HA-MRSA – Healthcare-Acquired MRSA
Aproximately 2 – 10% of the U.S. population is now colonized with MRSA. MRSA can cause serious infections such as:
- Surgical site wound infections
- Bloodstream infections
Methicillin is an antibiotic that belongs to a class of penicillin-related antibiotics called beta-lactams. Doctors often prescribe beta-lactams to treat staph infections and over time some strains have become resistant to beta-lactams, which means these antibiotics can’t kill them. Doctors refer to these organisms as methicillin-resistant staph bacteria. MRSA infections typically are resistant to a variety of antibiotics from other antibiotic classes as well and this can make treatment very difficult. Healthcare-acquired MRSA infections happen frequently in hospitals, rehab facilities, nursing homes and have been increasing in alarming rates for decades. MRSA is becoming more prevalent in healthcare settings due to lapses in infection control. If a person is colonized, they have a 8-12 fold greater chance of getting an infection. A comprehensive approach is required to prevent infections:
- Screening – active detection isolation (ADI)
- Isolation in an appropriate manor – gloves and gown used by all who enter the room. Designated equipment such as stethoscope are left in the patients room.
- Strict adherence to hand hygiene (handwashing)
- Routine environmental decontamination of equipment and frequently touched surfaces.
- Prudent use of antibiotics and patients finishing their full course of antibiotics.
Most infections are acquired by contact with a healthcare worker with contaminated hands or equipment. IV antibiotics such as vancomycin is administered. An infection can enter the bloodstream causing sepsis and 25% of patients with sepsis die.
MRSA INFECTIONS DEVELOP IN:
- Patients in healthcare facilities of all ages and particularly in the elderly
- People who have been exposed to chronic healthcare environments such as dialysis centers, nursing homes and rehab facilities.
MRSA infections can cause a broad range of symptoms depending on the part of the body that is infected. These include: surgical wounds, burns, catheter sites, eye, skin and blood. People who are colonized with MRSA may never develop an infection but have a 8-12 fold greater chance of doing so.
MRSA can cause urinary tract infections (UTI), septecemia, toxic shock and death. MRSA may also enter the bone marrow causing osteomyelitis and destroy hearts valves causing endocaritis. The sooner treatment is administered the better outcome.
People who are colonized with MRSA have no symptoms. They can carry MRSA in their nose and on their skin for many years. Staph skin infections often begin with an injury and develop into an infection. Symptoms are:
- Redness, warmth, swelling, tenderness of the skin and boils and blisters.
- Some people may have chills and fever, fell nauseous and acute pain.
- Staph infections are especially dangerous to those who have had surgery and may have a cast or heavy bandages that are not changed frequently.
- In serious cases, the patient may feel lethargic (fatigue) and have headaches.
MRSA can be acquired by direct contact with an infected or colonized person and contaminated objects. The lack of decontaminating surfaces and enviromental cleaning in healthcare facilities has lead to the spread of MRSA and lapses in infection control. Healthcare-acquired MRSA infections happen frequently in hospitals, rehab facilities, nursing homes and have been increasing in alarming rates for decades. Active detection isolation (ADI) is imperative to reducing MRSA infections along with strict adherence to hand hygiene. Most infections are acquired by contact with a healthcare worker with contaminated hands or equipment. IV antibiotics such as vancomycin is administered. The infection can enter the bloodstream causing sepsis and 25% of patients with sepsis die.
Patients must insist that healthcare workers wash their hands first and then put on gloves before touching the patient. Healthcare workers must also wash their hands again before leaving the room. Insist upon it, it is your life.
MENTAL AND EMOTIONAL EFFECTS
The healthcare community has not addressed the psychological effects that a traumatic MRSA infection or subsequent chronic disease can have on a patient. The whole patient must be treated, not just the infection. Many MRSA survivors feel very angry about what has happened to them and they know that this was preventable. Many feel betrayed by their doctor and hospital as over half of MRSA patients are not told that they have MRSA and that it is treatable, but not curable. Doctors and healthcare facilities need to be honest with their patients and disclose the truth, otherwise a patients’ rights have been violated and more emotional damage is done. And a simple, “I’m so sorry that this has happened to you”, would help a MRSA survivor greatly. MRSA patients can suffer from the following, which can impede their healing:
- Post traumatic stress disorder (PTSD)
HIGH RISK PATIENTS
MRSA can cause infections in healthy and ill patients of all ages. Most MRSA infections occur in patients 65 years or older. Patients who are seriously ill and and from nursing homes have a high occurence also. High risk patients are the following and should be screened: screening is done with a simple nasal swab to the nares)
- Patients coming from a nursing home or another healthcare facility
- Dialysis patients
- Those previously colonized or with MRSA infections
- The homeless
- ICU patients
- Those who have been in a hospital in the last few years
- Surgical patients receiving inplants