MRSA: A growing concern in health care

By Dr. Mohammad Shafi, FACP

Methicillin-resistant staphylococcus aureus (MRSA), also known as the super bug, is an increasing threat to our health. A 2007 report from the Association for Professionals in Infection Control and Epidemiology estimates that 1.2 million patients are infected with MRSA each year in the United States.

The infection is caused by a subgroup, about 40 percent, of the common staph aureus bacteria, which is resistant to a range of antibiotics, including penicillin. It’s only one of several bacteria that have become resistant to some antibiotics, but it accounts for the majority of infections.

Staph bacteria are normally found on the skin or in the nose, and healthy people can be colonized with MRSA and have no ill effects. However, they still can pass the germ to others. The infections, including MRSA, generally start as small red bumps which can quickly turn into deep, painful abscesses requiring surgical draining. Sometimes the bacteria remain confined to the skin. But, they also can burrow deep into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.

The Centers for Disease Control and Prevention (CDC) reported that nearly 19,000 people died in 2005 after an invasive MRSA infection, and it also was found that 27 percent of all invasive MRSA infections originated in hospitals, while a large percentage -- 58 percent -- began outside of a hospital in patients with recent exposure to the health care system.

It makes sense that MRSA infections occur most frequently among persons in hospitals and health care facilities because these individuals have weakened immune systems. Other risk factors include residing in a long-term care facility, recent antibiotic use, and the use of invasive devices like catheters or feeding tubes.

But, there’s also a second type of MRSA infection called community-associated MRSA, or CA-MRSA. Main risk factors include young age, close skin-to-skin contact, participating in contact sports, living in crowded or unsanitary conditions, and close contacts with health care workers.

Overall, leading causes of antibiotic resistance include unnecessary use of antibiotics in humans, antibiotics in food and water, and germ mutation. Personal hygiene is the key to avoiding MRSA infections. Wash your hands frequently, and don’t share personal items such as towels or razors. Cover all wounds with a clean bandage, and avoid contact with other people’s soiled bandages. If you share sporting equipment, clean it first with antiseptic solution.

In the hospital, people who are infected or colonized with MRSA are placed in isolation to prevent its spread. Visitors and health care workers caring for isolated patients may be required to wear protective garments - including a mask -- and must follow strict and frequent hand washing procedures.

For now, both hospital and community acquired MRSA still respond to certain medications, including vancomycin. But, it may grow resistance as well, and some hospitals already are reporting vancomycin-resistant MRSA. Other antibiotics also have proved effective against particular strains, and the benefits of using specific antibiotics can be determined by the medical staff treating colonized or infected patients.

Dr. Mohammad J. Shafi is a nephrologist with Nephrology Consultants, and he is on the active medical staff at Blount Memorial Hospital.

Two locations for caregiver support

The Caregiver Support Group at Blount Memorial Hospital meets at two different locations each month. The group meets every Wednesday from 7 to 8 p.m. on the hospital’s 3-east floor. The group also meets from 10 to 11 a.m. every first and third Tuesday at the Everett Senior Center at 702 Burchfield St. in Maryville.

The Caregiver Support Group is a free service for any adult who is caring for another adult. There are no membership requirements.

For more information, call Blount Memorial Senior Services at 865-977-5744.

© 2008 All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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