Methicillin-resistant Staphylococcus aureus
Methicillin-resistant Staphylococcus aureus (MRSA) is a mutation of very common bacterium spread easily by direct person-to-person contact. Previously limited to large teaching hospitals and tertiary care centers, MRSA is now endemic in nursing homes, long-term–care facilities, and even community hospitals. Patients most at risk for MRSA include immunosuppressed patients, burn patients, intubated patients, and those with central venous catheters, surgical wounds, or dermatitis.
Others at risk include those with prosthetic devices, heart valves, and postoperative wound infections. Additional risk factors include prolonged hospital stays, extended therapy with multiple or broad-spectrum antibiotics, and close proximity to those colonized or infected with MRSA. Also at risk are patients with acute endocarditis, bacteremia, cervicitis, meningitis, pericarditis, or pneumonia.
Causes
MRSA enters health care facilities through an infected or colonized patient or a colonized health care worker. Although MRSA has been recovered from environmental surfaces, it’s transmitted mainly by health care workers’ hands. Many colonized individuals become silent carriers. The most common site of colonization is the anterior nares (40% of adults and most children become transient nasal carriers).
Other sites include the groin, axillae, and the gut, although these sites aren’t as common. Typically, MRSA colonization is diagnosed by isolating bacteria from nasal secretions.
Other sites include the groin, axillae, and the gut, although these sites aren’t as common. Typically, MRSA colonization is diagnosed by isolating bacteria from nasal secretions.
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