What Is MRSA?
Staphylococcus aureus (SA) is a bacterium often found on the nose and skin of a person. SA can cause a variety of illnesses from minor skin infections to more severe diseases such as meningitis and septicemia. MRSA stands for Methicillin-resistant Staphylococcus aureus and is a strain of SA that is resistant to a range of antibiotics.
Being Colonised With MRSA
An MRSA carrier is a person who has the MRSA bacteria living on their skin or in their nose but who does not demonstrate the symptoms of MRSA. Such people are often described as being colonised with MRSA.
In the case of colonisation, and unlike infection, the bacteria causes no adverse effects in a person and it exists on their skin or in their nose but does nothing more. MRSA carriers can lead normal lives and most people who are carriers don’t know it. About 30% of people are colonised with SA and most do not develop an infection.
There exists minimal risk to a person who is a carrier providing that their skin is not broken. Should an open wound develop, the bacteria can enter the carrier’s body.
Symptoms Of MRSA Infection
The following are symptoms that may suggest that the patient is infected with MRSA:
- Impetigo – pus-filled blisters produced by a skin infection;
- Cellulitis – a skin infection and infection of the fat and tissues beneath the skin;
- Carbuncles – usually with several openings to the skin, a carbuncle is an infection larger than an abscess;
- Styes – the infection of glands in the eyelid;
- Abscesses – pus in pockets under the skin;
- Boils – pus-filled infections
To begin with a small red inflammation develops. This may be mistaken for a pimple, boil, or even a spider bite. In time, the inflammation will develop into deep pus and will require surgical draining. If this is ignored, or not recognised as a symptom it could enter the body causing a fatal infection.
Once MRSA bacteria is able to enter the bloodstream, almost any part of the body can be affected. When this happens, the bacteria can cause:
- Septicaemia (blood poisoning) – the type of MRSA infection with the highest death rate;
- Lung infection (pneumonia);
- Septic shock;
- Bone marrow infection (osteomyelitis);
- Inflammation of the tissues that surround the brain and spinal cord (meningitis);
- Infection of the heart lining (endocarditis)
- Severe joint problems (septic arthritis);
- Internal abscesses.
How Does MRSA Spread?
Bacteria are spread from person to person by direct contact. A person with MRSA on their skin, especially on their hands, may touch another person and by doing so can spread MRSA.
A person may have MRSA on their hands as a result of being a carrier or from touching another person who is a carrier or infected with MRSA. People with weak immune systems, and are living in hospitals, nursing homes and other healthcare centres, are most susceptible to MRSA infection.
Who Is At Risk From MRSA
If an individual suffers from a medical condition that weakens the immune system, for example HIV/AIDS and cancer, there is a considerably increased risk. Patients having recently undergone invasive medical procedures such as surgery, catheterisation and dialysis and individuals who have recently undergone a course of antibiotics are at risk.
Increased risk comes from hospitalisation within the past year and patients in long-term healthcare facilitie.
Healthcare workers such as doctors, nurses, physician assistants and people who are in close contact with healthcare staff are also at risk.
People exposed to crowded conditions, participating in contact sports such as football and sharing contaminated items are also high risk.
Community Acquired MRSA
Although the main area of contamination for MRSA is in hospitals, there are incidences of community acquired MRSA. MRSA infections that are acquired by persons who have not been recently (within the past year) hospitalized or had a medical procedure (such as dialysis, surgery, catheters) are know as CA-MRSA infections. However, it is difficult to differentiate true community based MRSA from MRSA that people in the community may have acquired from a health care setting.
Prevention Of MRSA
The introduction of surveillance systems that track bacterial outbreaks and products such as antibiotic-coated catheters and gloves that release disinfectants may certainly help. Additionally, patients infected or colonised with MRSA should be placed in isolation.
There are a number of measures you can take to help prevent the spread of MRSA:
- Wash your hands with soap and warm running water for at least 15 seconds and regularly;
- Wash your body with antiseptic soap;
- Never share personal hygiene items;
- Disinfect the home, particularly the kitchen and the bathroom;
- Wash linens and towels with bleach and dry their clothes in a dryer (to help kill bacteria);
- Avoid if possible, and certainly be more careful around, people with weak immune systems and people with skin conditions or wounds that would make them more susceptible.
When visiting a patient in hospital, hands must be washed before and after visitation. Alcohol gels must be used regularly. No physical contact with a patient known to be infected with MRSA should be made. Furthermore, avoid wherever possible physical contact with any of the objects that the patient may have touched.
- Healthcare workers must wash and dry their hands frequently and thoroughly.
- Healthcare workers must use antiseptic solutions like alcohol rubs or gels.
- When changing dressings, handling needles, inserting an intravenous drip, or when having any kind of physical contact with open wounds, healthcare staff should be wearing disposable gloves.
- Healthcare staff have a responsibility to ensure that hospital surfaces are properly disinfected and any kind of non-compliance should be reported.
- We should consider the impact of continuous educational and training programmes on the prevention of MRSA. Furthermore, reintroducing hospital matrons might impact positively, preventing any slip in hygiene and cleanliness standards.
New research has found a direct correlation between the amount of alcohol handwash supplied to a ward and reductions in the rate of hospital acquired MRSA infections.
A study by University College London (UCL), in collaboration with the Health Protection Agency, London School of Hygiene and Tropical Medicine, and the Hand-Hygiene Liaison Group, discovered that rates of MRSA infection are cut by 1% with each extra millilitre of alcohol hand rub supplied per patient per day.
These findings are the results of an independent evaluation of the cleanyourhands campaign to boost hygiene on hospital wards and were presented at this year’s Federation of Infection Societies conference in Cardiff.
In the UK, the Labour government has called on NHS hospitals to introduce screening for routine operations. However, this is just one part of its anti-infection strategy. The recruitment of additional infection control nurses and the deep cleaning of hospitals are included in the government’s approach.
Testing for MRSA plays an instrumental role in beginning to control its spread. Screening for MRSA can be made more effective by directing it towards higher risk groups; however, this must be done in conjunction with other measures. Whether this will significantly reduce the spread in the long-term, we do not know for sure, but certainly, it is a positive move in the right direction.