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Last Updated: February 2011

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Staphylococcus aureus is an opportunistic pathogen often carried
asymptomatically on the human body. Methicillin-resistant S. aureus (MRSA) strains
have acquired a gene that makes them resistant to all beta-lactam antibiotics.
Hospital-associated strains of this organism are serious nosocomial pathogens that
have become resistant to most common antibiotics, and treatment can be
challenging. Community-associated MRSA strains occur in people who have not
been hospitalized or recently had invasive procedures. They first appeared in highrisk populations (e.g., intravenous drug users, people with chronic illnesses), but are
now found even in healthy children. Until recently, community-associated strains
were susceptible to many antibiotics other than beta-lactams; however, resistance
seems to be increasing, and multiple antibiotic resistant strains have started to
emerge. Human-adapted MRSA can be transmitted to animals in close contact,
which can sometimes act as carriers and re-infect people.
Animal-adapted MRSA strains also exist. The pig-associated lineage MRSA
CC398 is a particular concern. This lineage, which apparently emerged between 2003
and 2005, has spread widely among swine in some locations. Colonization with
CC398 has also been reported in other species, including veal calves and poultry.
Asymptomatic carriage is common among people who work with colonized swine or
other livestock, and these organisms can cause opportunistic infections. Other MRSA
strains can also affect animals. Outbreaks in horses suggest that MRSA might be an
emerging problem in this species. Dogs and cats seem to be infected infrequently, and
mainly by human-adapted strains; however, carriage rates can be higher during
outbreaks in veterinary hospitals and other facilities. While colonization of pets is
often transient, it might contribute to maintaining MRSA within a household or

Staphylococcus aureus is a Gram positive, coagulase positive coccus in the family
Staphylococcaceae. Methicillin-resistant S. aureus strains have acquired the mecA
gene, which is carried on a large mobile genetic element called the staphylococcal
chromosomal cassette mec (SCCmec). This gene codes for a penicillin binding
protein, PBP2a, which interferes with the effects of beta lactam antibiotics (e.g.
penicillins and cephalosporins) on cell walls. It confers virtually complete resistance
to all beta-lactam antibiotics including the semi-synthetic penicillins.
Acquisition of mecA seems to have occurred independently in a number of S.
aureus strains. Some clonal lineages of S. aureus have a tendency to colonize specific
species, and may be adapted to either humans or animals. Other lineages (“extended
host spectrum genotypes”) are less host-specific, and can infect a wide variety of
species. Some MRSA strains, called epidemic strains, are more prevalent and tend to
spread within or between hospitals and countries. Other “sporadic” strains are isolated
less frequently and do not usually spread widely. There are also MRSA strains that
produce various exotoxins (e.g., toxic shock syndrome toxin 1, exfoliative toxins A or
B, and enterotoxins) associated with specific syndromes, such as toxic shock
syndrome. Community-associated MRSA strains that express a toxin called PantonValentine leucocidin (PVL) have been linked to skin and soft tissue infections and
severe necrotizing pneumonia. It is possible that PVL are associated with increased
virulence in general, although this remains to be proven.
Phenotypic methicillin resistance and/or the mecA gene has been reported
occasionally in various animal-adapted Staphylococcus species. Some of these
organisms can cause zoonotic infections or colonize people asymptomatically. There
are also concerns that they may transfer mecA to human-adapted staphylococci.
