Disease of the Day - MRSA

Staphylococcus

30 different species

Spherical, Gram +, Form irregular clusters like grapes

Staphylococcus aureus

• Normal microbiota of skin and nose of healthy people

• 20-30% of population colonized on nose

Sometimes causes skin infections

• Skin barrier is broken or invaded by medical procedures

Serious infections

• surgical wound infection, bloodstream infections, pneumonia, UTI

MRSA

Methicillin - in 1959 was first semi-synthetic penicillin designed against penicillinase

• Staphylococcus aureus developed the resistance in 1961 in the UK

• Outbreaks in US in late 1960s

• So prevalent that methicillin use is discontinued in the US

• Resistant to other antibiotics – amoxicillin, penicillin, amoxicillin, and cephalosporin

2% of population colonized with MRSA

MRSA and staff infections occurs most frequently among people in hospitals and healthcare facilities

• have we immune system

• Have wounds are open sores

• Lots of exposure to antibiotics

• Known as HA- MRSA

HA-MRSA

HA-MRSA - main reservoirs are infected or colonized patients

Personnel can be reservoirs, but are mostly links for transmission between patients

The hands are the main mode of transmission

CA-MRSA

Rise in community associated MRSA

• People who have not been recently hospitalized or had medical procedures

• Young and healthy

• Prisoners, athletes schools, daycare’s children, military recruits

• Usually more susceptible to antibiotics

Treatment

Drain boil/abscess – by healthcare provider

Vancomycin or Teicoplanin

• now strains of MRSA showing resistance to these antibiotics

• Visa – intermediate resistance staphylococcus aureus

• VRSA - Fully resistant Staphylococcus aureus

• New antibiotics

• Linezolid

• Daptomycin

Prevention and healthcare

Wash hands constantly

Glove use and proper use

Masks when needed

Gowns when needed

Appropriate device handling

Correct handling of laundry

Prevention and community

Wash hands

Keep cuts and scrapes, covered and clean

Avoid contact with other people’s wounds and bandages

Avoid sharing personal item, such as towels or razors

Epidemiology

United States

• 3 million carriers of MRSA

• ICU

• 1974 - 2% staph infections were MRSA

• 2004 - 64% staph infections were MRSA

Serious MRSA infections per year

• 120,000 people with 20,000 deaths

• 84% are health related

• 16% community related