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Research On Methicillin Resistant Staphylococcus Aureus Medical Essay

The topic because of this good article is Methicillin-resistant Staphylococcus aureus (MRSA). This area of research was chosen due to the research and medical aspect behind this very interesting issue.

MRSA is a subject of great importance for the general public but also for medical researchers, e. g. nurses and doctors. Though it wasn't until lately that MRSA was named a "superbug", the medical community remained relaxed when people found out about it, as they had been aware of the bacterium since the early 19060's. It's quite common knowledge that the most regularly found home of MRSA is medical health centres and assisted living facilities. The author of the medical journal is mostly worried about the problems and dangers MRSA posses to her, as she works in a medical center where the most the patients are the elderly. [2]

Firstly, MRSA was investigated in depth to all or any aspects, e. g. symptoms, treatment, and reduction methods. The information was cumbersome and helpful allowing for fully complete knowledge and knowledge of the topic.

Secondly, the info was collaborated and put together together to create a full and helpful graded unit on the subject of MRSA. This cooperation of information allows not only for the reader to get a detailed intro to MRSA, but also gives the reader an idea of what MRSA is and exactly how treatment is rolling out since the discovery in 1961. The usage of several resources designed that the info in the written text had not been only the most comparative but the most educational.

Thirdly, and lastly, the HND: Applied Knowledge Course was used not only to aid and raise the already present technology and medical aspects of MRSA, but to aid in the condition solving characteristics required in the graded product. Such subject matter as Fundamental Chemistry, Information Technology, Biochemistry, and Display Skills were used to better the knowledge of MRSA and increase the layout and design of the graded unit.

What is MRSA?

Shown below is a little cluster of bacterias known as Methicillin-resistant Staphylococcus aureus (MRSA) seen under a microscope. MRSA is a common pores and skin bacterium caused by Staphylococcus aureus (sometimes called, Staph) that is repellent to an array of antibiotics. [3], [4]

[5]: MRSA under the microscope

The name "Methicillin-resistant" means that the bacterias are not damaged by the antibiotic methicillin, and lots of other antibiotics such as penicillin and cephalosporin, that used to be the common drugs to destroy the Staph bacterias. There are a number of different MRSA strains, around 16, all with varying degrees of level of resistance to methicillin. [3]

Staphylococcus aureus (SA) is a commonly developing bacterium that has been around, for thousands of years and the discovery of MRSA in the early 1960s. Around a third of the world's population provides MRSA harmlessly on the skin, nose or throat (especially in folds like the armpit or groin). [3], [6]

MRSA is most commonly found in hospitals, due to the fact that there are higher amounts of infected surfaces and people in a medical center. The highest variety of patients in a clinic or normally elderly who are sicker and weaker than the overall population, which makes them more susceptible to infection scheduled to a weaker disease fighting capability. Since around a third of the world's society is colonizied by MRSA, the potential for infection is incredibly high. A person becomes afflicted when the organism invades your skin or deeper tissue and multiplies. [6], [7]

During the first 20th hundred years, 45% of the world's human population weren't living beyond 65 yrs. old, with infectious diseases being the main factor to the low life span. Because of the breakthrough of penicillin by Alexander Fleming in 1928, and the processing of the antibiotic, the fight infectious diseases - including attacks triggered by Staphylococcus aureus - could begin. Unfortunately, simply a ten years later Staph aureus became immune, not only to penicillin, but also new antibiotics such as: erythromycin, streptomycin, and tetracycline. [8]

In 1960, the hottest & most effective potential for controlling and halting Staph aureus was Methicillin. But this antibiotic that had once been the sole weapon against Staph aureus was temporary and soon joined up with the other antibiotics which were now inadequate and pointless in fighting Staph aureus. In the later 1970's the first outbreak of MRSA was reported in clinics in eastern Australia, and by the 1980's MRSA acquired emerged all around the globe. [8]