Naming conventions for S. aureus strains
There are at least three different genetic techniques currently used for the
classification of S. aureus strains, including pulsed-field gel electrophoresis (PFGE),
multilocus sequence typing (MLST), and DNA sequencing of the X region of the
protein A gene (spa typing). Additional methods were used in the past. Consequently,
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Geographic Distribution MRSA can be found worldwide. Equine MRSA isolates also appear to vary with the location. There is evidence that these organisms can be Last Updated: February 2011 © 2014 transferred to animals. Examples of strain names are USA100. pigeons and psittacine birds) and turtles. but community-associated MRSA may colonize sites other than the nares. based on PFGE typing.. although bovineassociated strains have been suggested and CC398 has been identified. cats. How long such colonization persists. MRSA ST8 SCCmecIV]) belong to older human lineages that were common in the past. CMRSA1 or EMRSA1. or ST9 in parts of Asia). In case reports. Animals Asymptomatic colonization with MRSA. aureus of that genetic type. Pigs seem to be true reservoir hosts for MRSA CC398. which contain genetically related ST types. Cats and dogs seem to be colonized only sporadically. S. Other strains may be common among pigs in some areas (e.g. CC398 does not seem to be particularly host specific. rodents. or livestock-associated MRSA (LA-MRSA). or “t” followed by a number (e. and strains given a single name in one system are sometimes separated into more than one strain in another system. Most people who develop symptomatic infections with hospital-associated MRSA carry the organism in the nares. depending on the test used for typing. Carrier animals may serve as reservoirs for disease in themselves. Both methicillin-sensitive and methicillin-resistant strains can be found as normal commensals on the skin (especially the axillae and perineum). the nasopharynx and anterior nares of some of the population. has been reported in animals. CC8. aureus (and presumably MRSA) can be transmitted from the mother to her infant during delivery.Methicillin Resistant Staphylococcus aureus a single S. and CC398 may be uncommon or absent in these regions. by MLST. and carriage may be transient or persistent. Although names such as ST9 or CC398 are used for both methicillinresistant and methicillin-susceptible S.. and carriage is often transient.g. Hong Kong and Malaysia. MRSA are also grouped. CC22. page 2 of 14 . and for captive dolphins and walruses at a marine park. MRSA can also be disseminated on fomites (including food that has been contaminated by human carriers) and in aerosols. with colonized or infected people. ST followed by a number (e. humans seemed to be the source of the organism for an elephant calf with skin disease. People can also be infected or colonized with MRSA clonal complexes maintained in animals. t011) in spa typing. Most infections in these species are thought to be acquired from people. a bat. CC30 and CC45. and clinical cases often occur in patients who are not colonized.. into clonal complexes (e. rabbits. However. which differ between geographic regions. and most likely re-transmitted from this source to humans. aureus isolate can have more than one valid name. Humans remain infectious as long as the carrier state persists or the clinical lesions remain active. a recent outbreak in a hospital in the Netherlands suggests that more extensive person-to-person transmission can be seen under some conditions. and may be spreading in horse populations. as well as rats living on pig farms. The organisms can colonize more than one site. many MRSA strains that cause mastitis seem to be of human origin. but have been superceded by other strains. Infection or colonization has been observed in people after as little as 4 hours of close contact with a sick. which is also called “non-typeable MRSA” (NT-MRSA) because most isolates cannot be typed by PFGE (although they can be typed by other methods). the isolates referred to in this factsheet are all MRSA unless otherwise noted. such as CC398. is still uncertain. Transmission Humans In humans. MRSA are usually transmitted by direct contact. a captive elephant. and additional community-associated strains. in the absence of continued contact with the animal.g. Poultry infected with either CC398 or ST9 have been found in Europe. dogs. The most common strains in dogs and cats are those found in humans. CC398 is the predominant MRSA among pigs in Europe. Species Affected Colonization or infection with MRSA has been reported in many species including domesticated ruminants. but it has also been recognized in North America and Singapore. although the prevalence varies between regions. MRSA colonized foal. MRSA strains in horses are varied and their origin is largely unknown.g. Naming conventions are complex. Equine-adapted strains may exist. ST398) based on MLST typing. and it has been detected in other species including horses. or to less common groups. poultry and dogs.. pigs. CMRSA2 [EMRSA3] in Canada. People can also transmit CC398 to animals such as dogs. aureus is an opportunistic pathogen. Many of the common strains in this species (e. mainly by human hospital-associated or community-associated strains. captive marine mammals. Person-to-person spread of the pig-adapted MRSA strain CC398 seems to be infrequent and limited. aureus can occur any time after birth. including both nasal and rectal carriage. CMRSA5 [USA500. and to occur mainly within families or in hospitals and institutions. S. cattle.g. often via the hands. Colonization with S. birds (including poultry. CC398). and they may transmit MRSA to other animals or people. horses. There is little information about MRSA in exotic animals. In cattle.. They include a the common hospital-associated clones CC5. ST9 appears to be the prevalent MRSA strain among pigs in China. Zoonotic potential A number of MRSA strains predominantly colonize people and circulate in human populations.

