MRSA: Is it another sexually transmitted disease?

By T. Douglas Gurley, MD

I’m at the gym riding my stationary bike and feel soreness on my testicles.

The pain is getting worse as the movement aggravates the discomfort in this area. I become alarmed and finish my workout early. In the shower I am shocked to see a red, tender, swollen area on my sack.

Of course, I panic about what could be the cause. I immediately recall hooking up with that guy a week ago.

My gut instinct told me not to trust this guy, but of course I had sex with him anyway. D/d free my ass! But I used a condom, I tell myself. However, this does not resolve my fears that I’ve contracted an STD from him.

Without a second thought, I set up an appointment with my doctor for the next day. After a brief exam, my doctor states that I most likely have contracted MRSA, or methicillin-resistant Staphylococcus aureus.

He tells me that Staphylococcus aureus, commonly known as “staph,” is bacteria commonly carried on the skin, rectum or nose of healthy people without causing any disease. Sometimes the bacteria don’t cause any problems.

But sometimes it can cause infections. Infection usually arises when some type of skin injury occurs. It typically causes a pimple or a boil but can cause more serious infections.

Staph infections can be easily treated with common antibiotics. However, when the staph becomes resistant to common penicillin antibiotics, it’s called MRSA.

I’m still wondering: How did I get this infection? I reluctantly confess to the doctor about having casual sex a week ago, feeling sure this had to be the cause.

But my physician begins asking me a lot more questions, interested that I frequent the gym three to four times a week, use the sauna after most workouts – and regularly shave my testicles.

I want to ask, Don’t you shave yours? But I refrain. He also asks if I’ve been to a bathhouse or used crystal meth. I said no; well, it had been more than a month ago on a business trip that I stumbled upon that bathhouse in Toronto.

I ask my doctor why he is curious about all of these activities.

He informs me that, during the past 20 years, MRSA has been mostly limited to patients in hospitals or nursing homes. However, recently it has appeared outside this setting. Although it is not an exclusive MSM (men having sex with men) disease, it is commonly affecting gay men.

I learn that MRSA is contracted through direct or indirect physical contact and not through the air. Although not a sexually transmitted disease, I could have contracted MRSA through skin-to-skin contact during sex, and skin-to-skin contact appears to be the most likely way to get the infection. I know I got it from him, I think to myself.

But MRSA can also be contracted by touching objects contaminated by someone else’s infected skin. The most likely objects: Towels and sheets at gyms or bathhouses, benches around whirlpools and in saunas and on sport equipment. So that is why my doctor needed to ask me those questions.

He tells me he has seen an increase among crystal meth users in his practice, again, likely because of spread of the disease by skin contact, sexual activity and shared needles.

I then ask my doctor how MRSA can be treated. He tells me that, while MRSA can’t be treated with standard antibiotics, it usually can be treated with oral medication – Bactrim being most common.

He obtains a culture by swabbing the lesion to make sure the medication will be effective in treating the infection. He tells me that, had I waited any longer before coming in, he most likely would’ve needed to drain the lesion and that, rarely, hospitalization is required.

I learn that MRSA is much more likely to cause disease when there is some compromise to the skin, with this commonly being caused by shaving body parts which can cause micro abrasions. Ah, shaving my balls! Also, dry/cracked skin is compromised, which is common in the winter.

My doctor informs me that I can protect myself from infections by practicing good hygiene.

He reminds me that I can have totally safe sex and still get this disease. He applauds me for using condoms! But he wants to know a few more details about my sexual experience. Oh, boy, I thought confessions were over!

He asks me if I took a shower after I had sex last week. I told him that only a warm, wet washcloth was provided to have a quick clean-up and then I went straight to the gym to meet my workout partner. He told me to be sure to wash my hands, body, and genitals thoroughly with soap and water after I have casual sex.

And at the gym it is impossible to prevent all exposure from sports equipment.

He told me to take my own towel to the gym, to take a shower after working out and to keep any abrasions or cuts bandaged or covered. If I’m sitting on a bench in a sauna or around a whirlpool, I should be sure to sit on my towel.

Maybe that was the cause. I did follow that cute guy that was eying me into the sauna and sat on the bench without my towel. But I kept that to myself. The Doctor told me to wash my gym clothes and towel after each workout and that the same principles apply if you frequent bathhouses.

If my skin gets dry and cracked during winter months, he reminded me to use moisturizer and take tub baths to hydrate my skin.

He told me, since I have an active staph infection, I could prevent spreading by keeping the wound bandaged or covered and washing my hands frequently with soap and warm water, especially after touching the infected area.

After a week of taking medication, I woke up and noticed my sore was completely resolved. I packed my clean towel and workout clothes and headed straight to the gym.

If you do get signs of a staph infection, see your doctor as soon as possible.

T. Douglas Gurley is an Internal Medicine physician focusing on gay men’s healthcare. He can be reached at 404-888-0228. Information from Dr. Gurley is provided for educational purposes. Always consult your healthcare provider for specific advice or treatment. www.tdouglasgurleymd.com

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