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TheÂ methicillin-resistant Staphylococcus aureusÂ orÂ MRSAÂ (also known by itsÂ English acronymÂ MRSAÂ -Â Methicillin-resistantÂ StaphylococcusÂ aureus) Â isÂ aÂ bacteriumÂ thatÂ has becomeÂ resistant to multipleÂ antibiotics,Â firstÂ toÂ penicillinÂ inÂ 1947, and soon after methicillin.Â It wasÂ originally discoveredÂ in the UKÂ inÂ 1961Â and is currentlyÂ muchÂ hype, particularlyÂ inÂ hospitalÂ buildings, where,Â becauseÂ ofÂ increasing resistance, StaphylococcusÂ aureusÂ (goldenÂ staph) isÂ evenÂ calledÂ aÂ superbugÂ (orÂ super-germ). MRSAÂ mayÂ alsoÂ beÂ known asÂ oxacillin-resistantÂ StaphylococcusÂ aureusÂ (ORSA)Â and multiple-resistantÂ StaphylococcusÂ aureus, while inÂ strains ofÂ S.Â notÂ aureusÂ resistantÂ to methicillinÂ areÂ sometimes calledÂ methicillin- susceptiblesÂ Staphylococcus aureus (MSSA),Â if anyÂ need toÂ distinguish them. Although,Â MRSAÂ has traditionally been seenÂ asÂ aÂ meansÂ of a hospitalÂ associated infection, there isÂ nowÂ anÂ epidemicÂ inÂ the U.S.Â of MRSAÂ thatÂ isÂ acquiredÂ by the community.Â TheabbreviationsÂ CA-MRSA (communityÂ associatedÂ MRSA)Â andÂ HA-MRSA (hospitalassociatedÂ MRSA)are used to distinguishÂ the twoÂ situations.
Methicillin-resistant aureus - is the bacterium that causes difficulty to cure disease in humans, such as blood diseases, pneumonia.Â Just call it: Staphylococcus aureus with multidrug-resistant Staphylococcus aureus. Methicillin-resistant aureus - represents any strain of Staphylococcus aureus bacteria that is resistant to a large group of antibiotics - beta-lactams (including penicillins and cephalosporins).Â Methicillin-resistant aureus has adapted to survive in the presence of methicillin, oxacillin and dicloxacillin.Â Most often linked with it, hospital (nosocomial) infections.Â In hospitals, patients with open wounds and with the weakened immune systems are at greater risk of infection than other patients.Â Hospital staff who does not comply with proper sanitary regulations, may transfer bacteria from patient to patient, according to Infectious Diseases. Methicillin-Resistant Staphylococcus Aureus (MRSA) (2010).Â Visitors with a staph infection of Methicillin-resistant are encouraged to follow the protocol of infectious hospital: use of gloves, gowns and masks if indicated.Â Visitors, including health care workers, who do not follow such protocols, facilitate the spread of bacteria in kitchens, bathrooms, elevators, and in various other areas.Â
Methicillin-resistant aureus is often referred to as the agents of community acquired staph infections methicillin-resistant or health sanitary connected methicillin-resistant staphylococcal infections, although this distinction is complex. The first cases of community-acquired staph infections methicillin-resistant were described in the mid 1990's in Australia, New Zealand, the United States, United Kingdom, France, Finland, Canada, the feature was that sick people who have not stayed in hospitals.Â New strains of community-acquired staph of methicillin-resistant, quickly became the most common cause of skin infections among individuals seeking treatment in urban areas of the United States.Â These strains also commonly cause skin infections in athletes, prisoners and soldiers.Â However, in many cases, the sick and children require hospitalization.Â As a fact, methicillin-resistant staph infection kills about 18,000 Americans annually.