This organism can also be destroyed by moist heat (121°C for a minimum of 15 minutes) or dry heat (160-170°C for at least 1 hour). colonies are usually beta-hemolytic. the product of mecA. S. postoperative wound infections. Disinfection S. Both Bordetella bronchiseptica and MRSA were isolated from the nasal and oropharyngeal tract of puppies after an outbreak of fatal respiratory disease. omphalophlebitis. alcohols. such as tracing outbreaks. and possibly even in air. In abattoirs that slaughter CC398 carrier pigs. MRSA clones or strains can be identified with molecular tests such as PFGE. One study reported that nasal swabs detected most colonized pigs. Biochemical tests such as the coagulase test are used to differentiate it from other staphylococci. MRSA can also occur in raw milk and cheese. quaternary ammonium compounds. The presence of the mecA gene defines MRSA. but only limited locations were still contaminated by the next morning. which may be found singly. A latex agglutination test can detect PBP2a. mastitis (including gangrenous mastitis) and urinary tract infections. as well as selective plates for MRSA. glutaraldehyde. Diagnostic Tests Infection with MRSA. On pig farms. If S. and less than 7 days on floors under laboratory conditions. Infections in Animals Incubation Period The incubation period varies with the syndrome. Post Mortem Lesions Click to view images The post-mortem lesions of MRSA infections are those seen with any purulent bacterial infection. bacteremia. aureus can also be identified with the API Staph Ident system. and tests to detect this gene. dermatitis including severe pyoderma. aureus is not ordinarily invasive when eaten. Phenotypic antibiotic susceptibility tests (e. metritis. phenolics. In a few case reports. including colonization. family pets seem to have acted as one reservoir for the bacteria. 17 hours in sunlight. MLST. The frequency with which this occurs is still poorly understood. such as CC398. fistulas. MRSA could be detected in a number of areas by the end of the day. Enrichment media. aureus is susceptible to various disinfectants including sodium hypochlorite. are available. The transmission of human-adapted MRSA lineages between animals is poorly understood. although the entire colony carries the resistance genes. and decolonization of humans was unsuccessful when carriage in these animals was not addressed. S. exudative dermatitis in pigs. which can cause a wide variety of suppurative infections. but some animals carried MRSA in both locations. S. formaldehyde. septic arthritis. Nasal and rectal sampling should both be done whenever possible. In addition. genetic testing or antibiotic susceptibility testing can identify methicillin resistant strains. are readily transmitted within the host species to which they are adapted. aureus. Both animal-associated and human-associated MRSA strains have been found in meat. aureus grows on a number of media. but have some drawbacks compared to detecting mecA or PBP2a. osteomyelitis. such as PCR. spa typing and other assays. iodophors. and vary with the organ system or tissue involved. One study conducted at a canine rescue facility suggested that these strains might not be transmitted readily between healthy dogs. This is usually done mainly for epidemiological purposes. aureus is isolated from an infection.. otitis. On microscopic examination. and a few carrier pigs (all weanlings) could only be found using rectal swabs. disk diffusion or MIC determination) can also be used to identify MRSA. Environmental sources and food products S. sinusitis.g. and in many species including dogs and cats.Methicillin Resistant Staphylococcus aureus Some MRSA strains. page 3 of 14 . and a combination of iodine and alcohol. isolates that do not carry mecA (and thus. and intravenous catheter or surgical implant infections. A combination of methods may be needed to identify a strain. S. in short chains or in irregular clusters. and these organisms are mainly of concern in contributing to carriage or infection by direct contact. non-spore forming coccus. rhinitis. the best sampling site to detect carriers is uncertain. aureus are reported to remain viable for 46 hours on glass. some susceptibility tests can overestimate methicillin resistance. On blood agar. MRSA