Question

Review an article about one of the following infections/superbugs: MRSA, VRE or C-diff.

1. How is the infection spread?
2. Is it treatable and preventable?
3. Are there long-term effects if left untreated?
4. How prevalent is the infection/How common is it?
5. Discuss an incident of a poor outcome or fatality related to the infection.

Answer 1

MRSA stands for methicillin-resistant Staphylococcus aureus, a type of bacteria that is resistant to several antibiotics.

Spread of MRSA-

MRSA is spread by two ways; Health care-associated (HA) and community-associated (CA). Most common way is Health care-associated MRSA (HA-MRSA), people who've been in hospitals or other health care settings, such as nursing homes and dialysis centers. HA-MRSA infections typically are associated with invasive procedures or devices, such as surgeries, intravenous tubing or artificial joints and by not following universal and standard precautionary measures.  Community-associated MRSA (CA-MRSA) is mostly spread in the community by contact with infected people or things that are carrying the bacteria. It's spread by skin-to-skin contact. People living in crowded conditions are at risk to develop CA-MRSA.

Is MRSA treatable and preventable? When MRSA is diagnosed treatment will depend on type of infection, location of infection, severity of symptoms and antibiotics to which the strain of MRSA reacts. Most MRSA infections are treatable with antibiotics like clindamycin, tetracycline drugs - doxycycline and minocycline, trimethoprim and sulfamethoxazole, rifampin and linezolid. MRSA infections needs to be managed so that it does not spread and we need to remove pus from lesion, culture and susceptibility testing of drained material, wound care and hygiene and antimicrobial therapy. If signs and symptoms are ignored, the infection can become serious, even fatal. If you're on medication, yet the infection continues to worsen or looks the same after 3-4 days and/or a fever develops or worsens, seek medical attention immediately.

Prevention of MRSA - Maintain good hand and body hygiene. Clean hands often, and clean your body regularly, especially after exercise. Keep cuts, scrapes, and wounds clean and covered until healed. Avoid sharing personal items such as towels and razors. Nurse should follow hand hygiene, following universal and standard precautionary measures when caring for patients ( PPE), disinfecting the surroundings of the patient, follow proper sterlization of articles and proper fumigation of rooms.

Are there long-term effects if left untreated?

If MRSA is left untreated, it will lead to complication such as;

• Organ failure (e.g., kidney)
• Osteomyelitis (bone marrow infection)
• Pharyngitis (throat infection)
• Brain or spinal cord abscess (nervous system infections)
• Cellulitis (connective tissue infection)
• Endocarditis (infection of the membrane that lines the heart)
• Pneumonia (respiratory infection that affects the lungs)

How prevalent is the infection/How common is it? About one out of every three people (33%) are estimated to carry staph in their nose, usually without any illness. About two in 100 (2%) carry MRSA. Both adults and children may have MRSA. MRSA may cause deep (invasive) or life-threatening infections in some people. A review of 15 studies shows between 13 and 74% of worldwide S. aureus infections are MRSA.

Below we have a graph reporting the number of MRSA cases in US

The national estimated number of MRSA infections in the US, stratified by infection setting. Adapted from data reported by the Center for Disease Control and Prevention [27] and Dantes et al. [28]. MRSA methicillin-resistant S. aureus

Discuss an incident of a poor outcome or fatality related to the infection.

From April 1991 to March 1993, there were 49 elderly patients with methicillin-resistant Staphylococcus aureus (MRSA) infection in a geriatric hospital in Fukuoka, Japan. The retrospective study was carried out in order to evaluate the various factors which may influence the case fatality rate of MRSA infection among the elderly. Among them, 33 patients (67.3%) died while only 16 patients became culture-negative for MRSA and discharged after recovering from MRSA infection.