It can be seen in the graph; MRSA Statistics of Isolates per 12 months in Europe; that one countries suffer from MRSA a lot greater than others. For instance, the Nordic Countries (Denmark, Finland, Iceland & Sweden) as well as the Netherlands have minimal outbreaks of MRSA per annum. Countries such as Malta, Greece, Ireland and the united kingdom all suffer every year from high numbers of MRSA victims or colonized individuals. It could be seen from the graph that the worst outbreak of MRSA is at Malta in 2001 with more than 50% of the individuals tested being sufferers, whilst in the same 12 months Iceland possessed no reviews of any MRSA outbreaks. The explanation for Malta's raised percentage of MRSA companies in 2001 might have been due to too little knowledge and knowledge of the bacterium. Another possible reason for the raised percentage could be that not enough procedures or guidelines regarding MRSA were available or even in place. The following 2 yrs MRSA in Malta declined to around 40% of examined individuals being providers, which show that policies had been placed into place following the outbreak in 2001. [9]

[9] - MRSA Numbers of Isolates per year in Europe

The extremely low percentages of MRSA service providers in The Nordic Countries and The Netherlands could be scheduled to these countries having many plans advising and informing people in the community and patients and doctors in medical facilities of the hazards of MRSA and the easy methods on avoiding the bacterium. Inside the graph below it implies that The Netherlands analyzed 1238 people per annum for the bacterium MRSA, with less than 3% every year between 2000-2003 being carriers of the bacterias, which is seen to be around only 37 people. [9]

The pass on of MRSA throughout European countries is a serious problem that seems to affect almost all countries seriously. The graph shows how easily MRSA can fluctuate from country to country, and from 12 months to 12 months. If more insurance policies and better education about MRSA were available not only to clinics but to the community in the UK then it's possible that the carrier percentage in Britain will decrease, but until such action is used the British population will suffer not credited a to lack of health care but to insufficient education.


The symptoms of contamination anticipated to MRSA may differ greatly, all depending on what area of the body is contaminated. MRSA can infect a wide range of body tissue and organs, which makes MRSA the "Superbug" that it is. [10]

Although there are a huge amount of symptoms of MRSA, there are just two types of contamination: Skin infection and Bloodstream contamination. Below is a table, of the sort of symptoms common to each one of the attacks. [10], [11]

[11]: Symptoms of MRSA related to disease type

Skin Infection

Bloodstream Infection






Septic Shock





The longer that any of these symptoms continue untreated, can greatly increase the threat of a widespread infections in the body. Shown below is the harm that a few of these symptoms can cause to a person. [12], [13]

[12]: Impetigo [13]: Abscess

Although MRSA can result in every one of the above symptoms, without treatment, it normally starts off as a reddish blotch or pimple on your skin. This leads onto an MRSA lesion [14] building, which is the first and most noticeable stage to discovering an MRSA an infection. [15]

[14]: MRSA lesions

However all these symptoms can not be determined without certain lab tests. Usually before diagnosis of MRSA has took place however the symptoms of a staph infection are obvious, doctors and nurses will treat the patient's an infection as a staph contamination, and prescribe antibiotics that would have no effect on MRSA. This hold off in diagnoses of MRSA could result in the patient having to stay much longer in a medical facility or worse the hold off could permit the infection to get worse and infect the blood and the heart and soul. Therefore the much longer it takes to diagnose MRSA, means that patients are affected more and the problems in the NHS and other health services shall continue being unresolved.

Causes of MRSA

MRSA can be transmitted by direct contact with a person taking MRSA on their skin, e. g. those who are colonizied with MRSA can cross the bacterias through a number of direct contact from a simple hand-shake to a kiss from someone you care about.

The transmission of MRSA can also happen through indirect contact. This form of transmission is just as common as direct if not more. An individual can be attacked by MRSA by coming in contact with any surface, e. g. a pedestrian walker button, which is likely to have a remarkably high number of individuals touching it day-to-day and all-day, and with around a third of the worlds society being carriers the chance of being infected is high. Hot locations for indirect contact are door grips, game controllers, keyboards, linens and towels.

The final and least likely form or transmitting is by airborne disease.

An airborne contaminant is the least likely form of growing as it is much more likely that a pores and skin to skin contact will take place with the colonized or contaminated individual transporting MRSA. An airborne contaminant can be spread when bedding in an area are tossed around the place when making the bed. As the duvet is fanned skin area debris are flown into the air causing chlamydia to be airborne and permits easy transmission.

The manner in which MRSA can be sent and individuals contaminated depends on where in fact the infection was purchased. The key areas of MRSA pass on are; the health-care system and the community in any country, and because these two are the major hot locations it means they can be classified. Healthcare-Acquired MRSA and Community-Associated MRSA are both of these categories.