can colonize more than one site. Methicillin-susceptible and resistant subpopulations can coexist in vitro. MRSA Last Updated: February 2011 © 2014 has also been found in other conditions including pneumonia. Environmental contamination with MRSA has been reported in some veterinary practices. in pairs. only a small number of bacteria may express resistance in culture. except under rare and unusual circumstances. the role of MRSA in the outbreak was uncertain. such as dust. are the gold standard for identification. The expression of resistance in phenotypic tests can also vary with growth conditions such as temperature. can be diagnosed by culture and identification of the organism. these organisms have been found in various samples. are not MRSA) can appear to be phenotypically resistant to methicillin. The presence of suture material or orthopedic implants seems to be linked to persistent infections in dogs and cats. Animals can be colonized for prolonged periods without developing clinical signs. MRSA has been specifically isolated from various skin and wound infections including abscesses. aurues is a Gram positive. even at times when MRSA patients were not detected. Clinical Signs Infection with MRSA results in the same syndromes as S. SCCmec typing.

they may the drugs of last resort. The efficacy of decolonization with antimicrobials is uncertain. regardless of susceptibility testing results.g. and many are also resistant to trimethoprim. Morbidity and Mortality Outbreaks or clusters of clinical cases have been reported occasionally among horses at veterinary hospitals. Certain antimicrobials. cephalosporins. particularly in horses. Some MRSA can appear sensitive to clindamycin during routine sensitivity testing. topical treatments and other measures have been used successfully to treat clinical cases. MRSA-infected wounds should be covered whenever possible. Although colonized people can transmit MRSA to animals. Animals treated with topical therapy alone must be monitored closely for signs of localized progression or systemic spread. Animals that have been in contact with either MRSA cases or infected/ colonized staff should be tested. all MRSA strains are considered to be resistant to penicillins. Topical treatment with mupirocin or other drugs to eliminate nasal carriage has been considered impractical in pets. and some studies suggest that MRSA may be an emerging pathogen in this species. also appear to be increasing. however.. together with antibiotics in two horses that remained longterm carriers. Dogs. intravenous catheterization and surgery. may decrease the risk of MRSA introduction to a farm by human visitors. An alternative is to screen targeted populations. e. surgical implants were also removed. and decolonization of human personnel. Avoiding routine antimicrobial use in food animals might reduce selection pressures. On farms. The best method to eliminate MRSA carriage in animals in poorly understood. It is not recommended for routine use in pets. In addition to hand hygiene. and may vary with the species. but may be considered in individual cases to control transmission. . including dedicated clothing and showering in. Researchers have recommended that veterinary hospitals initiate surveillance programs for MRSA. and re-infection is prevented. and environmental disinfection. clindamycin-susceptible MRSA isolates from dogs and cats in Canada. Whether MRSA in manure poses a risk when used as fertilizer. are critically important for treating human illnesses caused by MRSA. In some cases. and fusidic acid and chlorhexidine. inducible clindamycin resistance was very common among erythromycin-resistant. screening and segregation of animal carriers. These animals should be isolated. and lower the prevalence of these organisms in livestock. Meticulous wound management without antimicrobials was successful in one dog. lower mortality in superficial infections and higher case fatality rates in septicemia and other serious invasive page 4 of 14 . Local treatment with antiseptic compounds such as chlorhexidine or povidone iodine may be helpful in some types of infections. Successful treatments used in three colonized dogs were oral doxycycline and rifampin. non-healing or nosocomial infections. Recent publications