Methicillin-Resistant Staphylococcus Aureus - Essay Example

Topic:  MRSA Content Page Number Introduction…………………………………………………………….. 2 2. Discussion 2.1 What is Staphylococcus aureus……………………………… 2 2.2 MRSA……………………………………………………….. 2 2.3 The Signs and Symptoms of MRSA………………………… 3 2.4 Risk Factors for MRSA…………………………………….. 5 2.5 MRSA Transmission………………………………………. 6 2.6 Diagnostics………………………………………………… 6 2.7 Prevention…………………………………………………. 7 2.8 Adverse Effects of MRSA…………………………………. 8 2.9 Treatment…………………………………………………. 9 3. Conclusion…………………………………………………………. 10 1. Introduction Methicillin Resistant Staphylococcus aureus, a ubiquitous bacterial disease producing agent, better known as the superbug, is the most common cause of the hospital acquired infection (Oregon Public Health Division, 2007; Health Encyclopedia 2008). MRSA is a major nosocomial or hospital acquired infection that occurs in patients 48 hours following hospital admission (Kozier & Erb, 2004; Hawkes et al, 2007). MRSA occurs frequently among hospitalized patients, healthcare workers exposed with MRSA, and individuals with reduced immunity (Gemmell, et al, 2006). MRSA leads to fatal illness resulting from bacteriemia (Rotas et al, 2007). 2. Discussion 2.1 What is Staphylococcus Aureus? Staphylococcus aureus is a gram – positive cocci forming grapelike clusters. They have the capacity to cause skin lesions such as boils, carbuncles, impetigo, scalded skin as well as pharyngitis, pneumonia, endocarditis, food poisoning, and toxic shock syndrome (Robbins et al, 335). Moreover, Staphyloccus aureus is considered as the major microorganism causing severe burns and surgical wounds. Next to Escherichi coli, Staphyloccus aureus is the second cause of hospital – acquired infection (Robbins, et al, 335). Robbins, et al, added that this microorganism is remarkable for its local destructiveness. 2.2 MRSA MRSA, otherwise known as methicillin resistant Staphloccus areus is an organism that are resistant to the commonly used antibiotics, methicillin (MRSA, 2004). Methicillin was initially used as antibiotics to manage patients against Staphyloccus aureus infection. However, Methicillin was overused and misused and consequently resulted to a certain situation where MRSA bacterium was no longer sensitive to this particular antibiotic. As a result, methicillin was never used as antibiotics but was only intended to identify this particular type of antibiotic resistance (MRSA 2004; Stryer 2006). Stöppler (2008) stated that MRSA can be found all over the world and brings about a relatively short history. Stöppler noted that MRSA existed as long as humanity existed. In 1961, MRSA was first noted. This was approximately two years following the usage of methicillin as an antibiotic to treat the microorganisms Staphyloccocus aureus and other infectious microorganisms. During this time, it was found out that methicillin resistance was caused by a certain penicillin - binding protein that was coded for by a mobile genetic element called as methicillin resistant gene or mecA. Stöppler (2008) added that this gene continued to evolve in such a way that the strains of MRSA are resistant to other different antibiotics. Hence, Staphylococcus aureus is termed occasionally as a "superbug" due to its ability to be resistant to other types of antibiotics (Stöppler, 2008). Hecht (2008) noted that about 25% - 30% of the population was found to have Staphylococcus infection within the nostril; however, this had not caused any infection to the host. Hecht further reported that only 1% of this population had suffered from MRSA. MRSA organism has developed resistance to different types of antibiotics through genetic mutation (Payne, 2007). On the other hand, it was reported that about one – third of the total population are colonized by MRSA in the nose and skin (Mayo Foundation, 2008). Accordingly, MRSA microorganisms are classified as to where they were acquired, namely, community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA or epidemic MRSA (EMRSA). 2.3 The Signs and Symptoms of MRSA The following are the signs and symptoms that are exhibited by MRSA infections in the skin: (1) Cellulitis (2) Boils (3) Abscesses (4) Sty (5) Carbuncles (6) Impetigo It was reported that the above - noted signs and symptoms eventually develop into deep and painful abscess that requires surgical drainage. In worst cases, these bacteria would burrow inside the skin that causes “potentially life – threatening infections in the bones, joints, surgical wounds, the bloodstream, heart valves and lungs” (Mayo Foundation 2008). Figure 1: This is a picture of MRSA infection in the skin. (Source: MRSA Infection Index. 