MRSA

Question 1

What are some general characteristics of Staphylococcus aureus.

Answer 1

• Normal microbiota of skin and nose of healthy people
• 20-30% of population colonized in nose

Question 2

What are some minor and serious staph infections symptoms?

Answer 2

• Sometimes causes skin infections- skin barrier is broken or invaded by medical procedure
• Serious infections- surgical wound infection, bloodstream infections. Pneumonia, UTI

Question 3

% of folks with S. aureus? % of folks with MRSA?

Answer 3

2% colonized with MRSA

20-30% with S. aureus

Question 4

What is MRSA and when did it show up? What is VISA? What is VRSA?

Answer 4

Methicillin- in 1959 was the first semisynthetic penicillin designed against penicillinases

• S. aureus developed resistance- the first problem in UK in 1961
• Outbreak in US in late 1960s
• So prevalent that methicillin use is discontinued in US
• Resistance to other antibiotics- oxacillin, penicillin, amoxicillin, cephalosporins
• New strains of MRSA showing resistance
• Vancomycin intermediate-resistant Staphylococcus aureus (VISA)
• Vancomycin-resistant Staphylococcus aureus (VRSA)

Question 5

What is HA-MRSA and where does it frequently occur (what are some characteristics of it)?

Answer 5

• Healthcare-associated MRSA
• Main reservoirs are infected or colonized patients
• Personnel can be reservoirs but are mostly links for transmission between patients
• Main mode of transmission- hands by staff

o Weakened immune systems

o Have wounds and open sores

o Lots of exposure to antibiotics

Question 6

What is CA-MRSA and some characteristics of it?

Answer 6

• Community-associated MRSA
• People who have not been recently hospitalized or had a medical procedure
• Young and healthy
• Prisoners, athletes, school/daycare children, military recruits
• Usually, this MRSA is susceptible to more types of antibiotics

Question 7

List some treatment regimens for MRSA.

Answer 7

• Drain boil/abscess-by healthcare provider
• Vancomycin or teicoplanin

o Now strains of MRSA showing resistance

o New antibiotics

§ Linezolid (Zyvox)

§ Daptomycin (cubicin)

Question 8

• Prevention in healthcare:

Answer 8

o Wash hands constantly

o Glove use and proper use

o Masks when needed

o Gowns when needed

o Appropriate device handling

o Correct handling of laundry

Question 9

• Prevention in community

Answer 9

o Wash hands

o Keeps cuts/scrapes covered/clean

o Avoid contact with other people’s wounds or bandages

o Avoid sharing personal items such as towels or razors