition causes the skin to become itchy, dry, cracked and sore. Some only have small patches of dry skin, but others may experience widespread inflamed skin all over the body.

    SEPSIS

    Blue, grey, pale or blotchy skin, which can also appear on lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet

  • Is it contagious? NO
  • Could it be life-threatening? YES
  • Sepsis is a life-threatening reaction to an infection. It happens when the immune system overreacts to an infection and starts to damage the body's tissues and organs. Other names for sepsis include septicaemia or blood poisoning. Treatment in hospital is essential straight away. You should expect to be given antibiotics within one hour of arriving at hospital.

    If sepsis is not treated early, it can turn into septic shock and cause organs to fail, which can cause death. Patients may need other tests or treatments depending on symptoms; these can include treatment in an intensive care unit, being put on a ventilator, surgery to remove areas of infection and a stay in hospital for several weeks.

    Most people make a full recovery from sepsis. But it can take time. Physical and emotional symptoms may continue for months, or even years, after a person has had sepsis. These long-term effects are called post-sepsis syndrome and can include feeling tired and weak, lack of appetite, picking up illnesses more often, changes in mood, flashbacks and PTSD.

    STAPH INFECTIONS

    A painful red lump or bump on the skin

  • Is it Contagious? YES
  • Could it be life-threatening? YES
  • Staph infections are caused by bacteria called staphylococcus.

    Symptoms include a painful red lump or bump on the skin, hot, red or swollen skin, sore, crusts, blistering and red or sore eyelids. The infection tends to go away on its own but can sometimes need antibiotics.

    The bacteria that cause staph infections live harmlessly on many people's skin, often in the nose, armpits, groin and buttocks. They usually only cause an infection if they get into the skin – for example, through a bite or cut.

    The NHS says the bacteria can spread through close skin contact, sharing towels and toothbrushes and less common, through droplets in coughs and sneezes.

    MRSA

    Red and swollen patch of skin, which leaks pus of liquid. Warm to touch.

  • Is it contagious? YES
  • Could it be life-threatening? YES
  • MRSA is a type of bacteria that usually lives harmlessly on the skin, but if it gets inside the body, it can cause a serious infection that needs immediate treatment with antibiotics.

    Most people the bacteria on their skin do not have any symptoms, but if you get an MRSA infection under your skin, you may have an area of skin that is painful and swollen, feels warm when you touch it, leaks pus or looks red.

    The infection can spread to your blood, lungs, or other parts of your body, which causes symptoms that include high temperature, difficulty breathing, chills, dizziness and confusion. MRSA will only cause an infection if it spreads inside the body, as it lives harmlessly on the skin and mainly spreads through touch.

    This can also happen if you touch a person with MRSA, or something they've touched.

    PITYRIASIS VERSICOLOR

    May be darker or lighter than your normal skin colour, main discolouration may be red, brown or pink

  • Is it contagious? NO
  • Could it be life-threatening? NO
  • Pityriasis versicolor, also known as tinea versicolor is a common fungal skin infection. The condition is caused by a type of fungus that lives on the skin.

    With most people carrying this fungus on their skin without it causing problems, it can something grow and spread more than usual. It's not always clear why this happens. The NHS has suggested that it's not caused by not washing your skin and most people who have it are otherwise healthy.

    MENINGITIS

    A rash which starts with small, red pinpricks before spreading quickly and turning into red or purple blotches.

  • Is it contagious? YES
  • Could it be life-threatening? YES
  • Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). The infection can be very serious if not treated quickly. It can affect anyone, but is most common in babies, young children, teenagers and young adults.

    With the effects of meningitis developing suddenly it is important to be aware of symptoms, which include a high temperature, sickness, headaches, a rash that does not fade when a glass if rolled over it, a stiff neck, dislike to bright lights, drowsiness and seizures.

    Meningitis is usually caused by a bacterial or viral infection. Bacterial meningitis is rarer but more serious than viral meningitis. Infections that cause meningitis can be spread through sneezing, coughing and kissing.

    Meningitis is usually caught from people who carry these viruses or bacteria in their nose or throat but are not ill themselves. It can also be caught from someone with meningitis, but this is less common.

    Bacterial meningitis usually needs to be treated in hospital for at least a week while viral meningitis tends to get better on its own within seven to 10 days and can often be treated at home.

    CELLULITIS

    Red, Hot & Swollen

  • Is it contagious? NO
  • Could it be life-threatening? NO
  • Cellulitis is a skin infection that's treated with antibiotics. It can be serious if it's not treated quickly. The condition makes skin feel painful, hot and swollen. Skin may also be blistered, and well creating painful glands.

    MOLLUSCUM CONTAGIOSUM

    2 to 5mm wide spots usually appear together. They are raised and dome-shaped with a shiny white dimple in the middle.

  • Is it contagious? YES
  • Could it be life-threatening? NO
  • Molluscum contagiosum is an infection that causes spots on the skin. It is usually harmless and rarely needs treatment. The spots caused by molluscum contagiosum are usually harmless and should clear up within 18 months without needing treatment.

    The condition is usually passed on by direct skin-to-skin contact, however the chance of passing it on to other people during normal activities is so small that normal day-to- day activities can continue.


    What To Know About Necrotizing Cellulitis

    Necrotizing cellulitis is a type of bacterial skin infection that can spread and destroy the skin and underlying tissues. It is a medical emergency as it can progress rapidly and lead to severe complications.

    The speed of progression can vary depending on a person's health, the type of bacteria involved, and the timeliness of medical intervention.

