MRSA stands for Methicillin-resistant Staphylococcus aureus (MRSA) and is a bacterial infection that is highly resistant to some antibiotics. In short, antibiotics have been used since the 40’s to stop the growth of bacteria. However, the more antibiotics are used, the quicker the bacteria become resistant to it while each year more types of bacteria adapt and become resistant to antibiotics. With MRSA being so resistant to many of the antibiotics, classifying it as a “super-bug”, it makes treatment of skin infections and invasive internal infections much more complicated. This leads to many yearly deaths.
In fact, MRSA statistics show that more people die each year from MRSA infections than the AIDS virus. Etiology: MRSA is a strain of Staphylococcus aureus bacteria, which is also known as the staph infection. It is also medically known as S. aureus and is a common type of bacteria that normally live on the skin and sometimes in the nasal passages of healthy people. This S. aureus strain does not respond to some of the antibiotics used to treat staph infections. The bacteria can cause infection when they enter the body through a cut, sore, catheter, or breathing tube or simply when it comes into contact with the skin.
The infection can be as minor as a cut or pimple or it can be more serious when it involves the heart or lungs. However, serious staph infections are more common in people with weak immune systems such as the elderly or those who are already sick and hospitalized. MRSA infections are grouped into two types based on their causative factors. In Healthcare-associated MRSA (HA-MRSA) infections, people who are or have recently been in a hospital or health-care facility are affected. A large percentage of hospital-acquired staph infections are related to MRSA bacteria.
On the other hand, Community-associated MRSA (CA-MRSA) infections occur in people who have not recently been in the hospital within the past year. This type of infection has occurred among athletes who share equipment or personal items and children in daycare facilities. Members of the military and those who get tattoos are also at risk. A friend of mine acquired MRSA from a hot tub at a hotel resort while on vacation. This is also why it is important to cover toilet seats while using a public restroom or clean the gym equipment before and after you use it. Page 2 Epidemiology: MRSA has become a growing concern.
Research indicates that this violent bacteria is evolving rapidly and cases even outside healthcare facilities are increasing. As many as 1. 2 million U. S. hospital patients are infected with MRSA each year, which is almost 10 times more than previously estimated. According to the Centers for Disease Control, in the year 2005, MRSA was responsible for an estimated 94,000 invasive life-threatening infections and close to 19,000 deaths. In the US alone, there were an estimated12 million doctor or hospital visits for skin and soft tissue infections suspected to be caused by staph aureus in the year 2003.
The most recent statistics show that 20% of bloodstream infections in hospitals are now caused by MRSA. The common cause for this growing disease is that hospital staff who do not follow proper sanitary procedures transfer the bacteria from patient to patient. Some hospitals screen for MRSA and isolate such patients, but most US hospitals do not yet do this. On the other hand, statistics show that as hospital related MRSA is declining to due to improved precautions, community related MRSA is on the rise.
Until recently, hospitals were the most likely place that people would get MRSA, but now the biggest MRSA health risk is related to community acquired MRSA. According to the Journal of the American Medical Association, CA-MRSA has become the most frequent cause of skin and soft tissue infections in the United States. The CDC reports that in 2007, 14% of people with MRSA infections had CA-MRSA. Pathogenesis: The most common symptoms of MRSA start with a red, swollen, and painful area on the skin. It is advised to recognize these signs and consult a doctor as soon as these symptoms arise.
You should keep an eye on minor skin problems such as pimples, insect bites, cuts and scrapes (especially in children) and see a doctor if the wounds become infected. Other symptoms and signs that the infection is developing include drainage of pus or other fluids from the site, fever, skin abscesses, and warmth around the infected area. Symptoms of more serious MRSA cases that indicate the infection has spread include chest pain, chills, cough, fatigue, general ill feeling (malaise), headache, muscle aches, rash, and shortness of breath.
The risk factors for the two different strains of MRSA differ. In the healthcare associated MRSA, the risk is obviously increased for elderly patients and those who are sick with weakened immune systems. The risk of MRSA is also higher among patients who have an invasive medical device inserted such as IVs and catheters. These provide a pathway for MRSA to get into the body. MRSA is also more prevalent in nursing homes. Carriers of MRSA have the ability to Page 3 spread it even if they’re not sick or show symptoms of infection.
In terms of community acquired MRSA, those at higher risk include people who participate in contact sports since it spreads easily through cuts and abrasions and skin-to-skin contact. Also, are those living in crowded or unsanitary conditions. Outbreaks of MRSA have occurred in military training camps, child care centers, and jails. It is also said that homosexual men are at higher risk of developing MRSA infections. Diagnostic tools and techniques: After a doctor suspects MRSA, they will send a sample of tissue or a culture from the wound area and/or nasal secretion to a lab.