Methicillin-resistant aureus was first discovered in 1961 in the United Kingdom.Â For the first time its appearance in the U.S. pointed out in 1981 among injecting drug users.Â In 1997, four deaths were reported involving children from the Minnesota and North Dakota.Â Statistics indicate a growing epidemic to spiral out of control.Â It is difficult to determine the extent of morbidity and mortality from this disease.Â Population studies of the incidence of infection in San Francisco during 2004-2005, showed that about 1300 people suffer from the infection within a year.Â In 2004, the study showed that in the United States with S. aureus infection was on average three times the increased duration of hospital stay (14.3 vs. 4.5 days), and five times greater risk of death (11,2%Â vs. 2.3%) than patients without this infection.
Mortality: AlthoughÂ reportsÂ claimÂ thatÂ NoskinÂ andÂ otherÂ patientsÂ got infectedÂ withÂ MRSAÂ are five times moreÂ likelyÂ toÂ dieÂ thanÂ otherÂ patientsÂ is not yetÂ clearÂ that patientsÂ whoÂ are infectedÂ withÂ MRSAÂ haveÂ aÂ higherÂ mortality rate.Â In aÂ reportÂ ofÂ Wyllie Â etÂ al.,Â thisÂ refers to aÂ mortality rateÂ among patientsÂ infectedÂ withÂ MRSA,Â within 30Â days,Â 34%,Â while in patientsÂ withÂ MSSAÂ mortality rateÂ wasÂ similarÂ to 27%.
PresentationÂ andÂ clinical interests: TheÂ most commonÂ coloniesÂ ofÂ S.Â aureusÂ are inÂ the respiratory systemÂ andÂ open wounds, intravenous cathetersÂ and urinary system. MRSAÂ infectionsÂ areÂ usuallyÂ asymptomaticÂ in healthy individualsÂ andÂ thatÂ canÂ lastÂ from several weeks toÂ severalÂ years.Â PatientsÂ withÂ compromised immune systemsÂ have a higherÂ risk ofÂ symptomaticÂ secondary infectionÂ (manifestationÂ ofÂ disease symptoms).
Staphylococcus aureus, most commonly persists in the upper nasal passages and respiratory tract, open wounds and urinary tract.Â In healthy people, the disease can be asymptomatic for a period of several weeks to many years.Â In patients with compromised immune systems, to a large extent a higher risk of symptomatic infection. There have been taken additional sanitary measures for those who are in contact with infected people: family members, medical staff.Â They are found to be effective in minimizing the spread of infection in hospitals in the United States, Denmark, Finland and the Netherlands.Â
There is a significant progression of infection in 24-48 hours after the initial pressing of symptoms.Â At the end of 72 hours, the bacteria can penetrate into human tissue and acquire resistance to drugs.Â Initially, there are small red bumps that resemble pimples, spider bites, which may be accompanied by fever and sometimes a rash.Â A few days later bumps become larger, more painful, and can be filled with pus.Â About 75% metitsillin rezistentnyh staphylococci localized in the skin, soft tissue and can be effectively treated.Â However, strains have increased virulence and survive the disease more serious than the traditional staph infection.Â They can affect vital organs and lead to widespread infection (sepsis), toxic shock syndrome and necrotizing pneumonia.Â It is believed that this is due to the toxins of strains.Â It is not known why some healthy people develop skin infections, which are treatable, while others infected with the same strain develop severe infection that can result in death.Â The most common manifestations are skin infections, necrotizing fasciitis, piomiozit, necrotic pneumonia, infective endocarditis (which affects the heart valves).Â Often, the infection leads to the formation of abscesses that require surgical intervention.
