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Methicillin Resistant Staphylococcus Aureus (MRSA)

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Methicillin-resistant Staphylococcus aureus (MRSA) is a variant of S. aureus which is considered to be resistant to all beta-lactam antibiotics (including penicillins, cephalosporins, and cephamicins). It may also be resistant to one or more other classes of antibiotics.

MRSA strains have been identified as a major source of healthcare-acquired infections and outbreaks in the U.S. and Florida. For over four decades, MRSA has presented a challenge for hospitals attempting to control this organism. In recent years, long-term acute care hospitals, long-term care facilities, rehabilitation centers, and small community hospitals have seen increasing numbers of cases. Part of their challenge is the need to be continuously on guard against the frequent admissions and transfers of patients with MRSA infections within these settings.

More recently, MRSA has also been increasing in the community in individuals without healthcare-associated risk factors. Organisms that cause Community-Associated MRSA (CA-MRSA) infections are genetically distinct from the typical Healthcare-Associated MRSA (HA-MRSA) commonly encountered in healthcare settings.

  • HEALTHCARE-ASSOCIATED MRSA (HA-MRSA)
  • COMMUNITY-ASSOCIATED MRSA (CA-MRSA)

Infection and colonization with HA-MRSA are typically seen in older individuals with one or more of the following risks: long hospital stay; multiple hospitalizations; more than 65 years old; multiple invasive procedures; wounds; severe underlying disease; receiving broad-spectrum antibiotics; undergoing hemodialysis; and intravenous drug use.  Resistance to multiple classes of antimicrobial agents is common.

Community-Associated MRSA is frequently seen in younger persons and involve skin and soft tissue infections.  Risk factors for infection are referred to as the 5 C’s: Crowding, frequent skin-to-skin Contact, Cuts or abrasions, Contaminated items and surfaces, and lack of Cleanliness.  Frequently, community-associated cases have initially been misdiagnosed as spider bites.  This misdiagnosis prevents timely treatment and may increase the chance of transmission to others.  Outbreaks of these infections have been described in numerous groups including people found in correctional facilities (jails and prisons), sport teams, men who have sex with men, commercial fishermen, and minority populations. Resistance to multiple classes of antimicrobials is uncommon. Many of the CA-MRSA infections may be effectively treated with good wound care with or without oral antibiotics, while more resistant strains may require intravenous vancomycin.

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