The sample is placed in a dish of nutrients that encourage bacterial growth. It takes about 48 hours for the bacteria to grow in order to screen the results. However, newer tests still in research stages, can detect staph DNA in a matter of hours are now becoming more widely available. These new methods test for a gene that confers resistance to the antibiotics Methicillin, Oxacillin, Nafcillin, and Dicloxacillin and other similar antibiotics. Molecular tests for MRSA screening have the potential to detect nasal or wound carriage within hours instead of days required by culture, which then reduces the risk of MRSA related complications.
If either a culture or a molecular test is positive for MRSA, then the person is diagnosed with MRSA at the site that was tested. There are several conditions that can mimic MRSA before the area is tested for the bacteria. Some of the symptoms associated with MRSA are also associated with a yeast infection, diaper rash, acne, dermatitis, an ingrown hair, and bed sores. Treatment: As stated by the U. S. Centers for Disease Control and Prevention: “First-line treatment for mild abscesses is incision and drainage.
” Doctors will drain the affected hair and/or cut out the skin area that is affected by MRSA. This prevents growth and spread. Fortunately, most MRSA still can also still be treated by certain antibiotics. The CDC also states: “If antibiotic treatment is clinically indicated, it should be guided by the susceptibility profile of the organism. ” When the tests are run to determine that the Staph bacteria isolated from a given patient are Methicillin resistant, these tests also provide information about which antibiotics can successfully kill the bacteria (its susceptibility profile).
” Penicillin was once used as an effective antibiotic treatment against the staph bacteria, but after using it for just a Page 4 decade, half of the staph bacteria became resistant to the antibiotic. Now less than 10% of staph infections will respond to the Penicillin. Today, doctors use Vancomycin, which is a much stronger and more toxic antibiotic. Most moderate to severe infections need to be treated by intravenous antibiotics, usually given in the hospital setting. Prognosis: Since the beginning of 2010, the average adult death rate was about 5% of MRSA infected patients.
A study in 2009 shows that children under 18 years old are at less risk of dying from MRSA. Their mortality rate is currently about 1% of all infected patients. Community acquired MRSA has far less complications than hospital acquired as long as the patient adequately responds to treatment and does not require hospitalization. However, patients with complications generally are at greater risk for a far worse outcome. Complications of MRSA can occur in all organ systems and can lead to permanent organ damage or death. They include kidney or lung infection, heart disease, bone infection, tissue damage, and blood poisoning.
Of course, early diagnosis and treatment usually results in better outcomes and the reduction of further complications. It could take up to several months to recover from MRSA depending how much of the body is infected, complications, and how antibiotics respond. People who are infected are tested until the lab tests come up negative. Preventive Methods: There are several ways to lower a person’s risk of acquiring both hospital and community associated MRSA. In hospitals, people who are detected with MRSA bacteria are often placed in isolation.
Visitors and healthcare workers in contact with people in isolation are required to wear protective garments and follow strict hygiene procedures. Contaminated materials are also disinfected. Hospitals are required to follow strict procedures to prevent MRSA from spreading. There are several preventative methods for community related MRSA. Washing hands with soap is a major factor in preventing infection. You should wash them several times a day, especially after using restrooms or touching public materials such as payphones, rails, money, and so on.
It is also important to have hand sanitizer for when no soap or water is available. Another method is to keep cuts and sores covered by bandages. It will prevent MRSA from infecting a wound or prevents wounds already infected from spreading. Its also said to avoid sharing personal items such as towels, razors, sheets, athletic equipment, and more. Prevention also includes showering after athletic games and practices and to use soap Page 5 and water and not share towels. Finally, its important to sanitize linens.
You should always wash athletic cloths in hot water after each use and regularly wash bed sheets and bath towels. There is currently no vaccine to guard against MRSA, but several public facilities offer educational materials to prevent it. Various school campuses, health facilities, athletic organizations, and so on offer classes, brochures, and other resources to guard against MRSA and reduce an outbreak. In conclusion, as this strain of staph related bacteria continues to evolve and become resistant to more and more antibiotics, the number of cases of those infected outside of hospitals is on the rise.
This infectious disease known as MRSA has become an epidemic that has led to more deaths in recent years than the AIDS virus. Research for immunization is currently being conducted, but in the meantime, it is crucial to your health to be more aware of the preventative methods.
References: Medicinenet- “MRSA Infections”(pgs1 to 6): www. medicinenet. com/mrsa_infection/article. htm Mayo Clinic- “MRSA Infection” (pgs 1 to 9): www. mayoclinic. com/health/mrsa/DS00735 3. Beers, M. H. & Berkow, R. (Eds. ). (2005). The Merck Manual of Diagnosis and Therapy (17thed. ). Whitehouse Station, N. J. : Merck and Company.