The Identification of a Biological Pathogen - Report Example

Running Head: Biological Pathogen Identification of a Biological Pathogen: Methicillin Resistant Staphylococcus Aureus (MRSA) Assignment course number course title March 28, 2009 Topic:  Identify a Biological Pathogen (bacterial, viral, fungal, protozoan) that Can Affect either your Cardiovascular, Digestive, Respiratory, or Nervous system. Methicillin – Resistant Staphylococcus Aureus Methicillin – Resistant Staphylococcus Aureus (MRSA), otherwise known as HA – MRSA (hospital acquired – MRSA), CA – MRSA (community acquired MRSA) is a major nosocomial pathogen that is responsible for difficult to treat infections in human beings. MRSA occurs frequently among persons in hospitals, healthcare facilities, and among persons with reduced immunity (Gemmell, et al., 2006; Rod & Hoyt, 2007; Shams, 2007). A transmutation of S. aureus, has exceeded the ability of human beings to survive, even live, post – treatment with beta – lactam antibiotics, including penicillin (Rod & Hoyt, 2007; Shams, 2007). It is labeled as a super bug because this can not be eradicated by common antibiotics, and if healthcare providers are not smart about using the few weapons healthcare has left, this superbug will definitely morph again, to become more resistant to even more antibiotics (Rod & Hoyt, 2007; Shams, 2007). Cause of MRSA MRSA is caused by a strain of Staphylococcus aureus that is resistant to certain types of antibiotic, along with other similar types of antibiotics (Schoenstadt, 2008). In the past few decades, MRSA has gone from being controllable condition to a serious public health concern. New strains emerged known as community associated MRSA causing severe types of infections among healthy individuals in the community (Schoenstadt, 2008). (MRSA. Source: Hawkes, et. al., 2007) Understanding the History of MRSA In 1880’s, a bacterium known as Staphylococcus aureus, was discovered causing painful infection of the skin, which progresses occasionally to a very serious blood infection and pneumonia (Schoenstadt, 2008). In 1940’s, S. aureus is routinely and successfully treated with the introduction of antibiotics such as penicillin; however, the misuse and overuse of this type of antibiotic aided natural evolution of bacteria by helping microbes become drug resistant. In 1940’s and in 1950’s, S. aureus was noted to developed penicillin resistance (Schoenstadt, 2008). To counter the increasing problem of penicillin resistant S. aureus, another form of penicillin known as methicillin was introduced in the market. In 1961, the birth of MRSA was reported when a British scientist first identified the first strain of S. aureus bacteria that is resistance to methicillin. In 1968, the first human case of MRSA was reported in the United States. With the evolution of this bacterium, new strains of S. aures developed that resist drugs that are previously effective such as oxacillin, amoxicillin and among others. In 2002, first S. aureus strain resistant to vancomycin was identified by physicians in the US (Schoenstadt, 2008). Mode of Transmission MRSA can be transmitted via contaminated hands of healthcare workers from infected patients, infected sites, and inanimated sources such as hospital devices, items, and surfaces. . Schoenstadt further explained that MRSA is transmitted via direct contact with someone who has active infection, who is a carrier of infection, and from contaminated object. Contaminated things in the hospital include bedside rails, blood pressure cuffs, television remote controls, and toilet seats. A person becomes colonised (carrier) after coming in contact with a contaminated surface. Subsequently, a person becomes active with MRSA infection after getting colonised and following entrance of bacteria in the skin opening (Shoenstadt, 2008). Moreover, a person can also be colonised with MRSA by breathing tiny droplets expelled during breathing, coughing, sneezing as well as touching contaminated surface (Shoenstadt, 2008). Signs and Symptoms According to Schoenstadt (2008), MRSA enters inside the body through a cut or scrape and can be mistaken as skin infection. The site may appear as reddish, swollen, warm, and painful as it contains pus or drainage. This may occur at visibly traumatized areas as well as areas covered by hair such as the back of the neck, groin, buttocks, armpits, and beards in men. The following are the common signs and symptoms produced by MRSA skin infections: cellulitis, boils, abscesses, sty, carbuncle, and impetigo (Davis, 2009). Davis added that one major problem encountered with MRSA is that skin infection would occasionally spread to almost any other organs in the body, and when this happens, would cause severe symptoms as it spreads to internal organs producing life – threatening symptoms such as fever, chills, low blood pressure, joint pains, severe headaches, shortness of breath, and rashes all over the body. Furthermore, Dugdale (2008) stated that the following are more serious symptoms of staphylococcus infection: chest pain, chills, fatigue, fever, body malaise, and muscle aches. How it affects your System(s) MRSA is a deadly infection since it does not only infects the skin but invades different areas in the body. MRSA oftentimes present as pneumonia when they invade the lungs, bacteremia or septicemia when it infects the bloodstream, cellulitis when it infects the soft tissue, osteomyelitis when it infects the bone, and presents as endocarditis when the inner lining of the heart is infected (Schoenstadt, 2008). MRSA also penetrates into the body causing potentially life – threatening infections in the bones, joints, surgical wounds, bloodstream, heart valves, and lungs (Harms, 2009). On the other hand, Dugdale (2008) noted that the following are serious infections caused by MRSA: sepsis, cellulites, endocarditis, pneumonia, and toxic shock syndrome. Dugdale