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Methicillin-resistant Staphylococcus aureus (MRSA) is rapidly growing infection which originated as a mutation from a common bacterium (Lippincott Williams & Wilkins, 2013). MRSA is typically acquired through direct contact with person to person. However, there has been an increased number of community attained cases. It is suspected that the majority of community-acquired cases are the result of close contacts, such as athletes (wrestling) or bacteria contact with open wounds. One of the most challenging aspects of the treatment of MRSA is that it is highly resistant to the most common antibiotics such as penicillin and methicillin.

Signs of MRSA originate with a centralized skin infection that resembles pimples, bites and boils. Typically, these initially small bumps will become abscesses and deep infections. The infections bacteria will either stay localized on the skin or can transmit to joins, bones, and other organs. When these events happen, MRSA can become life threatening.

Hygiene such as handwashing and cleaning with antiseptic soaps are critical and reducing the risk of spreading. With the increased number of community-acquired MRSA cases, it is important for behavioral health consultants to educate patients on the risks and problem solve ways to reduce contact with others or items that could be contaminated. Behavioral Health Consultants should also evaluate for potential obsessive-compulsive features with patients who may have MRSA. The Diagnostic and Statistical Manual of Mental Health (DSM5) recently added the condition of Excoriation, also known as skin picking disorder (Hao, Nakamura, Farahinik, Abrouk, Reichenberg & Bhatani, 2016). Often the site of the infection can be painful or uncomfortable that drives the patient to want to itch or scratch the site. This behavior may lead to increased irritation and spread of the bacteria. Behavioral Health Consultants can support patients through direct coaching of mindfulness activities, difusion, and other interventions to ensure that engagement in compulsive scratching is avoided.

References

Hao Zhu, T, Nakamura, M., Farahinik B., Abrouk, M, Reichenberg, J., Bhatani, T. (2016). Obsessive-compulsive skin disorders: a novel classification based on degree of insight. Journal of Dermatological Treatment P 1-5.

Lippincott, Williams & Wilkins. (2013). Infectious Disorders. Pathophysiology made incredibly easy (5th ed.). Philadelphia, PA: Wolters Kluwer Health.

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