MRSA Facts (Also
called SUPERBUG)
Popularly termed a "superbug", it was first
discovered in Britain in 1961 and is now widespread. Non-methicillin
resistant Staphylococcus aureus is termed methicillin-susceptible
Staphylococcus aureus (MSSA) to make the distinction.
While an MRSA colonisation in an
otherwise healthy individual is not usually a serious matter, infection
with the organism can be life-threatening to patients with deep wounds,
intravenous catheters or other foreign-body instrumentation, or as a
secondary infection in patients with compromised immune systems. Part of
the problem is that MRSA does not respond to the antibiotics
normally prescribed for the infections in question, and can hence progress
unchecked.
MRSA Staff Infection Treatment and
initiatives
Vancomycin and teicoplanin are
glycopeptide antibiotics used to treat MRSA infections. These drugs
are administered intravenously. Several new strains of the bacterium have
been found showing antibiotic resistance even to vancomycin and
teicoplanin; those new evolutions of the MRSA bacteria are dubbed "vancomycin
intermediate-resistant Staphylococcus aureus" (VISA). Linezolid,
quinupristin/dalfopristin, daptomycin, tigecycline are more recent
additions to the therapeutic arsenal, generally reserved for severe
infections which do not respond to glycopeptides. Less severe infections
may be treated by oral agents including: linezolid, rifampicin+fusidic
acid, pristinamycin, clindamycin and co-trimoxazole.
At the end of August 2004, after a successful pilot scheme to tackle
MRSA, the British National Health Service announced its Clean Your
Hands campaign. Wards will be required to ensure that alcohol-based hand
rubs are placed near to all beds so that staff can hand wash more
regularly. It is thought that if this cuts infection by just 1% the plan
will pay for itself many times over. Unfortunately, most hospitals within
the United States are neglecting the simple-yet-effective practice of
hand-washing, despite the Centers for Disease Control and Prevention (CDC)'s
report that hand-washing alone would save the lives of roughly 30,000
patients per year, not from MRSA alone, but from all nosocomial
infections.
MRSA Occurrences
Because cystic fibrosis patients are
often treated with multiple antibiotics in hospital settings, they are
often colonised with MRSA, potentially increasing the rate of
life-threatening MRSA pneumonias among them. The risk of cross-colonisation
has led to increased use of isolation protocols among these patients.
In the US there are increasing reports of outbreaks of MRSA colonisation
and infection through skin contact in locker rooms and gymnasiums, even
among healthy populations. MRSA causes as many as 20% of Staphylococcus
aureus infections in populations that use intravenous drugs. These
out-of-hospital strains of MRSA, now designated as
community-acquired, methicillin-resistant staph. aureus, or CA-MRSA,
are not only difficult to treat but are especially virulent. CA-MRSA
apparently did not evolve de novo in the community, but represents a
hybrid between MRSA which escaped from the hospital environment and the
once easily treatable community organisms. Most of the hybrid strains also
acquired a virulence factor which makes their infections invade more
aggressively, resulting in deep tissue infections following minor scrapes
and cuts, and many cases of fatal pneumonia as well.
As of early 2005, the number of deaths in the United Kingdom attributed to
MRSA has been estimated by various sources to lie in the area of 800 to
955 per year. Source:
wikipedia
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