Methicillin Resistant Staphylococcus Aureus Infection (MRSA) - Causes, Symptoms and Treatment
Methicillin-resistant Staphylococcus aureus(MRSA) is a mutation of a very common bacterium that is spread easily by direct person-to-person contact. Once limited to large teaching hospitals and tertiary care centers, MRSA is now endemic in nursing homes, long-term care facilities,and even community hospitals. Patients most at risk for MRSA include immunosuppressed patients, burn patients, intubated patients, and those with central venous catheters, surgical wounds, or dermatitis. Others at risk include those with prosthetic devices, heart valves, and postoperative wound infections. Other risk factors include prolonged hospital stays, extended therapy with multiple or broadspectrum antibiotics, and close proximity to those colonized or infected with MRSA. Also at risk are patients with acute endocarditis, bacterium, cervicitis, meningitis, pericarditis, and pneumonia.
Causes of MRSA Infection
MRSA enters health care facilities through an infected or colonized patient or colonized health care worker. Although MRSA has been recovered from environmental surfaces, it's transmitted mainly on health care workers' hands. Many colonized individuals become silent carriers. The most frequent site of colonization is the anterior nares (40% of adults and most children become transient nasal carriers). Other sites include the groin, axilla, and the gut, though these sites aren't as common. Typically, MRSA colonization is diagnosed by isolating bacteria from nasal secretions. In individuals where the natural defense system breaks down, such as after an invasive procedure, trauma, or chemotherapy, the normally benign bacteria can invade tissue, proliferate, and cause infection.
Today up to 90% of Staphylococcus aureus isolates or strains arc penicillin-resistant, and about 27% of all S. aureus isolates are resistant to methicillin, a penicillin derivative. These strains may also resist cephalosporins, aminoglycosides, erythromycin, tetracycline, and clindamycin. MRSA has become prevalent with the overuse of antibiotics. Over the years, overuse has given once-susceptible bacteria the chance to develop defenses against antibiotics. This new capability allows resistant to flourish when antibiotics knock out their more sensitive cousins.
Diagnosis for MRSA Infection
MRSA can be cultured from the suspected site with the appropriate culture method. For example, MRSA in a wound infection can be swabbed for culture. Blood, urine, and sputum cultures will reveal sources of MRSA.
Treatment for MRSA Infection
To eradicate MRSA colonization in the nares, the doctor may order topical mupirocin applied inside the nostrils. Other protocols involve combining a topical agent and an oral antibiotic. Most facilities keep patients in isolation until surveillance cultures are negative. To attack MRSA infection, vancomycin is the drug of choice. A serious adverse effect (mostly caused by histamine release) is itching, which can progress to anaphylaxis. Some doctors also add rifampin, but whether rifampin acts synergistically or antagonistically when given with vancomycin is controversial. Due to S. aureus with reduced or total resistance to vancomycin investigation is ongoing for other effective antibiotics.
Special Considerations and Prevention Tips for MRSA Infection
1. Personnel in contact with patients should wash hands before and after patient care.
2. Use an antiseptic soap, such as chlorhexidine, because bacteria have been cultured from workers' hands after they've washed with milder soap. One study showed that without proper hand washing, MRSA could survive on health care workers' hands for up to 3 hours .
3. Contact isolation precautions should be used when in contact with the patient. A private room should be used, as well as dedicated equipment and disinfection of the environment.
4. Change gloves when contaminated or when moving from a "dirty" area of the body to a clean one.
5. Instruct family and friends to wear protective clothing when they visit the patient and show them how to dispose of it.
6. Provide teaching and emotional support to the patient and family members.
7. Consider grouping infected patients together and having the same nursing staff care for them.
8. Equipment used on the patient should not be laid on the bed or bed stand and should be wiped with appropriate disinfectant before leaving the room.
9. Ensure careful use of antibiotics. Encourage doctors to limit antibiotic use.
10. Instruct the patient to take antibiotics for the full prescription period, even if he begins to feel better.
11. Good hand washing is the most effective way to prevent MRSA from spreading. This includes hand washing between tasks and procedures on the same patient to prevent cross-contamination of different body parts.
HEALTH CARE | ABOUT US | CONTACT US | BLOG
© 2005 Online-Health-Care.com. All rights reserved.
Disclaimer: Online-Health-Care.com is for informational purposes only and is not intended to act as a substitute for a professional healthcare practitioner advise. For specific medical advice, diagnoses, and treatment, please consult your doctor. We will not be liable for any complications, injuries or other medical accidents arising from or in connection with the use of or reliance upon any information on this web site.