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MRSA: the Lurking Killer

MRSA: the Lurking Killer. Olga Filippova Stefanie Hallman Akash Patel Stephen Pollani Dheeraj Roy. MRSA Facts. Methicillin-Resistant Staphylococcus Aureus Various Strains Respiratory tract, open wounds, invasive devices, urinary tract Already weakened immune system Detection

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MRSA: the Lurking Killer

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  1. MRSA: the Lurking Killer Olga Filippova Stefanie Hallman Akash Patel Stephen Pollani Dheeraj Roy

  2. MRSA Facts • Methicillin-Resistant Staphylococcus Aureus • Various Strains • Respiratory tract, open wounds, invasive devices, urinary tract • Already weakened immune system • Detection • Swabbing of nostrils for culture

  3. MRSA Impact • 2 million patients infected • 100,000 deaths • 5th largest cause of deaths • Heart disease, Cancer, Stroke, Chronic respiratory disease • Greater than AIDS, breast cancer, Automobile accidents combined • Median hospital cost - $16,000 per case

  4. Creating Drug Resistance • Typically bacteria are susceptible to β-lactams • Inhibits cell wall synthesis • Common example: penicillin • Using β-lactams over time results in the genetic likelihood of β-lactamase expression (mec A gene) • Susceptible bacteria die while those that can express β-lactamase thrive; an example of evolution • This enzyme is capable of breaking open the four-atom β-lactam ring (the antibiotic portion of β-lactams) • Resistance now includes β-lactamase resistant β-lactam antibiotics as well

  5. MRSA Biology • Nasal colonization of MRSA has historically been used as the primary indicator for systemic MRSA infection • Nasal colonization positive: Substantially more likely to have a systemic MRSA infection. • Nasal colonization negative: One third of patients with systemic MRSA infections will have no nasal colonization. • Differential diagnosis must include decision to treat MRSA • Treatments for MRSA are not first-line therapies for non-MRSA infections. • Using non-MRSA treatments may endanger patients infected with MRSA.

  6. References Cimolai, N. Are all MRSA made equal? Can. J. Microbiol. 48, 560, 2002. “Deaths – Leading Causes.” National Center for Health Statistics, Center for Disease Control. April 01, 2008. (April 11, 2008). <http://www.cdc.gov/nchs/FASTATS/lcod.htm> Dorey, E. MRSA: Deadly Superbug. Chemistry and Industry 8, 12, 2005. Kopp, B.J., Nix, D.E. and Armstrong, E.P. Clinical and Economic Analysis of Methicillin-Susceptible and –Resistant Staphylococcus aureus infections. Infectious Disease 38, 2004. McCaughey, B. Unnecessary Deaths: The Human and Financial Costs of Hospital Infections: 3rd Edition. 2008. (April 10, 2008). <http://hospitalinfection.org/ ridbooklet.pdf> Robicsek A, Suseno M, Beaumont JL, Thomson RB, Peterson LR. "Prediction of methicillin-resistant Staphylococcus aureus involvement in disease sites by concomitant nasal sampling." Journal of clinical microbiology 46.2 (2008):588-92.

  7. Emmanuel, FXS. "Methicillin Resistant Staphylococcus Aureus (MRSA) and its clinical impact." Behind The Medical Headlines. 2003. 22 Oct 2008 <http://behindthemedicalheadlines.com/articles/methicillin-resistant-staphylococcus-aureus-mrsa-and-its-clinical-impact> Holten, Keith B. "Appropriate Prescribing of Oral Beta-Lactam Antibiotics." Clinical Pharmacology. 2000. American Academy of Family Physicians. 22 Oct 2008 <http://www.aafp.org/afp/20000801/611.html> References (contd.)

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