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Impetigo Skin Infection


In this chapter which is dedicated to MRSA symptoms intention will be to describe impetigo as one of most common MRSA symptoms. This very contagious infection commonly develops blisters or sores on the patient's facial area, neck, hands and diaper area. It is important to say that impetigo is recognized like one of most common skin infection among kids (in most cases are infected youngsters between 2 and 6 years old). Staphylococcus aureus and Streptococcus group A bacteria are most common strains that cause impetigo infection, mostly at preschool and school-age children. Youngsters may be more likely to develop this type of infection if the skin has already been irritated by other skin problems or traumas, such as poison ivy, eczema or insect bite. Regular hygiene can help to prevent this infection, which mostly develops when there is a sore or rash that has been scratched repetitively (impetigo may develop from poison ivy). Impetigo is generally treated with an antibiotic cream or oral medications.

As we previously said impetigo can appear on any part of body, but most common can be found on the nasal area, mouth, on hands and forearms and diaper area in youngest. We may recognize two tapes of this infection: bullous impetigo ( large blisters) and non-bullous impetigo (crusted type). Second type (non-bullous) is more common than first type. Both types are caused mostly by Staph aureus bacteria but can also be induced by Strep group A germ. Non-bullous impetigo starts as tiny blisters. They eventually burst and leave small wet patches of red skin that may weep fluid. Bit by bit, a tan or yellowfish-brown crust covers the affected region, making it look like it has been coated with brown sugar or honey. Bullous type of impetigo infection is almost always caused by Staph aureus bacteria, which triggers larger fluid-containing blisters that can appear clear, then cloudy. Blisters are more probably to remain whole on the skin without breaking.

Impetigo infection in some cases may itch and children can spread the infection by scratching it and then reaching other body parts. This type of infection is contagious and have ability to spread to anyone who comes into contact with infected skin or other items, such as towels, clothing, and bed linens, that have been touched by infected skin.

In case that is affected only a small part of skin tissue, impetigo can ordinarily be processed with an antibiotic ointment. But if the impetigo has spread to other areas of patient's organic structure, or the antibiotic cream isn't working, medical practitioner may advise an antibiotic pill or liquid. From the moment when antibiotic treatment starts, recovering should be viewable inside a few days. It is fundamental to make sure that your child takes the antibiotics as the doctor has prescribed. If that doesn't happen, there is a possibility of developing a deeper and more serious skin infections. Note: during the impetigo is healing, gently wash the areas of infected area of skin with clean gauze and antiseptic soap every day. Soak any parts of crusted skin in warm soapy water to help remove the layers of crust. To prevent spreading impetigo to other body parts, GP will probably recommend covering infected areas of skin with gauze and tape or a loose plastic bandage. Also, it is important to keep fingernails short and clean.


Impetigo and MRSA


Impetigo is most commonly caused by a bacterium called Streptococcus group A, but over the time significantly increasingly, impetigo is caused by MRSA; CA-MRSA now accounts for 7-20% of impetigo infections (Cohen PR,Int. J. Dermatol. 2007 Jan;46(1):1-11). Impetigo caused by Streptococcus and CA-MRSA look same.

Definition of impetigo and connection with MRSA infection - Impetigo is defined as a skin infection caused by Staphylococcus aureus or Streptococcus group A bacteria. This type of infection typically affects young children (mostly between 2 and 6 years old), most frequently during the hot and humid summer months. This infection has a preference for skin that has already been injured by other skin problems or minor traumas, such as eczema or poison ivy. A potentially more serious germ of the bacterium Staphylococcus aureus has emerged in recent years that develops immunity to beta lactam antibiotics - we are talking about Methicillin-resistant Staphylococcus aureus or MRSA . Community associated MRSA (CA- MRSA) will be discussed with impetigo skin infection, but they are clinically distinct entities.

Symptoms of impetigo and MRSA - Impetigo can occur skin anywhere on the organic structure, but mostly appears on facial area of skin. It causes itchy skin with tiny blisters particularly around the mouth and nose. Blisters will eventually burst to reveal areas of red skin that may weep fluid. Step by step, a tan or yellowish-brown crust will cover the affected skin region. Community–associated MRSA usually presents as pimples, boils or abscesses. Sometimes they may be painful and may be misdiagnosed as a insect bite. School personnel will generally only know that a student is infected with MRSA if given the diagnosis by a health care provider as it may be difficult to distinguish from other common skin infections. Incubation and contagious period for impetigo - Incubation - Skin sores develop in 7 to 10 days after bacteria enter to the skin.
Contagion - Until the skin sores are handled with antibiotics for minimum 24 hours or the crusting lesions are no longer present.
How does infection with impetigo occur? - Impetigo (and MRSA) can be passed from individual to individual. When someone in a household has impetigo, the infection can be passed to other house members on clothing, towels, and bed linens that have touched the infected person’s skin. Impetigo can also be spread from one area of the skin to another by scratching. On the face, the infection usually spreads along the edges of an affected area, but it may also spread to more distant parts of the body on contaminated fingers.

Prevention tips- Good general hygiene practices, such as a daily bathing with soap and water can help prevent impetigo infection. Areas of skin that have been injured should be kept clean and covered. Covering sores withgauze, loosely to allow airflow, can help prevent spreading the bacteria in group settings. If a family member is infected, all family members should use different towels.

Treatment facts for impetigo and MRSA - Impetigo is usually treated with antibiotics, which may be given by the mouth. In very mild cases, a topical antibiotic may be used. Community-associated MRSA is best treated with good wound care (incision and drainage by health care provider), coverage with a clean, dry bandage, and in some cases antibiotics (to which the organism is susceptible).

Exclusion from school & readmission - Absence from school or kindergarten is necessary measure as soon as impetigo is suspected. If the family is unable to pick up the child promptly, wash affected area with soap and water and cover it with a clean, dry bandage. Exclusion for MRSA is only recommended if the student is unable to cover skin lesion and control body fluids. Readmission is generally advised after 24 hours of appropriate (antibiotic) treatment for impetigo or when lesions are healed, with permission of school principal or other authorized personnel.


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