MRSA
Ahmed el-gazzar
What's MRSA ?
It's a gram positive bacteria that are distinct from other strains of staphylococcus aureus, it's responsible for many infections specially skin infection
MRSA is common in hospitals, prisons, and nursing homes, where people with open wounds , invasive devices such as catheters , and weakened immune system are at greater risk of hospital acquired infections.
MRSA began as a hospital-acquired infection, but has become community-acquired as well as livestock-acquired. The terms HA-MRSA (healthcare-associated or hospital-acquired MRSA), CA-MRSA (community-associated MRSA) and LA-MRSA (livestock-associated) reflect this.
Risk factors :
- People with indwelling implants, prostheses, drains, and catheters
- People who are frequently in crowded places, especially with shared equipment and skin-to-skin contact
- People with weak immune systems ( HIV /AIDS ,Lupus , or cancer ; transplant recipients; severe asthmatics ; )
- Diabetics
- Students living in Dormitories
- Veterinarians, livestock handlers, and pet owners
- People that ingest unpasteurized milk
- People who are immunocompromised and also colonized
- People with COPD
- People who had thoracic surgeries
Hospitalised people :
- Specially old people and immunocompromised have high incidence for MRSA
- Surgical site infection ( SSI ) is a very rich media for MRSA attack
Symptoms and Signs :
In humans, S. aureus is part of the normal bacteria present in the upper respiratory tract, and on skin and in the gut mucosa.
S. aureus, along with similar species that can colonize and act symbiotically but can cause disease if they begin to take over the tissues they have colonized or invade other tissues, have been called "pathobionts".
After 72 hours, MRSA can take hold in human tissues and eventually become resistant to treatment.
The initial presentation of MRSA is :
- Small red bumps that resemble pimples, spider bites, or boils; they may be accompanied by fever and, occasionally, rashes.
- Within a few days, the bumps become larger and more painful; they eventually open into deep, pus-filled boils.
Screening:
In health care settings, isolating those with MRSA from those without the infection is one method to prevent transmission.
Rapid culture and sensitivity testing and molecular testing identifies carriers and reduces infection rates.
Hand washing:
The CDC offers suggestions for preventing the contraction and spread MRSA infection which are applicable to those in community settings, including incarcerated populations, childcare center employees, and athletes. To prevent the spread of MRSA the recommendations are to WASH HANDs using soap and water or an alcohol-based sanitizer.
Additional recommendations are to keep wounds clean and covered, avoid contact with other people's wounds, avoid sharing personal items such as razors or towels, shower after exercising at athletic facilities, and shower before using swimming pools
Isolation:
Workers with active infections are excluded from activities where skin-to-skin contact is likely to occur.
To prevent the spread of staph or MRSA in the workplace, employers make available adequate facilities that encourage good hygiene.
Restricting antibiotics:
Glycopeptides , cephalosporins , and, in particular, quinolones are associated with an increased risk of colonisation of MRSA.
Reducing use of antibiotic classes that promote MRSA colonisation, especially fluoroquinolones, is recommended in cases of MRSA infection
Community settings:
It may be difficult for people to maintain the necessary cleanliness if they do not have access to facilities such as public toilets with handwashing facilities.
Some advocate regulations on the use of antibiotics in animal food to prevent the emergence of drug resistant strains of MRSA.
Treatment:
Treatment is urgent and delays can be fatal.
Vancomycin has proved high efficacy in MRSA treatment
In diabetics, specially feet infection consult your surgeon ASAP as in severe cases, wound debridement and cleaning is an urgent solution
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