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.