The human organism contains a large number of microorganisms such as fungi, viruses and bacteria. Most of them are completely harmless and even important for life. However, under adverse circumstances, such as severe damage, some harmless groups of microorganisms can cause significant health problems. One of such microorganisms is the bacterium Staphylococcus aureus, which could be found in the nose or on the skin of humans. These bacteria can cause purulent diseases, for example, carbuncle or inflammation of the middle ear. In recent years, some strains of this microorganism became resistant to antibiotics. They are called methicillin- or oxacillin-resistant Staphylococcus aureus. Thus, MRSA should be treated with advanced antibiotics; however, it could also become resistant to these antibiotics.
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Definition of MRSA and Its Complications
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that has mutated and acquired resistance to a wide range of beta-lactam antibiotics including penicillin and cephalosporin (Acton 66). Methicillin-resistant Staphylococcus, due its mutations, developed resistance to oxacillin, tomethicillin, and dicloxacillin. MRSA can be transmitted through the skin contact with the infected person or with the carriers of bacteria, even if they do not display any symptoms. MRSA is also able to survive for a long time on medical bandages, towels, bed linens and even clothes, which contributes to the spread of the infection. Therefore, infectious diseases caused by this bacterium are more difficult to treat than other bacterial infections. Because MRSA does not respond well to treatment, it is often referred to as a superbug (Acton 97). MRSA can cause both relatively light and heavy skin infections, especially in vulnerable groups such as the elderly, newborns, and people with chronic illness or acute ailments.
Infections caused by MRSA are most common in hospitals and nursing homes and are often acquired through postoperative wounds. The elderly, whose immunity is weakened, are unable to adequately protect themselves from infection (Bowden et al. 115). Therefore, frequent contact with other people increases the risk of infection, especially if one does not comply with the rules of hygiene. Symptoms depend on which part of the body is affected. In the most severe cases, the infection could lead to serious complications or even be life-threatening. In the US, the number of people with MRSA increases by 10% annually (Bowden et al. 121). The bacterium is highly contagious because one could be infected with methicillin-resistant Staphylococcus aureus in any public place. The mortality from infections caused by methicillin-resistant Staphylococcus aureus is about 30%. Every year, more than 20,000 people in the US die from infections caused by MRSA (Bowden et al. 125). According to experts, two percent of the population is carriers of a strain of staphylococcus resistant to beta-lactam antibiotics. Currently, the primary causative agent of staphylococcal infections in hospitals is methicillin-resistant Staphylococcus aureus (Bowden et al. 84). Despite some success of the decisive measures to combat nosocomial infections caused by MRSA, the number of household cases of infection with MRSA continues to grow.
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Origins of MRSA
Methicillin-resistant staphylococcus was first recorded in the UK in 1961. In the United States, this pathogen was first noted in 1981 among drug addicts who used injection drugs (Foley et al. 62). Later, in 1997, four child deaths from methicillin-resistant staphylococcal infection were reported in Minnesota and North Dakota. The first cases of out-of-hospital methicillin-resistant staphylococcal infections were described in the mid-1990s in Australia, the United States, Finland, New Zealand, Canada, and France (Foley et al. 70). The peculiarity of these cases was that the people were infected with MRSA without being in the hospital. New community-acquired strains of methicillin-resistant Staphylococcus quickly became the most common cause of skin infections among people seeking medical care in urban areas of the United States. These strains of MRSA often cause skin infections in athletes, prisoners, and soldiers. However, in many cases, children also were infected with MRSA. In the past, methicillin-resistant Staphylococcus aureus was a problem only for hospitals. However, the development of domestic MRSA raises concern because more and more frequently MRSA infections are acquired outside hospitals. They are found especially often in deprived areas and are responsible for acute purulent inflammations (Foley et al. 86). Due to unfavorable conditions, insufficient medical care and high prices, these cases are a serious challenge for the healthcare system.
Genes of MRSA Which Made It Dangerous for Humans
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has a mecA resistant gene of 4 and 5 types in the chromosome in contrast to hospital-acquired methicillin-resistant staphylococcus, in which this gene is 1-3 types (Rello et al. 135). Additionally, household methicillin-resistant Staphylococcus contains genes of Panton-Valentine, which cause increased virulence. For methicillin-resistant strains (MRS) of Staphylococcus, heterogeneity of the population is characteristic (Rello et al. 149). The same strain can contain resistant and sensitive cells. The degree of heterogeneity varies depending on a number of factors. Thus, the expression of resistance in the laboratory is influenced by the temperature and duration of incubation, the size of the inoculum, the osmotic factor, pH and even illumination.
Treatment of MRSA
The treatment of MRSA requires a high dose of drugs, an increased duration of treatment, and the use of an alternative antibacterial agent to which a certain type of MRSA is still sensitive. The major part of methicillin-resistant Staphylococcus aureus strains is resistant to ciprofloxacin and roxithromycin (Rohde 94). Methicillin-sensitive strains of Staphylococcus aureus are sensitive to levofloxacin, vancomycin, clindamycin, and tetracycline. However, diseases caused by MRCA could be also treated with surgical intervention. For example, to treat uncomplicated cutaneous abscess, the percutaneous drainage is enough. With deeper and more serious lesions, clindamycin, tetracycline (doxycycline, minocycline), and linezolid are applied until antibiotic susceptibility is established (Rohde 102). Therefore, due to the fact that MRSA rapidly develops resistance to new types of antibiotics, hospitals, medical personnel, and patients should follow strict rules to prevent the spread of MRSA.
Prevention of MRSA
In order to prevent the spread of MRSA, the carriers of the bacterium should be placed in separate rooms to protect other susceptible patients. When performing medical procedures, all preventive measures should be implied to stop the spread of the bacterium (Weigelt 47). Medical personnel should use a variety of protective equipment such as a protective robe, gloves, and masks. Hand hygiene before and after contact with the patient is also very important. It is the primary measure of preventing the spread of MRSA. Hands should be washed for at least 15 seconds before wiping them with a towel. One should have an antiseptic hand gel with 60% alcohol content to clean hands when there is no access to soap and water (Weigelt 49). The patients should use their personal hygiene items, which should not be shared with others. To prevent the infection in the domestic environment, one should immediately provide care to any wounds and abrasion by rinsing them and applying a waterproof bandage (Weigelt 50). In addition, it is highly important to wash sport clothes after each workout in the gym because MRSA has the opportunity to spread rapidly in public places.
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Methicillin-resistant Staphylococcus aureus (MRSA) is a type of staphylococcal bacteria that is unresponsive to beta-lactam antibiotics. MRSA is contagious and can cause an infection that threatens the patient’s life. MRSA lives in the nose and on the skin of a human. MRSA is usually found in the upper parts of the nasal passages and respiratory tract, in open wounds, and the urinary tract. Patients with a weak immune system face a significantly higher risk of infection. MRSA does not have any specific treatment since the bacterium is resistant to many antibiotics. An important factor in protecting patients from MRSA is to improve the hygienic conditions in hospitals since manual examinations in hospitals contribute to the spread of the infection. The solution to this problem lies in the careful hand hygiene before and after contact with each patient.