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Methicillin-Resistant Staphylococcus Aureus
(MRSA)
Jason RhynerHS 404
Northern Arizona University
MRSA background MRSA in the United States
Data and Measures Patterns of MRSA
MRSA in Germany Data and Measures Patterns of MRSA Summary and Conclussion
Outline
MRSA is a bacterial infection
Resistant to most antibiotics
Typically found in skin infections Also found in respiratory tract
MRSA Background
Typically found in hospital setting Until early 1990’s
Spread very easily
Spread through direct contact Open sores or shared items like towels and razors
Background cont.
Possible Symptoms:
Pimple like sores Red, painful, or swollen area around site May be warm to touch May have pus draining from site Fever
Background cont.
MRSA infections come in four stages:
Susceptibility Pre-symptomatic disease Clinical disease Recovery, disability, or death
Background cont.
SusceptibilityNo physical signs or symptoms
Four Stages of MRSA Infection
Pre-symptomatic stage:Detected with throat or rectal
swabsOften done in patients during long-term hospital stays
Four Stages cont.
Clinical Disease:Physical signs and symptoms presentRed spotsSwellingPossible pus production
Four Stages cont.
Recovery, Disability, or Death The end result of the infection and
treatment attemps
Four Stages cont.
Poor Hygiene habits Exposure to infected individual or equipment Recent hospitalization Long-term care facility stay Evasive medical devices like urinary catheters Homosexual sex between men
Risk Factors
Data and Measures Usually maintained at a hospital level Tracked based on occurrence Mortality rates also tracked
MRSA in the United States
As of 2013 per CDC:26 cases for every 100,000
population
Patterns in the United States
MRSA in GermanyData and MeasuresPatterns of MRSA
MRSA in Germany
Higher incidence since the late 1990’s in Germany Higher incidence in general public
Not just in health care facilities MRSA is most common drug resistant disease in Germany
Data and Measures
Since 2010 in German hospitals: Average of 132,000 new cases per year 20% of all staph infections positive for
MRSA
Data and Measures cont.
Elderly community is most commonly effected 66% infected are over the age of 50
Men more commonly effected than women Many infections came from contact with animals
Pig farms are a common source 86% of pig farmers in Germany test positive
Patterns of MRSA in Germany
MRSA typically found in skin infections Appear as pimples or ingrown hairs Painful sites Red area Possible pus production
Summary
MRSA is resistant to several antibiotics People at higher risk:
Elderly Long hospital stays Poor hygiene
Summary cont.
Prevention of MRSA techniques Thoroughly washing hands Covering open wounds until they scab over Body Substance Isolation in health care workers Clean and sanitize equipment
Summary cont.
Albrich, W.C. & Harbarth, S. (2008). Health-care workers: source, vector, or victim of MRSA?. The Lancet Infection Diseases, 8(5), 289-301.
Batra, R., Eziefula, A.C., Wyncoll, D., & Edgeworth, J. (2008). Throat and rectal swabs may have an important role in MRSA screening of critically ill patients. Intensive Care Medicine, 34(9), 1703-1706.
Center for Disease Control and Prevention. (2014). Methicillin-resistant Staphylococcus aureus (MRSA) infections. Retrieved from http://www.cdc.gov/mrsa
David, M. & Daum, R. (2013). Update on epidemiology and treatment of MRSA infections in children. Current Pediatrics Reports, 1(3), 170-181.
Dulon, M., Haamann, F., Peters, C., Schablon, A., & Nienhaus, A. (2011). MRSA prevalence in European healthcare settings: a review. BMC Infectious Diseases, 11(138). doi: 10.1186/1471-2334-11-138
Ferry, T. & Etienne, J. (2007). Community acquired MRSA in Europe. British Medical Journal, 335(7627), 947-948.
References
Harris, S.R., Feil, E.J., Holden, M.T.G., Quail, M.A., Nickerson, E.Kl, Chantratita, N., Gardete, S., Tavares, A., Day, N., Lindsay, J.A., Edgeworth, J.D., de Lencastre, H., Parkhill, J., Peacock, S.J., & Bentley, S.D. (2010). Evolution of MRSA during hospital transmission and intercontinental spread. Science, 327(5964), 469-474.
Hawkes, M., Barton, M., Conly, J., Nicolle, L., Barry, C., & Ford-Jones, E.L. (2007). Community-associated MRSA: superbug at out doorstep. Canadian Medical Association Journal, 176(1), 54-56.
Kallen, A.J., Mu, Y., Bulens, S., Reingold, A., Petit, S., Gershman, K., Ray, S.M., Harrison, L.H., Lynfield, R., Dumyati, G., Townes, J.M., Schaffer, W., Patel, P.R., & Fridkin, S.K. (2010). Health care-associated invasive MRSA infections, 2005-2008. The Journal of the American Medical Association, 304(6), 641-647.
Klevens, R.M., Morrison, M.A., Nadle, J., Petit, S., Gershman, K., Ray, S., Harrison, L.H., Lynfield, R., Dumyati, G., Townes, J.M., Craig, A.S., Zell, E.R., Fosheim, G.E., McDougal, L.K., Carey, R.B., & Fridkin, S.K. (2007). Invasive methicillin-resistant Staphylococcus aureus infections in the United States. The Journal of the American Medical Association, 298(15), 1763-1771.
References cont.
Kock, R., Mellman, A., Schaumburg, F., Friedrich, A.W., Kipp, F., & Becker, K. (2011). The epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) in Germany. Deutsches Arzteblatt Internation, 108(45), 761-767.
Kupfer, M., Jatzwauk, L., Monecke, S., Moblus, J., & Weusten, A. (2010). MRSA in a large Germany university hospital: male gender is a significant risk factor for MRSA acquisition. GMS Krankenhaushygiene Interdisziplinar, 5(2), 1-8.
Moet, G.J., Jones, R.N., Biedenbach, D.J., Stilwell, M.G., & Fritsche, T.R. (2007). Contemporary causes of skin and soft tissure infections in North America, Latin America, and Europe: report from the SENTRY Antimicrobial Surveillance Program (1998-2004). Diagnostic Microbiology and Infectious Disease, 57(1), 7-13.
Otto, M. (2012). MRSA virulence and spread. Cellular Microbiology, 14(10), 1513-1521.
Su, C.H., Chang, S.C., Yan, J.J., Tseng, S.H., Chien, Li.J., & Fang, C.T. (2013). Excess mortality and long-term disability from healthcare-associated Staphylococcus aureus infections: a population-based matched cohort study. PLOS ONE, August 06, 2013. doi: 10.1371/journal.prone.0071055
Wenzel, R.P., Bearman, G., & Edmond, M.B. (2008). Screening for MRSA: a flawed hospital infection control intervention. Infection Control and Hospital Epidemiology, 29(11), 1012-1018.
References cont.