18 Feb 2008. MedicineNet. 21). Figure 2: Another picture of a lesion caused by Staphylococcus aureus. (Source: Mayo Clinic. 08 Feb 2008. Mayo). Figure 3: Microscopy of Staphylococcus aureus organism (Source: Payne, Tanya. Treatment for the MRSA Staph Super bug Is Costly. 17 Oct 2007. Newstex). 2.4 Risk Factors for MRSA The following are the risk factors for Hospital – Acquired MRSA infection (Mayo Foundation, 2008): (1) Concurrent or recent hospitalization – it was reported that in the United States of America (USA), 1.2 million of patients who are hospitalized are infected with MRSA and 423, 000 are colonized by these organism. (2) Staying in a long – term care facility – carriers of MRSA are likely to spread this infection in a long – term facility than in the hospital. (3) Invasive devices – people wearing or having implanted devices such as catheter, feeding tubes and invasive devices are at high risk for MRSA. (4) Recent use of antibiotic – treatment with antibiotics such as fluoroquinolones and cephalosphorines increase the risk of acquiring hospital – acquired MRSA. The following are the principal risk factors for Community – Acquired MRSA Infections (Mayo Foundation, 2008): (1) Young age – children and young adults are at risk of acquiring this infection because their immune system is yet to develop or underdeveloped. They are most likely to acquire pneumonia than the adults. (2) Contact sports participation – MRSA easily spreads through cuts, abrasion, and skin contacts. (3) Sharing towels and athletic equipments (4) Weakened immune system – includes those who are immunocompromized patients such as cancer and HIV/AIDS patients. (5) Residing in a crowded or unsanitary environment – outbreaks of MRSA oftentimes occur in crowded places. (6) Constant contact with other health care workers – people who are in close contact with infected health care workers are at increased risk to MRSA. 2.5 MRSA Transmission MRSA are transmitted in both ways: (1) Via direct physical contact with the carrier or infected individual; and (2) Via physical contact with objects such as handles of the doors, floor, sink, and towels touched by an individual infected with MRSA (Stöppler, 2008). 2.6 Diagnostics Patients who are suspected for MRSA infection should have their tissue sample tested for any signs of MRSA by sending this tissue sample to the laboratory for bacterial culture and sensitivity (Mayo Foundation, 2008). This is done by sending the sample of infected tissue to the laboratory for Staphylococcus aureus microorganism culture. The tissue is grown in a Petri plate and is exposed to different types of antibiotics that include methicillin (Stöppler, 2008). Stöppler added that an individual with a tissue culture sample that grows well in a methicillin culture is considered as MRSA infected individual. Stöppler (2008) further noted that a rapid test that detects genetic material of MRSA in a blood sample in a span of two hours has been approved by the US Food and Drug Administration (FDA). This test has the capacity to identify whether the source comes from MRSA genetic material or from the less dangerous Staphylococcus bacteria. 2.7 Prevention In order to stop this superbug from spreading, it is important that individuals infected with minor skin infections must seek an immediate medical advice (Mayo Foundation 2008). Moreover, it is highly recommended that everyone must start practicing frequent hand washing especially among the medical health practitioners being exposed to MRSA. In order to fight back MRSA infection, hospitals are using surveillance systems to keep tract for any outbreaks. The best preventive measure against MRSA infection is to practice proper hand - washing technique especially among the health care professionals. Not only that, hospital health workers, family of the patient, and the patient alike must learn the importance of hand washing especially after the procedure in the ward, after transferring from one patient to another, and after holding stuffs that are exposed in the hospital setting that might be the potential source of MRSA infection (Mayo Foundation, 2008; Health Encyclopedia, 2008). On the other hand, in order to stop community – acquired MRSA from spreading, the following must be practiced (Mayo Foundation, 2008): (1) Hand washing – scrub hands for at least 15 seconds and dry it with disposable towels. Always keep at least 62 percent of alcohol when soap and water are not accessible. (2) Keeping personal things to oneself – avoid sharing personal belongings since MRSA oftentimes spreads to objects that are contaminated. (3) Keep the wounds covered – this will keep the bacteria from spreading (4) Shower after every game (5) Avoid from participating any athletic games once infection is suspected (6) Get yourself tested – early diagnosis and treatment is necessary to stop MRSA from spreading. MRSA identification through early diagnostic testing effectively treats MRSA infection and prevents it from spreading. (7) Appropriate use of antibiotics Since MRSA patients and carriers are oftentimes not identified, it is important not to have close or direct contact with individuals who are suspected with MRSA (Stöppler, 2008). 