should be consulted for the current list of critically important drugs. In some cases. and the effectiveness of measures such as composting or heat treatment. and should be avoided if at all possible. The mortality rate is expected to vary with the syndrome. Reports of infections in companion animals. Kenneling a colonized pet. MRSA may sometimes be introduced when buying new stock. Because CC398 has been detected in rats living on pig farms. and spread during livestock movements. However.g. e. Screening at admission allows isolation of carriers. preferably in isolation. but carry a gene that allows them to become resistant during treatment. are unknown. Antibiotic therapy should be based on susceptibility testing. risk factors include repeated courses of antibiotics. and animals belonging to healthcare workers or known MRSA-positive households. MRSA was eliminated with infection control measures. they are controversial for treating MRSA-infected animals.Methicillin Resistant Staphylococcus aureus Treatment Antibiotics. found among horses especially in Canada. the establishment of barrier precautions to prevent transmission to other animals. The use of these drugs in animals may place selection pressure on isolates that can infect humans. infection control measures (with particular attention to invasive devices such as intravenous catheters and urinary catheters). cats and some other animals have been known to spontaneously eliminate MRSA when the environment is regularly cleaned and disinfected. USA500). Thus. rifampin and ciprofloxacin. rats should be considered in control programs. barrier precautions should be used when there is a risk of contact with body fluids or when an animal has a recognized MRSA infection.. Susceptibility to fluoroquinolones and resistance to tetracycline seems to be typical of the epidemic MRSA strain CMRSA5 (CC8 lineage. Most CC398 MRSA are resistant to tetracyclines. when an animal remains a persistent carrier or infection control measures are impossible. In one study. such as animals with nonantibiotic responsive. such as vancomycin and tigecycline. On two colonized horse farms. hospitalizations. Biosecurity measures. screening all animals can be costly and may not be practical in some practices. one study suggests that there may be only a small risk of transmission from colonized surgical personnel if infection control protocols are followed. In addition to MRSA carriage or contact with carriers. and prompt recognition of opportunistic infections caused by these Last Updated: February 2011 © 2014 organisms. Prevention Veterinary hospitals should establish guidelines to minimize cross-contamination by MRSA and other methicillin-resistant staphylococci. or reduce transmission between units. mainly as postoperative complications and wound infections. might be considered in some situations. cephems and other ß-lactam antibiotics.

Studies from North America. One Canadian study reported that infections were clustered. endocarditis.5% to 11% were found on presentation at equine clinics and veterinary hospitals. necrotizing fasciitis. because the preformed toxin is eaten in food and the organism is not present in the body. Other toxinexpressing MRSA strains (exfoliative toxins A or B) can cause staphylococcal scalded skin syndrome. aureus. In Belgium. destructive otomastoiditis. CC398 has mainly been found in superficial skin and soft tissue infections. and in 4-7% of the cattle on infected farms. and up to 81% of the farms in some countries may be affected. In Iowa and Illinois. meningitis and septicemia. aureus. with apparently lower ST9 colonization rates in surveys from Malaysia. Infections in Humans Incubation Period The incubation period for S. page 5 of 14 . Some studies found that colonization in pigs varies with their age. although it was reported in a severely immunocompromised patient who had received antacids. or unaffected. aureus is very unusual. Elevated rates of MRSA carriage have been reported in some animal facilities such as veterinary clinics or kennels.Methicillin Resistant Staphylococcus aureus diseases. especially in Japan. as well as antibiotics to which the (methicillin-sensitive) strain was resistant. Another Belgian study detected MRSA in 20% to 100% of broiler chickens but not