Healthcare or Hospital Acquired MRSA


Healthcare-acquired methicillin-resistant Staphylococcus aureus, or HA-MRSA, is a potentially deadly strain of Staph aureus that is resistant to several antibiotics. This superbug has been appearing more and more in hospitals and other healthcare settings, representing a growing public health problem in the United States.

Species Name: Staphylococcus aureus

Type of Microbe: Gram-positive bacteria

How Does HA-MRSA Spread?

Many patients in hospitals are carriers of HA-MRSA but do not have disease symptoms. While these patients are the most common source of the bacteria, transmission occurs when healthcare workers’ hands touch other patients who are HA-MRSA carriers. Failure to wash contaminated hands can foster spread of the bacteria. It's important to have good hygiene practices in the hospital — for everyone — to prevent these infections from spreading.

Other sources of transmission in healthcare settings include open wounds, catheters, or breathing tubes.

Who Is at Risk for Getting Infected?

HA-MRSA infections occur frequently in hospitals and healthcare facilities, where patients undergo invasive medical procedures or have weakened immune systems.

Symptoms, Diagnosis, and Treatment 

Symptoms: HA-MRSA infections may include surgical wound infections, urinary tract infections, skin infections like cellulitis, bone infections like osteomyelitis, joint infections that are infectious arthritis, bloodstream infections with a sepsis picture, and pneumonia.

An HA-MRSA skin infection may appear as a red, swollen, painful area on the skin. It can also take on the form of an abscess, boil, or pus-filled lesion, and may be accompanied by fever and warmth around the infected area.

More serious HA-MRSA infections have symptoms that include chest pain, chills, fatigue, headache, and rash.

MRSA can even lead to infections in the heart — like endocarditis.

Diagnosis: Depending on your symptoms, your doctor may recommend tests, such as blood culture, drainage from the infection, skin culture, sputum culture, or urine culture, to diagnose HA-MRSA.

Prognosis: HA-MRSA-related pneumonia and bloodstream infections can be life-threatening, especially without treatment.

Treatment: Antibiotics (not including methicillin) are usually the first choice of treatment for HA-MRSA infections. Antibiotics that your doctor could select include clindamycin, linezolid, tetracycline, trimethoprim-sulfamethoxazole, or vancomycin. The choice of antibiotic will depend on the nature of the infecting bacterial strain (local patterns of antibiotic resistance and information from cultures)and severity of illness. It is important to complete your entire prescription according to doctor’s orders to avoid further complications. The choice of antibiotic depends on local resistance patterns, culture data (if available) and the severity of the illness. More serious infections may require hospitalization, during which treatments may include intravenous fluids and medication, kidney dialysis (in the case of kidney failure) and oxygen therapy (increasing oxygen supply to the lungs).

Prevention: Wash your hands frequently with soap and water, especially at hospitals or other healthcare facilities. Make sure your healthcare providers wash their hands with soap and water before examining you.

How Does HA-MRSA Cause Disease?

Staph aureus causes an array of diseases, and it is believed that each disease manifestation depends on many factors. In general, Staph aureus sticks to different kinds of tissue within the body and has ways of evading the immune response. For example, it can make proteins that interfere with and destroy white blood cells during an immune response.

Many symptoms of Staph aureus infections occur as a result of tissue destruction by bacterial enzymes. For example, Staph aureus produces toxins, known as superantigens, that can induce septic shock.

In hospital settings, Staph aureus can form a slimy material, called a biofilm, on certain solid surfaces (catheters and prosthetic devices); the biofilm serves as a protective barrier against the immune system and antimicrobial agents.

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Article Sources

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