Infection Control for Healthcare Level 2 (VTQ)

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MRSA is a type of bacterial infection that is resistant to a number of widely used antibiotics. This means it can be more difficult to treat than other bacterial infections. The full name of MRSA is Meticillin-Resistant Staphylococcus Aureus. You may have heard it called a superbug.

Staphylococcus Aureus (also known as staph) is a common type of bacteria. It is often carried on the skin, inside the nostrils and the throat and can cause mild infections of the skin, such as boils. If staph bacteria get into break in the skin, they can cause life-threatening infections, such as blood poisoning or an infection of the inner lining of the heart.

Antibiotic resistance can occur in several ways. Strains of bacteria can mutate and, over time become resistant to a specific antibiotic. Alternatively, if you are treated with an antibiotic, it can destroy many of the harmless strains of bacteria that live in and on the body.
This allows resistant bacteria to multiply quickly and take their place.

The overuse of antibiotics in recent years has played a major part in antibiotic resistance. This includes using antibiotics to treat minor conditions that would have got better anyway or not finishing a recommended course of antibiotics.  MRSA infections are more common in people who are in the hospital or nursing homes. Doctors often refer to this as healthcare-associated MRSA or HA-MRSA.

Hospital patients are more at risk because they often have an entry point for the bacteria to get into their body, such as a surgical wound, burn or an intravenous drip. They are usually older and weaker, which makes them more vulnerable to infection and they are surrounded by a large number of people, which means bacteria can easily spread through direct contact with other patients or staff or contaminated surfaces.

In recent years, rates of MRSA have fallen because of increased awareness of the infection by both medical staff and the public. However, MRSA still places a considerable strain on healthcare services.  Most NHS patients who are admitted to the hospital for a planned procedure are screened for MRSA. This helps reduce the chance of patients developing an MRSA infection or passing an infection on to other patients.

The symptoms of an MRSA infection will depend on what part of the body is infected. Many people carry the MRSA bacteria inside their noses but will never have any symptoms.   An MRSA skin infection usually first develops as a painful bump or a mark on the skin that looks like an insect bite.

The bacteria often enter the skin through a cut, graze or hair follicle. This develops into a painful, pus-filled swelling or boil.
Some people have additional symptoms, such as high temperature and a general feeling of being unwell. In some cases, MRSA can cause a larger, pus-filled lump to develop underneath the skin. This is known as an abscess.

MRSA bacteria are usually spread through skin-to-skin contact with someone who has an MRSA infection or who are colonised by the bacteria. Colonised means bacteria are present in your body but do not cause any symptoms.  Factors that increase the chance of developing HA-MRSA include l a weakened immune system, for example, in elderly people, newborn babies and people with a long-term health condition, such as type 2 diabetes. An open wound, a catheter or an intravenous drip, a burn or cut on the skin, a severe skin condition, such as a leg ulcer or psoriasis, surgery and taking frequent courses of antibiotics.

MRSA infections usually develop in people being treated in hospitals, particularly patients in intensive care units and on surgical wards.  More recently, MRSA has been known to develop outside hospitals and nursing homes. This is known as community-associated MRSA or CA-MRSA.

Community-associated MRSA or CA-MRSA, is much less common than HA-MRSA. However, in recent years the number of cases has increased and could continue to increase in the future. The following factors increase your risk of getting CA-MRSA.

Living in a very crowded environment - for example, a military base, prison or student hall of residence, with frequent skin-to-skin contact - outbreaks of CA-MRSA have been reported in people who play contact sports, such as rugby, cut or grazed skin - this is more vulnerable to infection, as are people who regularly inject illegal drugs, such as heroin.

Contaminated items and surfaces - places where many people share utensils and tools or where many people are likely to touch the same surfaces and general lack of cleanliness. Outbreaks of MRSA can occur in homeless people or in people on active military duty who have limited access to cleaning facilities and previous use of antibiotics.  

An MRSA infection is most commonly diagnosed using a blood, urine, tissue or spits culture.  This involves taking a sample of one or more of these substances and placing them in a dish of nutrients. This should encourage any staph bacteria that are present to reproduce and grow.  If the bacteria develop, different antibiotics can be directed at them to see if the bacteria have developed resistance to the antibiotics. This type of test is often used to screen people before they are admitted to the hospital to help reduce rates of MRSA.