CA-MRSA (Community-Associated-MRSA)

CA-MRSA can certainly be spread in virtually any enclosed space, especially any congested or unsanitary condition. Outbreaks of CA-MRSA will be more than common in prisons around the world - with American and European countries being the worse - as well as in military services training facilities.

The high number of MRSA victims in any jail can be seen as issues for just about any country. The over filled state and having less space and health could be fixed by an increase in the size of prisons or a reduction in quantity or prisoners in a jail. Although the challenge seems easy to fix the strain on any country to repair this problem can be seen as over-whelming.

CA-MRSA has influenced sports teams, athletes and gyms. The bacterium spreads easily through slashes and abrasions and skin-to-skin contact. Posting towels or athletic equipment rises spreading contamination among athletes.

This problem can be solved by equipment being cleaned after use and bath towels not being shared.

CA-MRSA can be dangerous in children and young adults, causing a wide-spread illness when it enters the body through the slice or scrape.

Children may be more susceptible to contamination because of the immune systems not being completely developed.

The pass on of MRSA and the realities of who's most vulnerable to contracting the problem all come under as the Causes of MRSA, because each immediately links to the way the person becomes infected. The environment that a person prevails in can majorly affect their likelihood of being attacked by MRSA, for example, private hospitals. If a person is spending the majority of their time or even browsing for a short period of the time, their presence within an environment just like a clinic will greatly raise the potential of illness.

HA-MRSA (Hospital-Acquired-MRSA)

The reason that nursing homes are seen as the "hot spot" of MRSA contamination is because the majority of folks there are unwell. For any specific that suffers from a medical condition like HIV or tumor, that weakens the disease fighting capability, the chance for illness is increased exponentially. [16]

HA-MRSA can normally enter though an entry point into the body, like a surgical wound or a catheter.

This can sometimes be a problem for some patients and can deal with in fatality. Abscess's normally form to control and heal chlamydia. For most HA-MRSA infections very little can be done to resolve the problem except to be sure that medical staff are stored constantly alert to how vital cleanliness is when dealing with patients.

The patients tend to be old, sicker and weaker than the overall population, making them more vulnerable to contamination from HA-MRSA.

These are some of the few issues that nothing can be done about. Age a person is not a major factor unless the patient is elderly as their immune systems are weaker they are inclined to disease and illness.

Hospitals are crammed by many patients, doctors and nurses, so HA-MRSA can certainly be contracted, through direct connection with other patients or personnel, or through polluted surfaces and through an airborne contaminant. [17]

This can be solved by causing sure contact with infected individuals is bound and the staff, made to contact is also limited. Floors in any health care facility should be sanitised and maintained clean.

The "superbug" that is MRSA is seen as a never ending problem because MRSA contamination can arise locally, which I feel won't eliminate the stress on private hospitals but instead increase it. Even when hospitals were to have better control methods and better guidelines addressing the condition of MRSA, the exterior world cannot always keep surfaces completely clean, with door holders being constantly used. The condition seems to be more like a never ending round-about rather than an instant sprint to resolving the spread of MRSA.

Screening for MRSA

Screening for MRSA is an effective and safe method to find out if one is a carrier of MRSA. Screening process for MRSA before a person gets into an environment just like a clinic can greatly decrease the opportunity for a carrier to be infected or even to infect others, as the staff at a healthcare facility can remove as a lot of the bacteria as it can be through a simple treatment. [18]

The testing process is easy and includes no shots. Instead several swabs are considered at the most typical carrier sites of the bacterias; the anterior nares (nasal), the axilla (armpit), and the perineum (groin) are all tested. If any skin damage were seen or found they would also be analyzed, due to them being one of the first signs or symptoms of an MRSA illness. [19]

There are 3 ways of screening the swabs extracted from a suspected carrier of MRSA. These include:

Polymerase Chain Response (PCR)

PCR is a way for producing huge amounts of specific DNA or RNA fragments of described length and sequence from smaller amounts of primers. The reaction is not only reliable and specific, but is also very rapid and extremely delicate. Uses for the response include disease medical diagnosis, detection of difficult-to-isolate pathogens, and the direct diagnosis of MRSA from nasal swab examples. [20]

PCR can be seen as the quickest of the three methods as it takes out all the wearisome work of having to total the colonies with an agar dish and it generally does not involve having to wait for several times for the results as an enrichment broth. PCR is also a simple procedure. [21]

PCR is also the most costly of the three, which although is a negative quality it is not a major factor when screening to see whether someone is contaminated by MRSA.