High-risk groups include:Â People with weakened immune systems (people with HIV / AIDS, cancer patients, patients after organ transplantation, severe asthmatics, etc.); Diabetics, People who use injection drugs, Patients receiving antibiotics, Kids, Older people, Students living in dormitories, Persons within or working in medical institutions for a long period of time, People who spend time in coastal waters, beaches, People who spend time in a confined space with other people, including prisoners, soldiers, athletes.Â
Staphylococcal infections occur mainly in hospitals and medical facilities, nursing homes.Â However, it should be noted that the infection may be outside hospitals - in closed systems, such as prisons, with constant admission of new inmates, usually with poor health and non-compliant rules of personal hygiene.Â Infections increased in livestock - mostly sick pigs and cattle and poultry, from which the pathogen can be transmitted to humans.Â In the United States was to increase the number of reported outbreaks of infection transmitted through the skin into the locker rooms and gymnasiums, even among the healthy population.Â Also methicillin-resistantÂ staphylococcal infection becomes a problem in pediatrics, according to Methicillin- ResistantÂ Staphylococcus AureusÂ (MRSA) (2011).
Prevention and control of infection: Screening System, Disinfection of surfaces - alcohol was effective disinfectant - can be used quaternary ammonium in combination with alcohol to extend the disinfection.Â In health care, methicillin-resistantÂ staph can survive on surfaces and clothing of health workers. Complete decontamination of the surface is needed in the wards, procedural; Personal hygiene- Isolation of patients with suspected (or confirmed) by infection with S. aureus,Â Limited and rational use of antibiotics.
Laboratory diagnosis: Detection of outbreaks of staphylococcal infection methicillin-resistantÂ conducted microbiological diagnostic and reference laboratories.Â There are rapid methods for determining the form and characterize the strain of the pathogen.Â Methods such as real-time PCR or quantitative PCR is increasingly used in clinical laboratories for rapid detection and identification of strains of Staphylococcus methicillin-resistant.Â Another widely used laboratory test - a test of latex agglutination, allowing to determine Î²-lactam-resistant penitsillin connecting protein (English) PBP2a, which confers resistance of Staphylococcus aureus to methicillin and oxacillin.
According to Methicillin-ResistantÂ Staphylococcus AureusÂ (MRSA) (2011), vancomycinÂ andÂ teicoplaninÂ areÂ glycopeptide antibioticÂ (s)Â used toÂ treatÂ MRSAinfections.Â TeicoplaninÂ isÂ aÂ congenerÂ estructuralÂ vancomycinÂ thatÂ hasÂ aÂ similar spectrumÂ ofÂ activity, butÂ withÂ aÂ higherÂ average lengthÂ (tÂ Â½).Â BothÂ drugs Â haveÂ aÂ slow oral absorption, soÂ they areÂ administeredÂ intravenouslyÂ forÂ infectionsÂ inÂ the body(system),Â withÂ theÂ exceptionÂ ofÂ pseudomembranousÂ colitisÂ whereÂ vancomycinÂ can be administeredÂ orally. ManyÂ newÂ strainsÂ ofÂ MRSAÂ wereÂ foundÂ thatÂ showed resistance toÂ antibioticsÂ evenÂ to vancomycin and teicoplanin. Linezolid,Â quinupristinÂ /Â dalfopristin,Â daptomycin, tigecyclineÂ additionsÂ areÂ theÂ mostÂ currentÂ treatments,Â usuallyÂ reserved Â forÂ more severe infections,Â the glycopeptidesÂ whichÂ can notÂ respond.Â TheÂ less severe infectionsÂ may be treatedÂ byÂ oral agentsÂ (administeredÂ orally),Â including:Â linezolid, rifampicinÂ +Â fusidicÂ acid,Â pristinamycin,Â cotrimoxazoleÂ (trimedoprimasulfamedoxazoleÂ +), doxycycline,Â and clindamycin. OnÂ May 8, 2006Â aÂ team ofÂ researchers fromÂ MerckÂ Pharmaceuticals,Â the magazine Nature, whichÂ published, and wasÂ discoveredÂ by them,Â aÂ new typeÂ of antibiotic, called platensimicina,Â and demonstratedÂ that thisÂ couldÂ beÂ usedÂ toÂ effectively combatÂ the MRSAÂ .Â
Although colonization of MRSA in an otherwise healthy individual is usually not serious, infection with this germ can be life threatening in patients with deep wounds, intravenous catheters or other instruments that introduce foreign bodies, or as a secondary infection in patientsÂ with a weakened immune system.
