MRSA

What is MRSA?

MRSA is the most common hospital acquired infection costing the NHS around one billion pounds per year. MRSA is part of the Staphylococcus family of bacteria. As with any form of bacteria, they are constantly mutating creating new strains, each with subtle genetic mutations that make it different.

Staphylococci are carried on the surface of our bodies, and many people carry MRSA in their throat, nose and on their skin. Staphylococci bacteria can cause a mild infection such as spots but, Staphylococci can in more severe cases cause serious infections such as: Pneumonia, Sepsis, cellulitis & Endocarditis.

MRSA is frequently used as shorthand for strains of Staphylococcus that are resistant to one or more powerful antibiotics that are used to treat serious Staphylococcal infections. MRSA is no more aggressive than other infections, but crucially it is more resistant to treatment.

The problem of MRSA is not unique to hospitals. There are at least 17 variants of MRSA, with different abilities to spread between hosts and differing degrees of immunity to antibiotics. Community acquired MRSA has developed quite separately involving separate strains of Staphylococcus infecting both healthy as well as at risk individuals. Antibiotic treatments have been found to be effective against many strains.

MRSA has become synonymous with hospitals due to the quantity of vulnerable individuals in close proximity. Bacteria can be easily spread between patients and with existing strains containing mutations that are antibiotic resistant combining with new strains, a vastly accelerated evolution can take place.

Symptoms of MRSA

Because MRSA is more likely to attack those with pre-existing conditions, such as infections or wounds, it is critical to get urgent treatment to avoid further deterioration in the patient’s overall health and avoid chronic disability.

MRSA can be symptomless in some individuals but typically, symptoms will include tenderness, discolouration, swelling and suppuration. Wounds may not heal at typical rates and the patient may feel nauseous, weak and may develop a fever. MRSA symptoms may vary depending on the location of the infection. Common areas for infection to occur include burns, the blood, catheter areas, eyes & surgical wounds.

Treating MRSA

To date MRSA remains susceptible to antibiotics although studies indicate the likelihood of a time when an entirely resistant strain emerging. Typically, considerably higher quantities of antibiotics over a longer duration, often administered intravenously, will be necessary to combat it. This can means greater discomfort to the patient.

Prevention

The NHS recommends hospital patients reduce their risk of infection by:

• Always washing their hands after using the toilet or commode. Many hospitals now routinely offer hand wipes.
• Always washing their hands or cleaning them with a hand wipe immediately before and after eating a meal.
• Making sure their bed area is regularly cleaned and reporting any unclean toilet or bathroom facilities to staff.

Visitors can reduce the chance of spreading MRSA to other people by not sitting on the patient’s bed and by cleaning their hands before and after entering the ward. They should use hand wipes or hand gel before touching the person they are visiting.

Hand gel or hand wipe dispensers are often placed by patients’ beds and at the entrance to clinical areas.

Hospital staff that come into contact with patients should maintain very high standards of hygiene and take extra care when treating patients with MRSA:

• Staff should thoroughly wash and dry their hands before and after caring for a patient, before and after touching any potentially contaminated equipment or dressings, after bed making and before handling food.
• Hands can be washed with soap and water or, if they are not visibly dirty, a fast-acting antiseptic solution like a hand wipe or hand gel.
• Disposable gloves should be worn when staff have physical contact with open wounds, for example when changing dressings, handling needles or inserting an intravenous drip. Hands should be washed after gloves are removed.
• The hospital environment, including floors, toilets and beds, should be kept as clean and dry as possible.
• Patients with a known or suspected MRSA infection should be isolated.
• Patients should only be transferred between wards when this is strictly necessary.

By Finn Langley

For more information on MRSA got to – www.nhs.uk/conditions/MRSA