in laying hens. Human community-acquired-MRSA strains are mainly associated with superficial skin or soft tissue disease. Overall MRSA carriage may also be low among healthy horses in the community. and severe invasive infection with multiorgan failure. Invasive disease after ingesting S. pneumonia. but its prevalence and importance are still poorly understood. but some case reports have described aggressive wound infection. study found that up to 4% were colonized. It may be involved in various skin and soft tissue infections. the quarter-level prevalence of MRSA in milk was reported to be less than 0. sporadically colonized. In South Korea. in CC5). CC398 was isolated from healthy poultry on 13% of the farms sampled. 92% of dogs with infections mainly affecting the skin and ears were discharged. and colonization seems to be transient in many animals. a study found that 25% of swine. MRSA strains that produce enterotoxins while growing in food can cause acute staphylococcal gastroenteritis (food poisoning). where MRSA is common among people. In susceptible patients. endocarditis. Hong Kong and Brazil reported carriage rates of 0-2% among healthy dogs and cats in the community. aureus infections in humans is highly variable. Hospital-acquired MRSA strains are major causes of nosocomial infections associated with indwelling medical devices and surgical sites. with 13% or 5% of the horses colonized on two farms. Prevalence of MRSA carriage in animals Colonization with MRSA seems to be uncommon in healthy dogs and cats not linked to a source of MRSA. Clinical Signs MRSA is an opportunist.5%. antibiotic resistance is generally irrelevant in this condition.S. although one U. necrotizing pneumonia and other conditions. In Canada. a disease characterized by widespread blistering and loss of the outer layers of the epidermis. MRSA strains that carry the exotoxin TSST-1 have been found in cases of toxic shock syndrome. 84% of horses with MRSA infections at 6 veterinary hospitals in Canada survived to discharge. 0% to 24% of each broiler group entering abattoirs carried MRSA. however. nosocomial bacteremia. One study also found MRSA (mainly CC398) in 88% of the veal calf rearing units and 28% of the veal calves tested in the Netherlands. At several veterinary referral hospitals. and no MRSA detected on eight other farms. and 45% of farms were colonized with MRSA.g. In Belgium. 11% of tested swine carried MRSA. and can cause the same types of infections. sinusitis. as well as invasive conditions such as pneumonia. Some North American and European surveys reported that MRSA was isolated from 0% to less than 2% of horses surveyed. The colonization status can differ for each animal in a multi-pet household or institution. septic arthritis. All of these isolates were CC398. and 23% of their flocks of origin were colonized. However. Zoonotic MRSA can presumably cause the same types of infections as human-associated MRSA strains. assisted living facility) where humans are MRSA carriers. clinical cases may become apparent 4 to 10 days after exposure. mainly CC398 but also CMRSA2 (US100. while others detected no significant difference. Information on livestockassociated MRSA strains in other parts of the world is limited. individual animals may be persistent carriers. The reported prevalence ranges from approximately 1% to 40% in different countries. opportunistic infections can also occur after an indefinite period of asymptomatic carriage. osteomyelitis. Colonization with CC398 is very common among pigs in some parts of Europe. In another study. Approximately 11% of pigs on Chinese farms and 16% of pigs from Hong Kong markets were colonized with MRSA ST9. like other S. EMRSA3. Last Updated: February 2011 © 2014 MRSA has also been detected in poultry in several countries. with no significant differences in the survival rate compared to methicillin-sensitive S. In a household or institution (e.. Europe. but of a spa type not usually detected in other livestock. Carriage rates varying from less than 0. MRSA was detected on almost 10% of farms with mastitis problems. In the Netherlands. The mortality rate was 20% in an outbreak of exudative dermatitis caused by CC398 in young pigs. although they have also caused sepsis. especially during outbreaks.

