MRSA

Our skin and nose are colonized by bacteria. These being the natural resident flora there are vital to keep away infections of these sites that are constantly exposed to the external environments. One such bacterium is the Staphylococcus aureus.

Skin is the first physical defense against any infection entering the body. When breached, the resident bacteria invade the body structures causing infections. Sometimes these infections are difficult to treat as they get resistant to the treatments available. Such resistant strains are a challenge in medical practice. It is interesting to know that one can keep away for such infections by exercising some precautions.

About MRSA

Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of Staphylococcus aureus (S. aureus) which is resistant to the usual treatment for these bacteria. An infection by S. aureus is treated with antibiotics, medicines that fight infection by killing or arresting the growth of bacteria.

The MRSA strains are resistant to the usual antibiotics and hence infections are difficult to treat and control. The MRSA bacteria enter the body through a cut, sore, abrasion, cannula, catheter, or breathing tube to cause either a localized infection like a pimple or a small collection of pus, or more generalized and serious infections that affect the blood, bone, heart, and lung.

The resistant strains evolve because the bacteria learn how to survive the antibiotics over time. There has been rampant and irrational use of antibiotics, especially so when these are prescribed for viral infections and when the entire regimen for MRSA treatment is not completed. MRSA is very common in the general population.

Around 1% people are believed to be carriers of the bacterium. These then spread rapidly from one person to another through sharing of belongings and establish themselves in the general community. The infections can be acquired in the hospitals and healthcare settings or the community.

Risk factors

Elderly with weak defense systems in the body who remain hospitalized for long duration for any medical illness are at risk for hospital acquired (HA)-MRSA. However, a person of any age can be affected.

The risk increases when there are any medical devices used for medical management in the hospital. These include the cannulae and catheters that are inserted into the body through the skin, nose, or urinary outlet.

A person who is carrier of MRSA may transmit the MRSA infection without having symptoms for the infection. A special risk is through the hands of nurses and healthcare personnel who examine several patients without washing hands after each one are touched.

Community acquired (CA)-MRSA affects the healthy general population and spreads through direct or skin contact. People at highest risk are those who live in crowded conditions, childcare workers, workers in old age homes, wrestlers, military training camps, jails, and daycare centers. Homosexuals have greater risk for MRSA.

Such infections are usually localized and cause a pimple, boil, pustule, or an infected wound. The infection spreads by sharing of personal belongings like towels and razors.

A localized skin infection due to MRSA may cause the following symptoms;

  • Red patch
  • Swollen
  • Pain
  • Pus filled elevation in the skin
  • Fever
  • Area may be warm to touch
  • Tiredness
  • Headache
  • Body aches
  • Chills
  • Difficulty in breathing
  • Chest pain
  • Cough
  • Skin rash

Medical help must be sought if pimples, insect bites, cuts, abrasions, wounds, and scrapes, oozing fluid or pus are observed, especially in children.

A more serious and generalized infection occurs when the MRSA invade the blood stream to spread to various organs in the body.

 

MRSA are diagnosed on the basis of culture. This is a procedure by which the bacteria are isolated and grown in laboratory conditions from samples collected from patients or healthy carriers.

The samples usually collected for this include blood, sputum, urine, pus, or other fluids depending upon where the infection is.

A swab may be taken from wounds or from the skin surface.

As the name implies, this strain of S. aureus is resistant to methicillin, an antibiotic used in the treatment of such infections.

  • If the infection is a local one, say a skin sore, then that may be drained by making a surgical incision.
  • More serious HA-MRSA infections may need treatment with other antibiotics to which they may be sensitive. These include clindamycin, daptomycin, doxycycline, linezolid, minocycline, tetracycline, trimethoprim-sulfamethoxazole, or vancomycin. These need to be taken in proper and prescribed regimen to achieve complete results, and prevent any further resistance.
  • The widely spread and life threatening infections need treatment with antibiotics given as infusion or injection into the blood vessels. This needs hospitalization.
  • entilator support and dialysis may be required if the infections involve lungs or kidneys.
  • In an MRSA skin infection, it is good to keep the wound, cut, or sore covered with a dry and sterile bandage till they heal.
  • Covering the skin wounds helps to contain the spread of infection to others.
  • One should avoid using a public swimming pool, a common bathing facility, saunas, spas, and whirlpools till the wounds heal completely.
  • These wounds should not be frequently touched.
  • Hands should be washed regularly especially so after handling the wound or after any accidental touch on the infected wound.
  • Hand washing is best done with soap and water. Alternatively, a hand sanitizer with 60% alcohol may be used.
  • Any belongings that have been exposed to MRSA should be cleaned properly. This is most ideally done with disinfectants, chemicals that kill or inactivate the germs on surfaces.
  • Cleansers or sanitizers may be used.
  • The U.S. Environmental Protection Agency (EPA) provides a list of such chemicals that can be used for MRSA. Before using any such cleanser, detergent, or disinfectant, the label should be carefully read for instructions for use. One should know how much to apply and how long to leave the chemical on the belongings. Many of these may need cleaning prior to use and rinsing after one or a dilution before application.
  • Only those that are safe for surfaces may be used with precaution using gloves or aprons, if one is required.
  • Hands should be washed with soap and water after any infected items are handled.

MRSA can be prevented, if proper care is exercised. One should be watchful if one ever gets hospitalized.

  • It is good to remind and request he healthcare workers to wash their hands before one is touched by them.
  • One may even discuss with them how to safely remove the catheters, infusion ports, or catheters, if any are used.
  • All visitors to the hospital should be requested to wash hands.
  • After discharge from a healthcare facility, one should be attentive to any signs of infections like fever, chills, malaise, or increased soreness around a wound.
  • Medical help should always be sought if any sign of suspicion of infection occurs.
  • To prevent the spread of infection and to keep away from acquiring an infection form others at home or in the community, one should avoid sharing of personal belongings like razors, combs, towels, napkins, linen, utensils, beddings, clothing, or sheets.
  • Any sports equipment if shared should be cleaned with cleaning agents. If there is somebody at home with an infection, the environment should be kept clean, ventilated, and hygienic.
  • Bed rails, chairs, tables, and other surfaces should be regularly disinfected with proper chemical agents.
  • The personal items of these patients should be handled only after wearing protective gloves.
  • Hands should be washed with soap and water before and after handling any objects soiled with infectious fluids.