Enrichment Broth Cultures

An enrichment culture is a medium with specific and known characteristics that favors the progress of a particular micro-organism [22]

The major pro with Enrichment Civilizations is that they provide an easy way in which to isolate natural cultures of scarce microbial types.

The two biggest disadvantages when working with Enrichment Cultures is that they quickly become contaminated, which is often viewed as very big negative when wanting to isolate a MRSA. [21]

Direct Plating

Direct Plate counting is a method used to rely the number of cells in an example.

Once the cells to be counted have been isolated, they are really dilute; because of the fact that way too many cells may cause the Petri dish to be so filled with colonies, that it would be impossible to matter. After the skin cells have been diluted, these are incubated on an agar medium until colonies form. It really is given that the cells are counted. [21]

Direct Plating is seen as the technique with negatives. Sampling problem is the most clear negative as it identifies the uneven spread of the test on the agar dish. This is a serious negative as it could hinder the end results. Another negative is that it offers little effect on cells that do not break up, as it hinders the ultimate count. Through most of Direct Plating's negatives it continues to be seen as the best available way for identifying viable cells. [21]

All three types of testing and assessment methods are valid and useful for different end results needed. It can be seen from the information that Enrichment Civilizations and Direct Plating aren't as quick and effective as PCR. Though PCR is flawed by the price the pros may easily be observed to outweigh this small negative. I believe PCR is the best method for evaluating for the occurrence of MRSA, as it provides the results quick and easily and avoids all the boring work of counting cells.

Prevention Methods

Hand Hygiene

By having good side hygiene the risk of distributing MRSA can be reduced greatly. Wrists and hands should be cleaned thoroughly using an antiseptic palm clean or simple dispenser soap. Cross-contamination and propagate of MRSA in hospitals is being tackled by using special anti-microbial side cleansing products and alcohol-based antiseptic brokers. Hand hygiene is essential even if disposable gloves have been worn. Hand hygiene procedures should always be performed before departing the room (even if there has been no direct connection with the patient, e. g. when portion food, airing the room or making the foundation).

The diagram below shows the proper method to cleaning hands effectively. [23]

[23]: How to wash hands properly


Infection control safeguards can be seen as apparent things in stopping cross contamination. The following precautions should be completed at all times and with all patients and medical personnel.

Cover all slashes, abrasions and lesions - especially those on hands and forearms with a waterproof dressing.

Maintain side hygiene

Before and after working with each patient

Before handling food

Following bed making

After handling blood vessels and bodily fluids and also items contaminated with bloodstream or bodily fluids

Dispose of waste products safely

Isolate patients with a known or suspected infection

Use throw-away gloves and aprons when working with patients, blood vessels, fluids and the making of bedrooms. [7]


The ongoing education of most health-care staff members can be an essential skill of any MRSA control scheme, as well as making sure up-to-date information is obviously available and known.

The education of patients is also vital to handling MRSA infections. The Division of Health Services: Centres for Disease Control and Protection (CDC) offers a link to a MRSA patient information sheet. Such information as this is viewed as extremely helpful as it answers the most common asked questions regarding MRSA. [24]

All the possible elimination methods boil down to maintaining excellent health. By keeping your environment, your individual treatment items, and yourself clean you can decrease the risk of contracting MRSA. It is imperative to follow the directions organized by personnel when you are in nursing homes, nursing homes, and gyms, as these locations can hold an increased risk of MRSA an infection. [25]


The treatment of MRSA, nowadays is more challenging than ever before. MRSA being truly a superbug means that it is resistant to a wide range of antibiotics. With such antibiotics as Methicillin, Penicillin and Cephalosporin being among the countless antibiotics which may have no have an effect on on MRSA. When MRSA was first discovered to be protected against methicillin a number of other treatments were devised so as to stop the outbreak of the bacteria. Although the alternative antibiotics were affected for a while, MRSA became tolerant to them also. This supposed that new drugs needed to be made in order to control MRSA from learning to be a worldwide pandemic.