and in some cases. the case fatality rate differs with the syndrome. and antibiotic use is restricted. environmental cleaning and other infection control measures are expected to reduce the risk of acquiring MRSA from infected or colonized animals. page 6 of 14 . close contact with other people (or susceptible animals) should be avoided. including people who work with pigs or veal calves. although severe infections can occur. High risk patients. Decolonization of humans can be controversial. Agents used to treat serious infections caused by multiple drug resistant MRSA strains include vancomycin linezolid. and vancomycin-resistant strains have been reported. but only some people are persistently colonized. Infections caused by community-acquired MRSA are also becoming more common. The best procedure to follow when a resident animal becomes colonized in a healthcare facility is still uncertain. MRSA carriage is also elevated in farm and abattoir workers who handle live swine.). and resistance to drugs. Antibiotics must be selected based on susceptibility testing. equine and small animal veterinarians). In Belgium. barrier precautions when handling animals with illnesses caused by MRSA. are isolated until the screening test demonstrates that they are MRSA-free. and screening of patients on admission. veal calves or poultry infected with CC398. Treatment may also require adjunct measures such as the removal of catheters. as in animals. Reported colonization rates among staff at veterinary hospitals and referral clinics in Europe and North America vary from 0% to 10%. Germany and Belgium. In one recent outbreak. can occur. particularly hand washing.. dry bandages. as well as the age and health of the patient. Infection control measures. carriage in pets may need to be considered. Skin infections are sometimes treated by management techniques that do not require systemic antibiotics (e. MRSA carriage Carriage rates for human MRSA strains in the general population range from less than 1% to 5%. Decolonization is not always successful. Some evidence suggests that CC398 might be less virulent in people than traditional human-adapted strains. (Staphylococcal food poisoning is diagnosed by examination of the food for the organisms and/or toxins.g. while 42% of patients colonized with other isolates were affected. skin infections occurred in 0. can affect the type of treatment chosen. mupirocin and fusidic acid) and systemic antimicrobials have been used in people. options presented to the facility included removing the animal until it cleared the bacterium. tigecycline. reported colonization with CC398 can be as high as 86% in some populations. due to occupational exposure. People who work with pigs carrying CC398 often become recolonized from this source. Community-acquired MRSA strains have often been resistant only to ß-lactam agents. including the elderly and people with open wounds. and with continued monitoring (culture) and the encouragement of good hand hygiene among human contacts. Some studies have suggested that human colonization with animal-adapted MRSA strains might be transient. and may be recommended in some situations or groups of patients. macrolides and azalides. such as the inability to adequately cover a MRSA-infected wound. incision and drainage for abscesses). and have occasionally been reported to be as high as 27%. aureus infections in humans are diagnosed by culture and identification of the organism. approximately 13% of the patients who carried CC398 had symptomatic infections.Methicillin Resistant Staphylococcus aureus Diagnostic Tests S.g. compared to universal infection control procedures alone. Resistance has been reported to some of these antibiotics. Prevention Hand washing. avoidance of direct contact with nasal secretions and wounds. It can be difficult to find an effective choice for hospital-acquired MRSA. Treatment Factors such as the location.. The Netherlands and Scandinavian counties have greatly reduced the incidence of hospital-associated human MRSA by screening and decolonization of hospital staff. In one hospital in the Netherlands. A variety of agents. Human healthcare workers are expected to be at an increased risk for colonization. MRSA outbreaks are Last Updated: February 2011 © 2014 investigated aggressively. In the Netherlands. with or without antibiotic treatment. or pigs infected with ST9. Morbidity and Mortality Hospital-associated MRSA is one of the most prevalent nosocomial pathogens worldwide. In particular. Other family members may need to be decolonized concurrently. A number of studies have also reported elevated MRSA carriage among veterinary personnel (including livestock. vancomycin resistance seems to be increasing. or allowing it to remain. quinupristin/dalfopristin and daptomycin. Most infections occur in high risk patients. Opinions in other countries remain divided on the benefits of screening on admission. Mortality also depends on success in finding an effective antibiotic for the strain. multiple antibiotic resistant strains have started to emerge.8%. even in people with no known link to a MRSA case. including mupirocin. As with many bacterial infections. Outpatients with MRSA skin lesions should keep them covered with clean. which are often resistant to most common antibiotics. but not others. including various combinations of intranasal agents (e. are also important in preventing MRSA transmission from humans. In some circumstances. resistance to other antibiotics may be increasing. where 38% of humans who lived on swine farms were colonized with CC398. However. severity and progression of the infection. the organism may be reintroduced by carriage in other parts of the body.

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