MRSA infection occurs mainly nosocomial, for example an infection contracted in a hospital.Â Its most serious nosocomial pneumonia is a disease that can be fatal and is spread by the insertion of a tube fan in the patient's body.Â In the United States report are increasing outbreaks of MRSA colonization by skin contact in locker rooms and gymnasiums, even among healthy populations, and MRSA causes at least 20% of infections of S.Â aureus in people who use drugs intravenously.Â While MRSA, as noted above, does not respond to common antibiotics, other drugs such as vancomycin and linezolid, which help fight infection.Â
In Europe, EFSA estimates that in 2010 the main animal reservoirs of MRSA (antibiotic resistant staph) in affected by countries where there are pigs, calves and broilers, especially in factory farms.Â Infections can be subtle or completely asymptomatic.Â Among MRSA strains, strain "CC398" is most often associated with asymptomatic carriage in intensive farming of animals for food production.Â The CC398 has been associated in some cases of deep infections of the skin and soft tissue infections, pneumonia or sepsis in humans.Â Where the CC398 is common in animal food producers, farmers, veterinarians, and their families are more likely colonization and infection than the general population.Â MRSA often carries genes for enterotoxin but before 2010 there was only one report of food poisoning identified as due to MRSA.Â
CC398 strain was also isolated from animals (dogs and cats) and horses on farms with infected livestock, with sporadic cases in "many other pets."Â But no study, by EFSA has specifically assessed the risk of transmission to humans from small animals, or following contact with horses or horse meat, according to Antimicrobial (Drug) Resistance (2010).
MRSA infections in pets are becoming more frequent, and almost always, the strains responsible for infection of these animals are the same as those frequently encountered in hospitals in the same geographic region.Â Humans are therefore likely to spread MRSA to pets, and these can then be a reservoir for humans.Â Horses can be colonized and / or infected with MRSA from humans or animals from other sources in their environment (dogs, cats ...).Â There are sporadic reports of cases of disease in humans (typically minor skin infections), attributable to a source equine.Â The strain CC398 can enter and move through the slaughter of live animals or raw meat.Â Based on data available in 2008/2009, although this strain can be part of the microflora of some endemic slaughterhouses, the risk of infection for slaughterhouse workers and the persons handling meat seems to stay low, according to Methicillin-resistantÂ Staphylococcus aureus (MRSA) (2011).
MRSA can cause potentially lethal infections and usually only can be treated with expensive, intravenous antibiotics.Â A drug-resistant strain of potentially deadly bacteria crossed the borders of U.S. hospitals and is spreading, researchers say. They said that the Staphylococcus aureus is resistant to methicillin, or MRSA, and it is beginning to appear outside hospitals in San Francisco, Boston, New York and Los Angeles.Â
"Once this reaches the general population, it is really unstoppable," said Binh Diep, a researcher at the University of California at San Francisco, who led the study.Â "This is why we are trying to spread the message of prevention," said Diep.Â According to chemical analysis, bacteria are spreading among the communities of San Francisco and Boston, the scientists said.Â "We believe it is spreading through sexual activity," Diep said.Â This superbug can cause life-threatening infections and usually only can be treated with expensive, intravenous antibiotics.Â MRSA killed 19,000 Americans in 2005, most of them in hospitals, according to a report published in October in the Journal of the American Medical Association.Â About 30 percent of people carries staph chronically, which may be transmitted by contact with other people or because the bacteria are deposited on surfaces or objects that people touch then.Â The bacteria can cause deep tissue infections if they enter the body through a wound in the skin.Â Of the people who carry staph, most carry it in your nose, but MRSA can also live in and around the anus and therefore frequently transmitted via anal sex.Â Staph infections look like a rash on the skin, which if left untreated can become inflamed and fill with pus.Â The best way to avoid infection is by washing hands and / or genitals with soap and water.