Methicillin-Resistant Staphylcoccus aureus (MSRA) is a group of bacteria which produce penicillinase, a Beta-lactamase or enzyme that makes the bacteria resistant to penicillin and ampicillin. Such strains of Staphylococci were first noticed in 1948 shortly after Penicillin was introduced. Beta-lactamase-resistant antibiotics, including methicillin, nafcillin, and the cephalosporins were developed. By the 1960s MRSA appeared within hospitals and hospital associated infections were acquired. MRSA adapted the mechanism for cell wall assembly and produced modified receptors for binding penicillin. These modified receptors make the bacteria resistant to all penicillins and cephalosporins. By the year 2000 hospital acquired MRSA infections increased to up to 50% of infections in hospitals. MRSA now freely moves from the hospital to the community and it is estimated that 25% to 32% individuals in the community are nasal carriers of MSRA. MRSA accounts for 63% of Staph infections in the United States.
The appearance of MRSA infections now in the community is a life threatening concern. The incidence of community acquired MTSA infection has increased from 24 per 100,000 in 2000 to 164 per 100,000 in 2005. MRSA accounts for 18,650 deaths per year in the United States, more deaths per year than HIV. What may clinically seem to the physician as a simple infection that was once treated with a single antibiotic may not necessarily be the case, especially if the infection is caused by MRSA. Mild-to-moderate infections can be treated with oral antistaphylococcal agents, while more serious disease can be treated with intravenous drugs. The risk factors for such infections include:
Recent arrest or incarceration less than 1 yr
Recent antibiotic treatment
IV and nasal drug use
Household with greater than three members, public housing
Household pets, dogs and cats colonized with MRSA
Lower socioeconomic status
Child day care
Athletic and sports participation, i.e. Wrestling, contact sports, gym
Long-term care facility
Awareness of the infection is first in prevention. MRSA may spread directly from individuals with a an MSRA infection or from nasal carriers to others through a simple cut or skin abrasion. To prevent MRSA infections instruction and encouragement of frequent hand washing should be practiced. Good hygiene practices are encouraged of showering, washing hands with soap and hot water and wearing clean clothing. If you have a wound, cover the wound. If the wound cannot be covered, do not involve yourself in contact sports or use any equipment used frequently by other. Do not go to the gym. Recognize if you have a skin infection, boil or abscess and get treated. Do not share personal items, towels or clothes of others. If you use the gym or athletic equipment, wipe the equipment down with a bactericidal or chlorine wipe before and after use.