MRSA

Methicillin resistant
Staphylococcus aureus
 How many kinds of MRSA are
there?
There are 2 types of MRSA:
Community-acquired MRSA (CA-MRSA)
This is passed throughout a community.
You hear about school outbreaks often.
Hospital-acquired/Epidemic MRSA (EMRSA)
Generally the infection is acquired during
a hospital stay.
 A quick review
MRSA was first noted in 1961, two years
after methicillin use began.
The resistance is caused by penicillinase. This
enzyme destroys the penicillin binding protein.
MRSA is termed a superbug because of its
ability to become resistant to several
antibiotics.
MRSA is known for causing skin
(Staphylcoccus aureus) infections.
 What does MRSA look like?
Cellulitis: superficial infection Boils: pus filled infections
of skin or fat and tissues common in hair follicles
This starts as small red bumps on
the skin.
 What does MRSA look like?
Abscess: collection of pus Sty: infection of an eyelid
under the skin gland
 What does MRSA look like?
Carbuncles: infection that Impetigo: skin infection that
is larger than an abscess. exhibits pus-filled blisters
Usually you will see several
openings.
If MRSA spreads to the internal organs, it exhibits more
severe symptoms. It can become life threatening.
Symptoms include fever, chills, low blood pressure,
joint pain, severe headaches, shortness of breath,
and/or a rash covering most of the body.

My uncle acquired EMRSA while staying in a

hospital. He has since recovered ,but it took almost
2 years and he almost died twice!
 How do I get MRSA?
During an active infection, transmission occurs when
there is physical contact with the carrier.
Physical contact with fomites (objects that aid in the
transmission of infection) such as door handles,
floors, sinks, towels, etc.
People at high risk for contracting MRSA: people with
obvious skin breaks, surgical patients, hospital
patients with I.V.s, burn patients, patients with skin
ulcers, people with depressed immune systems,
infants, elderly, people with chronic diseases, people
who have Diabetes Mellitus or Cancer.
 Are there other ways of getting
MRSA besides contact?
Pneumonia MRSA is spread by droplets that
are airborne.
Health care workers are especially at risk for
contracting pneumonia MRSA. If there is a
patient with MRSA, health care workers will
wear gloves, gown up, and put on a face mask.
 How do I know if I have MRSA?
In order to get a diagnosis, they need a sample to look
at. The sample can come from skin, pus, blood, urine,
or a biopsy of the infection site.
Once they have the sample, they will culture S. aureus
and then expose it to different antibiotics. If the
sample grows well with Methicillin then it confirms
MRSA. This tends to be a time consuming method.
You can carry MRSA and not even know it! To test for
carriers, they will swab your skin or a mucous
membrane.
When I worked in Idaho Falls, I had a co-worker die
from MRSA getting into his lungs. They caught the
MRSA when they swabbed his nose.
How do I know if I have MRSA?
Recently on January 2, 2008
the FDA cleared a rapid blood
test for MRSA for use. It is
made by GeneOhm and is called
StaphSR assay test. At this
point, it can detect CA-MRSA in
95% of skin and soft tissue
infections.
How can I protect myself?
Excellent hand washing is essential. Using
good hygiene practices will help keep you
safe as well. Washing clothing, not
sharing towels, razors, or personal
hygiene products, and using disposable
items is helpful.

Avoid direct contact of a known MRSA

source or infection!
How can I protect myself?
Treat and cover skins
breaks immediately.
Use antiseptic cream
and a bandage.

Proper wound care is

essential as well. You
must dispose of used
bandages appropriately.

Dont forget to wash

your hands!
How can I protect myself?

Keeping surfaces and fomites clean will help

deter the spread of MRSA.
How is MRSA treated?
When treating MRSA you
cannot use any Methicillin
derived antibiotics.
Common antibiotics used
are Linezolid and
Vancomycin.

For the treatment of

carriers of MRSA they
use Mupirocin or
Bactroban antibiotic
cream.
How is MRSA treated?

Maggot therapy is gaining

ground in the treatment
of MRSA. The maggots
will eat the necrotic
(dead) tissue. The MRSA
does not harm the
maggots because the
maggots secrete an
enzyme that kills MRSA.
Good-bye MRSA?

Current research shows it may be

possible to use a specific virus to
kill off the MRSA cells.
 A little FYI on MRSA
1.2 million hospital patients are infected each year.
67% of non surgical medical wards test positive for
MRSA.
Mortality rate of MRSA is between 4-10%.
With all of the Vancomycin use to treat MRSA, we are
now seeing VRSA (Vancomycin resistant staphylcoccus
aureus)!
VRSA is an invasive infection that causes bacteremia, septic
arthritis, Toxic Shock Syndrome, osteomylitis, and
endocarditis.
 References
http://www.medicinenet.com/mrsa_infection/article.
htm
http://www.kaisernetwork.org/daily_reports/rep_in
dex.cfm?DR_ID=45809
http://www.cdc.gov/ncidod/EID/vol11no06/04-0831.h
tm
http://www.medicinenet.com/script/main/art.asp?art
iclekey=84780
http://www.medicinenet.com/mrsa_infection/page4.
htm