The manufacturer of such drugs as Chlorhexidine hydrochloride, Vancomycin Hydrochloride and Linezolid supposed that MRSA acquired a chance of being managed.

[26]: Assessment of Vancomycin and Linezolid



Mechanism of Action

Cell wall structure synthesis inhibitor

Protein synthesis inhibitor

Dosage Form Availability




Adverse Events

Red man syndrome




Bone marrow suppression

Mitochondrial toxicity: neuropathies and lactic acidosis

Serotonin syndrome

Routine Healing Drugs Monitoring Performed



The desk above shows a comparison between two drugs that are being used to treat MRSA. From the stand it is clear to see that both treatments offer undesireable effects. With Vancomycin only having the ability to be administered intravenously (IV) while Linezoid can be implemented by IV or orally. The number of undesireable effects is better for Vancomycin recommending that Linezoid is the better method for treatment of MRSA.

[27]: Linezoid [28]: Vancomycin Hydrochloride

The images above show the complexity of the Linezolid and Vancomycin Hydrochloride and how they are organised.

Isolation of any patient/person suffering from MRSA sometimes appears as an alternative treatment. The isolation of a person is extreme as this means confiding them to one room in another ward. The benefit of such an extreme treatment is the fact that, the physical hurdle between the infected and the uninfected works as a disruption preventing the further transmission of the bacterias. The other gain is usually that the separation gives a clear psychological subject matter to the sufferer that they are infected and also have a huge potential to infect those around them. With any edge comes a downside, with isolation having one huge disadvantage. The psychological damage that isolation can have on a person might leave them so unhappy that they begin to distrust those around them. The average person may become so self-employed that they see no dependence on help form others which can result in an extended and lonely existence. [29]

Available Aid

There are extensive sources of help, available for individuals who are colonised, afflicted or related to someone with MRSA. MRSA victims and their own families who are being the pressures of living with MRSA can retreat of their ordinary lives, of folks asking things such as "are you ok" and "do you will need any help", online. Through such support groups as MRSA Action UK, a signed up charity with the purpose of helping and assisting not only the victims of MRSA but their families also, the strain to be a sufferer of MRSA can be relieved. MRSA Action UK not only operates as a charity to make the general population aware of the superbug but offers links to other sites which give information and additional support for anybody who needs it.

MRSA Resources is an online discussion board, where individuals who have MRSA, have lost you to definitely MRSA, or perhaps want to talk about the subject, have the ability to. The discussion board allows for folks to talk about not only the info they have on the internet or in literature and papers but also allows these to connect on an individual level where they can show their own personal experiences with MRSA.


The elimination and controlling options for MRSA infections is dependent on the procedure and high expectations of which professional medical workers follow, as well as, strong authority to identify the dangers of the MRSA infections. Standard safety measures, e. g. hands hygiene, together with isolation, and education are fundamental to the avoidance and control of MRSA. The entire welfare and protection of a person is of the up most importance, and options undertaken to control MRSA shouldn't interfere with the already founded health care of patients. Therefore, it can be seen that the investment in more isolation rooms in nursing homes and increased hygiene care across the world can decrease the potential of MRSA infections.

MRSA can be seen as a major problem for health services throughout the world, as it diminishes mortality rates, enhances morbidity rates and triggers patients to stress over the possible symptoms.

It is vital to have a well-structured and clear plan on contamination control in private hospitals and universities to avoid or a t a minimum of stunt the get spread around of MRSA and also other infectious bacterium. As well as a clear insurance policy educational programs and leaflets on infectious control should be made available at demand as well for working out of nurses, all to aid in the knowledge of MRSA.

In any medical facility it is nurses who are in immediate contact with many patients over continuous periods of time. With this thought it means that the cleanliness of nurses should be managed continuously at a higher standard. Not only as long as they keep their health high when working with patients but also with family members and people to the hospital.

In spite of all possible improvements which have been set up and explained in this graded device, the situation of MRSA control and eradication still seem to be a subject that will never be resolved. Though nursing homes could improve cleanliness and lower the probable of HA-MRSA, the potential risk of increased CA-MRSA is obviously a possibility anticipated to community health being impossible to control or establish a insurance plan to which CA-MRSA would be effected by.