added that organ failure and eventually death may result from untreated MRSA infections. Diagnosis To diagnose MRSA, a skin or tissue sample, pus on the skin, blood, and urine is sent for S. aureus sample in the microbiology laboratory (Davis, 2009). It is then exposed to different types of antibiotics including methicillin, once it is grown and isolated on a Petri dish. The patient is diagnosed to have MRSA – infection when S. aureus grows well when methicillin is in the culture (Davis, 2009). To screen for MRSA carrier, the same procedure is done; however, the samples are only swabbed instead of biopsied (Davis, 2008). The following are diagnostic tests that detects and confirm MRSA infection: blood culture, culture of the drainage from the infection as well as from the skin, urine, and sputum. Newer test that detects staph DNA in a matter of hours is widely available (Schoenstadt, 2008). Nasal secretions can also be tested for signs of MRSA. For more serious infections in the body, x –rays, CT scan and blood test may be recommended by healthcare providers (Schoenstadt, 2008). Prevention Centers for Disease Control (2006) noted that the single most important preventive mechanism for spreading MRSA is hand washing. This is done by washing the hands with warm water and liquid soap between fingers, up to wrists, under fingernails. After rinsing, the hands must be dried with paper towel. CDC (2006) noted that when soap is not available, isopropyl alcohol can be used as a substitute. Apart from thorough hand washing, the healthcare personnel must use gloves, caps, masks, and gowns and other protective appliances when handling patients to create barriers for contact transmissions. On the other hand, cough etiquette is important, since nose harbors these bacteria. Hence, it is important to use a handkerchief or paper towel for sneezing and coughing, and caution must be exercised while handing devices (CDC, 2006). An individual can also be protected from MRSA spread by strictly prohibiting sharing of towels, soap, or other personal items. An immediate shower with soap to wash out infections is recommended for immediate contact. To eliminate colonization, a clean dry towel should be used after the shower (CDC, 2006). Treatment The treatment recommended for MRSA infection depends on the severity of infection, results of different tests, existing medical conditions, and the age of the person (Schoenstadt, 2008). For less severe infections, one of the following antibiotics may be recommended: Sulfamethoxazole/trimethoprim such as Bactrim, Bactrim DS, Septra, Septra DS, Sulfatrim, Minocycline, Doxycycline, and Tetracycline. The patient will be re – evaluated in 24 – 48 hours following antibiotic administration, and if the patient do not respond with the treatment, another strain of MRSA that is resistant to specific antibiotic is considered (Schoenstadt, 2008). Deeper infection can also be ruled in. In this case, patients are advised for admission for treatment with IV antibiotics. In mild to moderate infection of the skin, it is recommended that needle will be inserted by healthcare provider to remove infected fluid or drainage of infected skin and to facilitate quick tissue healing (Schoenstadt, 2008).   Zetola, Francis, Nuermberger, et al., (2005) reported that in cases MRSA organisms would not respond to antibiotics that contains beta – lactam rings, the following antibiotics are suggested: vancomycin, trimethoprim-sulphamethoxazole, and linezolid and combination with Daptomycin, Rifampicin, Clindamycin, Gentamicin. References CDC, (2006). Clean Hands Save Lives. Retrieved March 26, 2009 from http://www.cdc.gov/cleanhands CDC, (2006). Standard Precautions. Retrieved March 26, 2009 from http://www.cdc.gov/ncidod/dhqp/gl_isolation_standard.html Davis, C. (2009). MRSA Infection. Retrieved March 25, 2009 from http://www.medicinenet.com/mrsa_infection/page2.htm Dugdale, D. (2008). MRSA. Retrieved March 26, 2009, from http://www.nlm.nih.gov/medlineplus/ency/article/007261.htm Gemmell, C.G.,et al.,(2006). Guidelines for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus: (MRSA) infections in the UK. The Journal of Antimicrobial Chemotherapy, 57 (4) 589 - 608. Retrieved March 26, 2009, from http://jac.oxfordjournals.org/cgi/content/abstract/57/4/589 Harms, R. (2008). MRSA Infection. Retrieved March 26, 2009, from http://www.mayoclinic.com/health/mrsa/DS00735 Hawkes, M. et al., (2007). Community-associated MRSA: Superbug at our doorstep. Canadian Medical Association Journal, 176 (1) 54 - 56. Retrieved March 25, 2009, from http://www.cmaj.ca/content/vol176/issue1/ Huang, H. et al. (2006). Comparisons of Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) and Hospital-Associated MSRA Infections in Sacramento, California. Journal of Clinical Microbiology, 44 (7), 2423 – 2427. Retrieved March 25, 2009, from http://jcm.asm.org/content/vol44/issue7/ Rod, L., & Hoyt, K.S. (2007). Methicillin – resistant staphylococcus aureus (MRSA) infection. Advanced Emergency Nursing Journal, 29 (2), 118 – 128. Retrieved March 25, 2009, from the Journals at OVID research database. Shams, W.E. (2007). Methicillin – resistant staphylococcus aureus: An established pathogen with emerging infections. Southern Medical Journal, 100 (5), 464 – 465. Retrieved March 26, 2009, from the Journals at OVID research database. Schoenstadt, A. (2008). MRSA. Retrieved March 25, 2009, from http://bacteria.emedtv.com/mrsa/complications-of-mrsa-p2.html Zetola, N., Francis, J.S., Nuermberger, E.L. et al., (2005). Community-Acquired Methicillin-Resistant Staphylococcus Aureus: An emerging threat. Lancet Infect Disease, 5 (5), 275–86. Retrieved March 26, 2009, from http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6W8X-4G11GJP-W-3&_cdi=6666&_user=10&_orig=browse&_coverDate=05%2F31%2F2005&_sk=999949994&view=c&wchp=dGLbVzW-zSkzk&md5=75e05f983782c5a33a48ca19bb5a40f4&ie=/sdarticle.pdf Read More