Content

• What is Staphylococcus aureus or Staph?
• What medications are used to treat staph skin and wound infections?
• What will a staph or MRSA infection look like?
• What should I do if I think I have a staph or MRSA infection?
• How can I prevent staph or MRSA skin infections from spreading?
• I am pregnant and have a staph or MRSA skin infection. Will it harm the baby?
• I am pregnant and I have a staph infection. Is there a safe treatment?
• I am breastfeeding. Can I take antibiotics for a staph or MRSA infection?
• Can my breastfed baby get a staph or MRSA infection from me?
• What if I am pregnant or a nursing mother and I have MRSA or have been in contact with someone who has MRSA?
• Should I limit contact by anyone who has MRSA with me or my baby?
• Other useful sources of information
• References

What is Staphylococcus aureus or Staph?

Staphylococcus aureus (staph) is a type of bacteria (germ) found on the skin or in the nose. Most of the time, people will not have problems with these bacteria, and people who have been screened or tested before having surgery are said to be 'colonised' if they have been found to have staph on their skin or in their nose. Being colonised means the germ causes no harm. However, if staph gets inside the body through a cut or sore, it may cause painful boils or abscesses on the skin or infection in the lungs (pneumonia), bloodstream, or in a wound that is healing after surgery.

People who are more vulnerable to staph infections include people who are already unwell, such as recovering from surgeries or other medical procedures, people with long-term conditions such as diabetes, and people who have had a staph infection before. Around 30% of the population are carriers of Staphylococcus aureus. When skin breaks occur, such as cuts or sores, this organism may take the opportunity to enter the body and cause skin infection, which can result in painful boils or abscesses or infection in the lungs.

What medications are used to treat staph skin and wound infections?

Draining of abscesses by your doctor may be the only treatment needed for staph skin infections. Other deeper wound infections may need medication. If medication is needed, antibiotics are used. Some of the antibiotics used to treat staph infections include meticillin, penicillin, oxacillin, and amoxicillin. In some cases, the staph bacteria do not respond to these kinds of antibiotics. This is known as 'Meticillin resistance to Staphylococcus aureus' or 'MRSA'. Other medications are available for treatment in this situation.

What will a staph or MRSA infection look like?

Staph bacterial infections, including MRSA, can look like a pimple or a boil and can be red, swollen and have pus or other liquids coming out of the sore.

What should I do if I think I have a staph or MRSA infection?

See your doctor. Tests will determine if the infection is staph or MRSA and allow the doctor to prescribe the correct antibiotics. If you are given an antibiotic, it is very important to follow the instructions and use all of the medication for the time indicated, even if the infection is getting better. Do not share your medicine with other people and do not save your medicine to use at another time. If the infection does not get better in a few days, or it gets worse, tell your health care provider right away.

How can I prevent staph or MRSA skin infections from spreading?

Practice good hygiene particularly focusing on cleaning hands: Wash your hands often with soap and water, especially after using the toilet, handling money, preparing food, or changing nappies. Regular use of anti-bacterial soap may be helpful. Clean any cuts or scrapes and cover with a bandage until a scab forms. Don't touch other people's cuts or their bandages. If you are caring for someone vulnerable or visiting someone in hospital you will be asked to use a hand sanitiser (usually an alcohol gel) which helps to remove the bacteria from your hands.

I am pregnant and have a staph or MRSA skin infection. Will it harm the baby?

While staph or MRSA infections are not well studied during pregnancy, it is important to know that serious infections in babies caused by MRSA are rare and if baby were to develop an MRSA infection it can be treated. These infections have not been linked to causing birth defects. There have also been no reports of this infection causing miscarriage. Any infection can make it easier for you to catch other infections, so treating the staph infection will help you have a healthier pregnancy.

I am pregnant and I have a staph infection. Is there a safe treatment?

Yes. Many types of antibiotics can be used to treat symptoms during pregnancy. If needed, an antibiotic in the class of penicillin may be prescribed. Studies looking at use of a penicillin or penicillin derivative during pregnancy show that these antibiotics do not appear to cause birth defects or any other problems during pregnancy.

Some people are allergic to penicillins and should not take penicillin or antibiotics derived from penicillin such as meticillin. You might be allergic if you start taking the antibiotic and get a rash or diarrhoea. If these or other side effects happen after taking an antibiotic, contact your doctor as soon as possible.

I am breastfeeding. Can I take antibiotics for a staph or MRSA infection?

Yes. Most breastfed babies do not have problems when their mothers take antibiotics. However, some babies can have an allergy to the drug. If your baby develops a rash or if there is a change in the baby's stools, call the doctor right away. You may need to take a different antibiotic to treat the skin infection if your baby is allergic.

Can my breastfed baby get a staph or MRSA infection from me?

It is possible that a staph infection may spread from mother to baby, or from baby to mother, during breastfeeding. As mentioned, individuals can carry Staphylococcus aureus in their nasal passage. Because of this, if your newborn has staph in his nasal passage, you may be at increased risk to develop mastitis (breast infection), particularly if you have some nipple damage.

