MRSA

MRSA Concerns

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chart of mrsa in 2004 and 2005

MRSA (sometimes referred to as the superbug) stands for methicillin-resistant Staphylococcus aureus (SA). SA is a bacterium from the Staphylococcus aureus family.

About 1 in 3 of us carries SA on the surface of our skin, or in our nose, without developing an infection. This is known as being colonised by the bacteria. However, if SA bacteria get into the body through a break in the skin they can cause infections such as boils, abscesses, or impetigo. If they get into the bloodstream they can cause more serious infections.

Most SA infections can be treated with antibiotics such as methicillin (a type of penicillin). However, SA is becoming increasingly resistant to most commonly used antibiotics. MRSA bacteria are those types of SA bacteria that are resistant to methicillin (and usually to some of the other antibiotics that are normally used to treat SA infections). 

MRSA is no more infectious than other types of SA bacteria. However, MRSA infections are more difficult to treat due to the antibiotic-resistance of the bacteria. Antibiotics can still be used to treat MRSA - the infection may simply require a much higher dose over a much longer period, or the use of an antibiotic to which the bacteria is not resistant.

However, if SA bacteria are able to enter the body they can cause infection. The symptoms will depend on the type of infection they cause.

Most SA infections are skin infections, including:

• boils (pus-filled infections of hair follicles),
• abscesses (collections of pus in pockets under the skin),
• styes (infection of glands in the eyelid),
• carbuncles (infections larger than an abscess, usually with several openings to the skin),
• cellulitis (infection of the skin and the fat and tissues that lie immediately beneath it), and 
• impetigo (a skin infection that produces pus-filled blisters).

You should keep an eye on minor skin problems like spots, cuts or burns. If you have a wound that becomes infected you should see your doctor.

Although most SA infections are skin infections, if SA bacteria are able to enter the bloodstream (bacteraemia) they can affect almost any part of the body. They can cause:

• septicaemia (blood poisoning),
• septic shock (widespread infection of the blood that leads to a fall in blood pressure and organ failure),
• severe joint problems (septic arthritis),
• bone marrow infection (osteomyelitis),
• internal abscesses anywhere within the body,
• inflammation of the tissues that surround the brain and spinal cord (meningitis),
• lung infection (pneumonia), and 
• infection of the heart lining (endocarditis).

SA bacteria can also cause scalded skin syndrome and, very occasionally, toxic shock syndrome.

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium responsible for difficult-to-treat infections in humans. It may also be referred to as multiple-resistant Staphylococcus aureus or oxacillin-resistant Staphylococcus aureus (ORSA). The organism is often sub-categorized as Community-Associated MRSA (CA-MRSA) or Hospital-Associated MRSA (HA-MRSA) depending upon the circumstances of acquiring disease, based on current data that these are distinct strains of the bacterial species.[1]

MRSA is a resistant variation of the common bacterium Staphylococcus aureus. It has evolved an ability to survive treatment with beta-lactam antibiotics, including penicillin, methicillin, and cephalosporins.[2] MRSA is especially troublesome in hospital-associated (nosocomial) infections. In hospitals, patients with open wounds, invasive devices, and weakened immune systems are at greater risk for infection than the general public. Hospital staff who do not follow proper sanitary procedures may transfer bacteria from patient to patient.

About 0.8% (2.3 millions people) of the U.S. population has MRSA, and these people are called MRSA carriers. Invasive (serious) MRSA infections occur in approximately 94,000 people each year and are associated with approximately 19,000 deaths, reportedly more deaths than HIV per year. Of these MRSA infections that cause death, about 86% are HA-MRSA and 14% are CA-MRSA (community-acquired MRSA ; MRSA infections that are acquired outside health-care settings).

MRSA is the abbreviation for methicillin-resistant Staphylococcus aureus. Staphylococcus is a group of bacteria, familiarly known as Staph (pronounced “staff”), that can cause a multitude of diseases as a result of infection of various tissues of the body. In 1959, methicillin, an antibiotic closely related to penicillin, was introduced to treat Staphylococcus and other bacterial infections. Within one to two years, Staphylococcus aureus bacteria (S. aureus) started to be isolated that were resistant to methicillin. These S. aureus bacteria were then termed methicillin-resistant. MRSA usually show resistance to many antibiotics.

Because MRSA is so antibiotic resistant, it is termed a “superbug” by some investigators. This superbug is a variation of an already recognized human pathogen, S. aureus, gram-positive bacteria that occur in grape-like clusters. Distribution of S. aureus is worldwide: As many as 11%-40% of the population is estimated to be colonized. The bacteria are usually found in the human armpit, groin, nose, and throat. In the majority of cases, the bacteria do not cause disease. However, damage to the skin or other injury may allow the bacteria to overcome the natural protective mechanisms of the body leading to infection.

Even without antibiotic resistance, S. aureus has effective means to cause infections. Bacterial strains of S. aureus can produce proteolytic enzymes (enzymes that break down proteins resulting in pus production), enterotoxins (proteins that cause vomiting, diarrhea and in some cases, shock), exfoliative toxin (a protein causing skin disruption, blisters), and exotoxin TSST-1 (a protein that can cause toxic shock syndrome). Adding antibiotic resistance to this long list of pathogenic mechanisms (ways to cause infection) makes MRSA a formidable superbug.

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