How to Avoid Recurrent Boils
Tips on Managing the Carrier State of Staphylococcus Aureus
Jan 10, 2009
Some individuals are prone to develop recurrent boils, also known as furunculosis, every now and then. There are many reasons for repeated infections with Staphylococcus aureus, the causative bacteria for boils or abscesses, the main being the carriage state of the bacteria in different parts of the body.
What is the Carrier or Carriage State of Staphylococcus Aureus?
Carriage or carrier state of staphylococcus aureus implies the resident state of the bacteria in certain body parts, particularly inside the nasal opening, the perineum (groin, peri-anal area and the intragluteal cleft in between the buttocks), the armpits, and toe webs. The surrounding skin of healed boils was found to carry the bacteria for months in many patients.
Studies have revealed that 20% of normal individuals are persistent nasal carriers, 60% intermittent carriers and the other 20% resistant to the carriage state of staph. A genetic factor involving bacterial adherence to the skin and mucosa and immune responses has been cited as reasons for these differences. Whites have higher carrier state of the bacteria than blacks. Patients with atopic eczema and phenylketonuria are known to have higher than normal rate of the carrier state of the staphylococcus.-
What are the Reasons for Recurrent Boils?
- A genetic predisposition to the carriage state of the staphylococcus aureus as described above.
- Carrier state of the staph in other family members or colleagues
- Transfer of the staph from carrier sites to the skin.
- Poor hygiene.
- Over Crowding.
- Malnutrition.
- Obesity.
- Hospital based (nosocomial) infections.
- Development of resistant strains like MRSA (Methicillin Resistant Staphylococcus Aureus), which are not eliminated by normal antibiotics.
- Manual jobs involving sweating, long distance driving etc.
- Resistance to staph infection caused by low immunity in patients with poorly controlled diabetes, HIV infection, renal insufficiency, blood cancers, malnutrition, alcoholism, and in those who receive medications like corticosteroids or other immune suppressive drugs.
- Diseases like atopic eczema, Chediak-Higashi syndrome, chronic granulomatous disease, Job’s syndrome, hyper IgE syndrome, cyclical neutropenia and Wiskott-Aldrich syndrome, where immune functions are lowered, reducing the body’s resistance to bacterial infections including that of staphylococcus.
- Treatment with retinoids predisposes the patients to increased susceptibility to the staphylococcus aureus by compromising the skin barrier function.
Tips on Managing the Carrier State of Staphylococcus Aureus.
- Managing the carrier state of S.aureus involves finding and managing thespecific causes for the carrier state. It is not possible to get rid of carrier state permanently, but in those with risk factors and recurrent attacks of boils or abscesses, the following will reduce the carrier state of the staph.
- Regular, long term application of chlorhexidine cream or antibiotic creams like mupirocin or fusidic acid to the carrier sites like nose and body folds. In a study, mupirocin applied inside the nasal opening eliminated S.aureus after a 5 day course in all patients and 50% were free of the bacteria after 5 months.
- Use chlorhexidine or povidone iodine skin cleansers during daily baths.
- For severe infections and recurrences, oral antibiotics like oral Rifampicin or low dose Clindamycin help in clearing the resident bacteria for a few months. Rifampicin, 600 mg daily for 7-10 days cleared the bacteria for more than 3 months in 80% of the patients. Clindamycin, 150 mg daily for 3 months also provided prolonged protection from the carrier state.
Having reviewed how to avoid recurrent boils and the tips on managing the carrier state of S.aureus, let us now examine how to manage recurrent boils. You may also be interested in-“Can Boils be Treated at Home?”
Reference
Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
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