MRSA

1. MRSA SUPER BUG !!!!

2. What is MRSA? MRSA stands for methicillin-resistant Staphylococcus aureus. It is a type of bacterium commonly found on the skin and/or in the noses of healthy people. Although it is usually harmless at these sites, it may occasionally get into the body (eg through breaks in the skin such as abrasions, cuts, wounds or surgical incisions) and cause infections. These infections may be mild (eg pimples or boils) or serious (e.g. infection of the bloodstream, bones or joints).The treatment of infections due to Staphylococcus aureus was revolutionised in the 1940s by the antibiotic penicillin.Unfortunately, most strains of Staphylococcus aureus are now resistant to penicillin. This is because Staphylococcus aureus has 'learnt' to make a substance called ß-lactamase, that degrades penicillin, destroying its antibacterial activity. Some related antibiotics, methicillin and flucloxacillin, are not affected by ß-lactamase and can be used to treat many infections. Unfortunately, certain strains of Staphylococcus aureus, known as MRSA, have now become resistant to treatment with methicillin and flucloxacillin.Infections caused by MRSA require alternative drugs which are not available in tablet form and must be administered through a drip inserted into a vein.

3. Who gets infected? MRSA infections most often occur in patients in hospitals and are rarely seen among the general public. As with ordinary strains of Staphylococcus aureus, some patients harbour MRSA on their skin or nose without harm (such patients are said to be 'colonised'), whereas other patients may develop infections. Some patients are at increased risk of developing infectionsuch as those with breaks in their skin and those with certain types of deficiency in their immune system, such as low numbers of white cells in their blood.

4. Controlling the spread of MRSA • Hospital staff should wash their hands scrupulously, preferably using antibacterial soap and disposable towels. • Patients colonised or infected with MRSA may be kept away from other patients by being placed in separate rooms and access to such rooms should be restricted to essential personnel. • Hospital staff should wear gloves and disposable gowns prior to having physical contact with MRSA patients. Before leaving the room, they should discard these safely, and wash their hands. • Visitors and carers likely to have a lot of physical contact with patients should also wear disposable gloves and gowns. All visitors should wash their hands before leaving the room. • MRSA can survive on inanimate objects or surfaces such as linen, sinks, floors and even mops used for cleaning. For this reason, areas where MRSA patients are nursed should be thoroughly cleaned using disinfectants.

5. How is MRSA diagnosed? To diagnose MRSA infection, 'specimens' are taken from the patient, such as a swab of an infected wound or a sample of blood or urine. These are sent to a microbiology laboratory, where bacteria present in the specimen are cultured and identified. This process may take several days. Colonisation with MRSA is detected similarly, using swabs of a person's skin or from the inside of the nose.

6. Treatment of MRSA infections Although MRSA are resistant to many drugs, most remain susceptible to the antibiotics vancomycin and teicoplanin (Targocid). Infections due to MRSA are therefore often treated with one or other of these drugs. Both must be administered by infusion or injection, and for this reason, they are used for treatment only in hospitalised patients. A very few MRSA resistant to vancomycin and/or teicoplanin have been found and there is concern that they may become more common in the future. Fortunately, new antibiotics that are active against MRSA are under investigation and should hopefully become available for clinical use in the near future