Friday, January 09, 2009

Methicillin-resistant Staphylococcus aureus (MRSA)

Knowledge is Power, so says the quote of British philosopher, Sir Francis Bacon. I firmly believe that is true. MRSA is a real threat to our health and well being, and we are particularly vulnerable to this "Super Bug" when we are in the healthcare setting. I can't recall a time in the 14-plus years I've been involved in nursing when MRSA-infection wasn't an issue of concern. In the last few years media attention to this bacterial infection has waxed and waned resulting in a "sometimes" higher level of public awareness and level of concern.

Although patients and their families often know enough to be worried about acquiring MRSA, it can be difficult to receive reliable information within the healthcare setting. One hospital I worked in published a very nice brochure that was intended to educate patients and visitors about MRSA infection. Unfortunately, those brochures were so popular that the supply was quickly depleted; within weeks there were no more to be had. In my department, we constantly treated stubborn MRSA infections with intravenous antibiotics and/or complex wound care. However, influenced by departmental budget concerns, our director opted not to order the MRSA brochure from the hospital printshop to distribute to our patients. We managed to borrow one of the original brochures from another department, and we kept it in a cupboard where motivated employees could reproduce it on the copy machine when desired. (Many of our MRSA patients had been previously hosptalized with the condtion and had no teaching about their infection at any phase of their illness.) An understanding of MRSA is of the utmost importance in both prevention and treatment of this condition.

As a visual learner, I like to know step-by-step details. Because that's the way I like to learn, I feel it's probably useful to others to explain MRSA by going back to the basics of the bacteria responsible. (I'll follow-up in separate posts later with additional details and resources regarding treatment and prevention of MRSA.)

What Kind of Name is MRSA?

A level of confusion persists between the terms used to describe MRSA. (Some healthcare workers use the pronunciation "mersa," while others--me included--call it "M.R.S.A.")

Staphylococcus or "staph" is a type of bacteria. When seen under a microscope, staph looks like clumps of grapes. The round shape of the bacteria is responsible for the "-coccus" suffix. There are plenty of staph living on our skin and mucus membranes which do not cause any tissue damage or infection. When we harbor bacteria without ill effects, we are "colonized" rather than infected.


All bacteria have a scientific "first and last name,: so to speak. Of the more than 20 different kinds of staph infections, two are more common. Staphylococcus epidermis ("staph epi"is a nickname for this germ) usually lives harmlessly on the surface of our skin--hence the "last name" of epidermis. And although Staphylococcus aureus can and does live harmlessly on our skin and mucus membranes, it is the staph that is most likely to cause a serious infection. (Aureus means "golden" and refers to the color of the bacteria clusters.)

Methicillin is a type of antibiotic (in the same family as penicillin) which used to be effective in treating most staph aureus infections. When an antibiotic is not effective against a particular strain of bacteria, the bacteria is said to be "resistant" to the antibiotic. Other antibiotics must be sought to effectively kill the infecting bacteria.

To summarize:

MRSA refers to a staph bacteria that can causes serious infection because it is not effectively killed by penicillin-type antibiotics.

 

Read more about MRSA from the Mayo Clinic and the CDC.


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