Additionally, there are some reports of infants getting a staph or MRSA infection through expressed (pumped) breast milk that was contaminated. Therefore, it is important to thoroughly wash and sterilise pumping equipment and storage containers, as well as your hands when pumping breast milk.

What if I am pregnant or a nursing mother and I have MRSA or have been in contact with someone who has MRSA?

Guidance issued by the Department of Health is that if you are pregnant, and fit and healthy, there are no additional risks from MRSA.

Breastfeeding is safe for you and your baby. However, in common with the usual advice given to breastfeeding mothers, if you notice certain symptoms, you should contact your GP, midwife or health visitor for advice. These include:
- painful breasts
- red patches or a sense of 'lumpiness' around the breasts
- flu-like symptoms, including a temperature

These symptoms indicate that you may have mastitis but this may or may not be MRSA. It is important that you tell your healthcare professional that you have or have had MRSA so that they can treat you appropriately. You can usually continue to breastfeed a healthy term baby in the community, unless you have been told not to breastfeed until any antibiotic therapy is complete. If baby is in neonatal care and at significant risk of developing an invasive MRSA infection, consider withholding breast milk until the MRSA mastitis has cleared up. Risk factors include IV catheters, ventilation, recent surgery or a low immune system.

Should I limit contact by anyone who has MRSA with me or my baby?

MRSA exists throughout the community. It is more common in hospitals and care homes where people are having medical procedures and are being cared for. Mostly the germ will not cause harm to you or your baby unless it gains entry to the body via a break in the skin. Normal social contact such as holding hands or hugging does not usually present a risk.

People with breaks in their skin such as a sore or surgical wound, or those who have medical tubes in place, should keep them covered with a dressing to limit the risk of the germ getting into the body. They should also be sure to wash their hands before and after changing their dressings or touching their wounds. This is because germs are most commonly passed on from the hands. This is why your doctor or midwife will be asking to wash their hands when they come to visit you at home when you have had your baby. Healthcare staff should always wash their hands before they care for you or your baby, whether at home or in the hospital, and whether you have an infection or not.

Any risks by contact with a person who has staph or MRSA can be mitigated with basic precautions:
- Don't share towels, soap, razors, or other personal items.
- If you need to wash the person's laundry, rubber gloves should be used to handle his or her clothes and bedding. Wash any clothing that has been next to the skin, such as underwear, bedding and towels separately from the family's laundry.
- Don't touch the person's sores, cuts or bandages.
- Wash your hands with soap and water after direct contact with anyone who has any skin infection.

If you have any doubts then speak to your midwife or doctor.

This information does not replace qualified medical care, if you think you may have a problem with an infection please seek immediate medical advice from your doctor or midwife.



Other useful sources of information:

NHS Choices information about mastitis and breastfeeding

NHS Choices information about MRSA and pregnancy

References

Advice for those affected by MRSA outside of hospital, Department of Health 2008

Briggs G. 2005. Drugs in Pregnancy and Lactation, a reference guide to fetal and neonatal risk. 7th Ed. Baltimore, MD: Williams & Williams

Gastelum DT, et al. 2005. Transmission of community-associated methicillin-resistant Staphylococcus aureus from breast milk in the neonatal intensive care unit. Pediatr Infect Dis J. 24(12):1122-1124

Kawada M, et al. 2003. Transmission of Staphylococcus aureus between healthy, lactating mothers and their infants by breastfeeding. J Hum Lact 19(4):411-417

Laibl V, et al. 2005. Clinical Presentation of Community-Acquired Methicillin-Resistant Staphylococcus aureus in Pregnancy. Obstet Gynecol 106 (3):461-5

Bloomfield SF, Exner M, Signorelli C, et al (2011). The infection risks associated with clothing and household linens in home and everyday life settings, and the role of laundry

Amir LH, et al. 2006. A case-control study of mastitis: nasal carriage of Staphylococcus aureus. BMC Family Practice 7:57

Behari P, et al. 2004. Transmission of methicillin-resistant Staphylococcus aureus to preterm infants through breast milk. Infect Control Hosp Epidemiol 25(9):778-780

National Institute for Health and Clinical Excellence: Prevention and control of healthcare-associated infections quality improvement guide [PH36]:- Published date: November 2011

Infection: prevention and control of healthcare-associated infections in primary and community care - NICE Clinical guidelines, CG139 - Issued: March 2012

National Institute for Health and Care Excellence (NICE): Infection Control Quality Standard [QS61]: - Published date: April 2014

National Institute for Health and Care Excellence (NICE) quality standard [QS113]: Healthcare-associated infections - Published date: February 2016 - Information resource added 17 February 2016

Prevention and control Methicillin-Resistant Staphylococcus aureus (MRSA). National Clinical Guideline No. 2 (Health Protection Surveillance Centre, Ireland 2013)

Content written 09/08/2021

Review due 09/08/2024

(c) MRSA Action UK 2021