Methicillin-resistant Staphylococcus aureus (MRSA)

About This Disease

Staphylococcus aureus, often called “staph” are bacteria commonly found on the skin or in the nose of healthy people. If the bacteria enter the skin through a cut or scrape, the wound can become infected. Staph bacteria are one of the most common causes of skin infections in the US. Most staph skin infections are minor and can be treated without medicines. However, staph bacteria can also cause more serious infections when they invade deeper tissues, the bloodstream or the lungs, causing pneumonia.

Some staph bacteria do not respond to medicines. MRSA is a type of staph that is resistant to medicines such as penicillin and amoxicillin.

Signs and Symptoms

Staph bacteria, including MRSA, can cause skin infections that may look like a pimple or boil, and can be red, swollen, painful, or have pus or other drainage. More serious infections may cause pneumonia, bloodstream infections or surgical wound infections.


Staph is spread through skin to skin contact and from direct contact with contaminated surfaces. Athletes, especially wrestlers and football players, are at high risk of skin infections from staph. Staph lives in salt water, and swimming or surfing with broken skin can cause infection. In a healthcare facility MRSA is usually spread by direct contact with an infected wound or from contaminated hands.

Many people are also infected with the bacteria from their own skin or noses.


The only way to know if MRSA is the cause of an infection is to perform a laboratory culture of the bacteria. Obtaining bacteria to culture is a procedure done by a doctor or nurse.


Most staph infections are treatable with medications prescribed by a doctor. MRSA infections can be treated by draining the wound. If the infection is not getting better with treatment, contact your doctor again, as the bacteria could be resistant to the medicine.


Currently, there is no immunity for MRSA.

Risk in Hawaii

Anyone can get MRSA on their body from contact with an infected wound or by sharing personal items, such as towels or razors, that have touched infected skin. MRSA infection risk can be increased when a person is in activities or places that involve crowding, skin-to-skin contact, and shared equipment or supplies. People including athletes, daycare and school students, military personnel in barracks, and those who recently received inpatient medical care are at higher risk.

In healthcare facilities such as hospitals and nursing homes, patients most likely to get an MRSA infection are those with other health conditions making them sick. Also, hospital or nursing home patients who have been treated with antibiotics, have wounds or invasive medical devices such as catheters are more likely to get an infection.

The Department of Health prepares an annual report on specific healthcare-associated infections from select hospitals, which is available here. The Department of Health tracks cases of MRSA bloodstream infections that are acquired from a hospital. In 2017, 19 cases of inpatient MRSA bacteremia were reported.


  • Most skin infections can be prevented with good hygiene.
  • Wash your hands thoroughly and often with soap and water, or use a hand sanitizer, especially after changing bandages or touching a wound.
  • Keep cuts and scrapes clean and covered with a bandage until healed.
  • Avoid contact with other people’s wounds.
  • Don’t share personal items such as towels washcloths, razors or clothing that may have had contact with an infected wound.
  • Wash sheets, towels and clothing that have become soiled with water and laundry detergent. Drying clothing in a hot dryer, rather than air-drying, will help kill bacteria in clothing.
  • If you are an athlete, or someone who has frequent skin to skin contact with others, be extra careful with your personal hygiene. To learn more, visit: Prevention Information and Advice for Athletes

Additional Resources

Hawaii State Department of Health MRSA Fact Sheets (PDF) :
English | Chuukese | Ilokano | Japanese | Marshallese | Tagalog



Information for Clinicians


Clinicians play a critical role in slowing the spread of MRSA. Rapidly identifying patients colonized or infected with these organisms and placing them in Contact Precautions when appropriate, using antibiotics wisely, and minimizing device use are all important parts of preventing MRSA transmission.



Last reviewed December 2018