    This article looks at the symptoms of necrotizing cellulitis, its causes, and its treatment options. It also examines a person's outlook and when to contact a doctor.

    Necrotizing cellulitis, also known as gangrenous cellulitis, is a severe form of cellulitis. Cellulitis is a bacterial infection of the skin and the soft tissues underneath.

    Necrotizing cellulitis is a type of necrotizing soft-tissue infection (NSTI). When the infection spreads rapidly, it can cause tissue death within the soft tissues and the skin, called necrosis.

    The appearance of necrotic skin can vary depending on the cause and stage of the necrosis.

    Early symptoms of necrotizing cellulitis include:

  • fever
  • severe pain
  • warmth and thickening of the area of affected skin
  • As the infection progresses, a person may experience the following in their skin:

  • Color changes: The skin may turn shades of red, black, brown, purple, or blue. A purple color indicates a later stage of the condition.
  • Texture changes: The affected skin may become hard, leathery, or flaky. It might also feel thickened or firm to the touch.
  • Blisters or ulcers: Blisters, ulcers, or open sores may develop on the necrotic skin.
  • Surrounding inflammation: The area around the necrotic tissue might be inflamed or swollen.
  • Fluid discharge: There may be discharge or weeping from the area, particularly if an infection is involved.
  • During the late stages of the infection, a person can also experience:

  • low blood pressure
  • a rapid heart rate
  • changes in levels of alertness
  • Necrotizing cellulitis results from bacteria that invade the skin, usually through a break in the skin or a wound.

    It often develops due to Group A Streptococcus or Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA) species of bacteria.

    It can enter the body in the following ways:

  • Cuts and abrasions: Even minor skin injuries can provide an entry point for bacteria.
  • Surgical wounds: Postoperative wounds can become sites of infection.
  • Insect bites: Bites can break the skin and introduce bacteria.
  • Ulcers: Chronic skin ulcers, such as diabetic ulcers, are potential entry sites.
  • A person may have an increased chance of developing necrotizing cellulitis if they have a condition that makes it easier for bacteria to enter the body or a condition that weakens the immune system.

    Conditions that increase a person's risk include:

  • skin conditions such as Athlete's foot or eczema
  • obesity
  • chronic conditions, including diabetes, HIV, liver disease, and kidney disease
  • Certain medications that weaken the immune system can also increase the risk, including:

  • chemotherapy
  • corticosteroids
  • medications to help prevent the body from rejecting an organ transplant
  • Diagnosing necrotizing cellulitis typically involves a combination of clinical evaluation and laboratory tests.

    The doctor will ask about symptoms, onset, any recent injuries or surgeries, and underlying health conditions. They will also perform a thorough examination of the affected area can assess the severity of the infection, the extent of skin involvement, and signs of tissue necrosis

    The diagnostic process helps to distinguish it from other conditions, such as less severe forms of cellulitis or more severe conditions like necrotizing fasciitis.

    People are usually admitted to the hospital for close monitoring and treatment. In severe cases, care in an intensive care unit (ICU) may be necessary, especially if there are signs of systemic infection or sepsis.

    The treatment of necrotizing cellulitis is a medical emergency and requires immediate and aggressive intervention to manage the infection, prevent further tissue damage, and address systemic effects.

    Treatment typically involves a combination of the following methods:

  • Intravenous (IV) antibiotics: High-dose IV antibiotics are started when necrotizing cellulitis is suspected, even before laboratory test results are available.
  • Broad-spectrum antibiotics: Initial treatment often involves broad-spectrum antibiotics to cover a range of possible bacteria. Once culture results are available, antibiotic treatment may be adjusted to target the specific bacteria causing the infection.
  • Debridement: Surgical removal of dead tissue, called debridement, is often necessary to prevent the spread of the infection.
  • The sooner treatment is started, the better the chances of recovery.

    Without prompt treatment, necrotizing cellulitis can lead to extensive tissue damage and other complications, such as blood infection, sepsis, and bone tissue infection.

    Necrotizing cellulitis is a serious condition that can lead to several potential complications without prompt treatment.

    These complications can range from local effects on the skin and soft tissues to systemic, potentially life threatening issues. Some of the key potential complications include:

  • sepsis
  • necrotizing fasciitis
  • gangrene
  • chronic wound or ulcer formation
  • scarring and disfigurement
  • limb loss
  • organ failure
  • immune system overload
  • recurrent infections
  • Preventing necrotizing cellulitis involves reducing the chance of bacterial skin infections and managing any existing conditions that could increase susceptibility.

    To prevent necrotizing cellulitis, it is important to prevent cellulitis. To do this, a person should practice the following measures:

  • cleanse any cuts, scraps, or wounds immediately with soap and water
  • apply an antibiotic ointment and cover the wound with a clean bandage
  • maintain good personal hygiene, including regular handwashing
  • monitor any wounds for signs of infection
  • It is also important for a person to follow the doctor's advice and take any prescribed medications to help manage conditions such as diabetes.

    Due to its rapid progression, anyone who suspects they have cellulitis should seek medical attention.

    Prompt treatment, typically involving intravenous (IV) antibiotics and possibly surgical intervention, is essential for a better outcome.

    Necrotizing cellulitis is a type of bacterial skin infection affecting the skin and underlying tissues.

    It is a medical emergency as it can progress rapidly and can result in severe complications.

    Treatment might involve removing the dead tissue, treating any infection, and addressing any underlying health issues that led to the necrosis.






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