2.8 Adverse Effect of MRSA One of the most dreadful sequelae for MRSA is death secondary to MRSA infection. Stöppler (2008) reported that among the hospitalized American patients infected with MRSA, the estimated mortality rate is 4% - 10%. Additionally, isolation, fear of infection, anxiety, confusion and uncertainty are among the psychological effects. 2.9 Treatment Staphylococcus aureus infection is a type of infection ranging from mild folliculitis to a very serious septicemia. People who have weakened immune system such as the children, elderly, and patients infected with cancer and HIV/AIDS are prone to have this infection. This infection is commonly passed to susceptible individuals. MRSA is a very expensive infection and commonly, drugs such as penicillin and tetracycline are not effective to use against this type of illness (Payne, 2007). Even with the presence of multiresistant feature of MRSA, this bug is still known to respond to certain types of antibiotics such as vancomycin. However, due to the existence of vancomycin resistant MRSA, doctors oftentimes makes use of draining the abscess rather than treating the abscess with drugs (Mayo Foundation 2008). Hence vancomycin resistance can be the next superbug to consider (Stöppler, 2008). Mupirocin antibiotic cream can be used by the potential careers to eliminate MRSA from the mucous membrane (Stöppler, 2008; Gemmell, et al, 2006). Stöppler added that MRSA resistance quickly changes and therefore, antibiotics must also be changed. Stopping antibiotic intake quickly is not a wise decision to make since most of MRSA are still viable when one considers that they are not and results to reinfection (Stöppler, 2008). Another reason for resistance is that the MRSA that survived may be exposed to low doses of antibiotics when the medication is soon stopped allowing enough time for MRSA to become resistant to the antibiotic. Hence, patients with MRSA must follow the appropriate dosage and course of antibiotic intake (Stöppler, 2008). 3. Conclusion In conclusion, Methicillin resistant Staphyloccus aureus remains to be the cause of the dreadful hospital acquired infection. The primary approach of prevention and treatment for the so called superbug lies at the hands of everyone and this involves proper hand hygiene technique as well as early detection and treatment of the so – called super bug before it will spread causing fatal sequelae. References Gemmell, Curtis, David Edwards, Adam Fraise. “Guidelines for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the UK.” The Journal of Antimicrobial Chemotherapy 57.4 (2006): 589 – 608. Hawkes, Michael, Michelle Barton, and John Conly. “Community-associated MRSA: Superbug at our doorstep.” Canadian Medical Association Journal, 176.1 (2007): 54 - 56. Kozier, N., & Erb, G.. Fundamentals of Nursing (7th ed.). NJ: Person Education Inc. 2004. Mayo Clinic. 08 Feb 2008. Mayo Foundation 21 Apr 2008 < http://www.mayoclinic.com/health/mrsa/DS00735/DSECTION=2> MRSA. 23 Feb 2004. Western General Hospital, Edinburg, Regional Infectious Disease Unit (RIDU) 21 Apr 2008 < http://www.link.med.ed.ac.uk/RIDU/Mrsa.htm > MRSA. 14 March 2008. NHS Direct 21 Apr 2008 < http://www.nhsdirect.nhs.uk/articles/article.aspx?articleID=252>. MRSA SuperBug. 30 Oct 2007. Oregon Public Health Division 21 Apr 2008 http://oregon.gov/DHS/ph/cdsummary/2007/ohd5622.pdf. Payne, Tanya. Treatment for the MRSA Staph Super bug Is Costly. 17 Oct 2007. Newstex. 21 Apr 2008 Robbins, Stanley, Ramzi Cotran, and Vinay Kumar. Pathologic Basis of Disease. Philadelphia: W.B. Saunders Company, 1995. Rotas, Michael, Sandra McCalla, Chunchua Liu, and Howard Minkoff,. “Methicillin-Resistant Staphylococcus Aureus necrotizing pneumonia arising from an infected episiotomy site.” Obstetrics and Gynecology 109 (2007): 533 – 536. Stöppler, Melissa. MRSA Infection Index. 18 Feb 2008. MedicineNet. 21 Apr 2008 Stryer, Stacy. Dr. Stacy: The Portable Pediatrician. 23 Oct 2007. Revolution Health. 21 Apr 2008 Read More