(All glossary meanings were taken from the internet, from a number of different sites).

Abscess - an accumulation of pus in a body tissue, usually caused by a bacterial infection.

Airborne - in or carried by the air.

Antibiotics - a substance derivable from a mold or bacterium that can kill microorganisms and remedy bacterial infections.

Bacteria - bacteria are very small, single-celled organisms that are in your body. Some can cause disorder and disease and some others are good for you.

Bloodstream infection - a disorder in which bacteria enters the bloodstream, which may appear by way of a wound or infections, or via a medical procedure or shot.

Boils - an inflamed, raised area of skin area that is pus-filled; usually an contaminated locks follicle.

Carbuncles - skin lesion typically induced by Staphylococcus aureus, and resembling a boil with multiple minds.

Catheter - a hollow, versatile tube inserted in to the body to put in or remove fluid, or to start or close arteries.

Cephalosporin - any of a category of natural and fabricated antibiotics developed from Cephalosporium fungi.

Chlorhexidine hydrochloride - an anti-microbial agent.

Colonized - the existence and multiplication of microorganisms without muscle invasion or harm. The infected person demonstrates no indicators of infection, while the potential to infect others still is out there.

Culture - the growing of microorganisms in a nutritional medium (such as gelatine or agar).

Endocarditis - infection of the endocardium and center valves.

Endocardium - coating of the interior surface of the heart's chambers.

Erythematous - a reddening of the skin.

HIV - (Human immunodeficiency disease) a retrovirus that disorders helper T skin cells of the disease fighting capability and causes attained immunodeficiency symptoms (Helps); sent through sexual intercourse or contact with infected blood.

Impetigo - an extremely contagious skin an infection caused by bacteria, usually occurring throughout the nose and mouth area.

Intravenous (IV) - a dose of medicine administered from a drip, down via a hollow needle put into a patient's vein.

Isolation - the take action of isolating something; sets something aside from others.

Linezolid - a man-made antibiotic used for the treating serious infections brought on by Gram-positive bacteria that are tolerant to several other antibiotics.

Meninges - the three membranes that surround and protect the spinal cord and brain.

Meningitis - infection of the meninges; usually brought on by infection with a microorganism.

Methicillin - antibiotic drug of the penicillin family found in the treating certain staphylococcal attacks.

Mitochondrial toxicity - a problem where the mitochondria of your body's skin cells become harmed or decrease significantly in quantity.

MRSA - (Methicillin-resistant Staphylococcus aureus) a significant and probably fatal infection brought on by Staphylococcus aureus bacteria that is resilient to the broad-spectrum antibiotics widely used to take care of it.

Nephrotoxicity - damage to the kidneys made by drugs or other substances.

Osteomyelitis - the swelling of bone fragments and bone marrow because of an infection, usually caused by bacteria.

Ototoxicity - harmful to the organs of hearing or balance or to the auditory nerve.

Pandemic - an epidemic that is geographically widespread; occurring within a region or even throughout the world.

Penicillin - an antibiotic used to cure or stop the pass on of certain infections, due to its capacity to inhibit the growth of certain bacteria.

PCR - approach to amplifying or copying DNA fragments that is faster than cloning.

Red man syndrome - an infusion a reaction to vancomycin, creating flushing of your skin and an erythematous rash on the chest muscles.

Septicaemia - a life-threatening condition in which bacterias multiply in the blood vessels and produce poisonous materials; commonly known as bloodstream poisoning.

Septic great shock - a life-threatening condition in which tissues become damaged and blood circulation pressure drops scheduled to bacterias multiplying and producing poisons in the blood.

Serotonin syndrome - a potentially life-threatening adverse medicine reaction that might occur following therapeutic medication use.

Skin infections (Dermatitis) - infection of your skin.

Staphylococcus aureus - probably pathogenic bacteria found in nasal membranes, skin area, hair follicles, and peritoneum of warm blooded animals. They could cause a variety of microbe infections and intoxications.

Styes - a pus-filled abscess in the follicle associated with an eyelash; caused by a infection.

Superbug - a tension of bacteria that is resilient to all antibiotics.

Vancomycin - an antibiotic effective against some microbe infections.

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