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Methicillin-resistant Staphylococcus aureus (MRSA)

As part of the 2010 Conference on Antimicrobial Resistance, Symposium 5

brought together experts in the area of Methicillin-resistant Staphylococcus aureus (MRSA).  An MRSA bacterium can cause infections in the blood, heart and bones of people with reduced immunity or during the use of drips and catheters.  Research indicates that MRSA infections lead to excess mortality. (1)

Dr. J. Todd Weber, CDC Liaison at the European Centre for Disease Prevention Control, of the Centers for Disease Control and Prevention (Stockholm, Sweden) moderated talks given by Dr. Peter Davies, BVSc, of the University of Minnesota (St. Paul, MN), Dr. Usha Stiefel, of Louis Stokes Cleveland Veterans Affairs (Cleveland, OH), and Dr. Sheldon L. Kaplan, of Baylor College of Medicine and the Texas Children’s Hospital (Houston, TX).

Dr. Davies presented on the topic of MRSA in Livestock: Zoonotic Issues.  Conventional wisdom tells us that MRSA infections are largely caused by the over-use of antibiotics in hospitals, explained Davies.  “Conditions in which animals are being raised today have created a quantum shift in MRSA epidemiology,” said Davies.  These conditions have created a reservoir for community acquired MRSA (CA-MRSA).

Davies noted the emergence of The Netherlands as an epicenter of low MRSA prevalence because of their specific and strict policies regarding treatment and screening for the disease.  According to hospital literature, high-risk groups are screened and patients are nursed in strict isolation.

Dr. Davies also noted a study findings from 2005 and 2006 which found that 39 percent of market hogs had single clonal group non-type-able MRSA while other findings indicated that between 20-25 percent of farm workers had MRSA, which is 760 times the rate of infection in the general population.  (Neeling et al, 2006; Voss et al 2005)

Davies noted the prevalence of occupational exposure to MRSA not only for farm workers, but for veterinarians as well. In these professions, the risk of inter-species transmission of bacteria which require no host adaptation is extremely high, thus requiring workers to be on antibiotics more often than the general population. 

The doctor showed statistics indicating that between 1994-2004, there has been a 600 percent increase of MRSA across the globe.  Because of the increased use of antibiotics by workers in these professions, the rapid growth and development of antibiotic resistant strains with no new drugs to treat them is an enormous problem, explained Davies.  “It’s a MRSA epidemic waiting to happen,” he said.    

The second presentation in Symposia 5 was by Dr. Stiefel on The MRSA Prevention Initiative and the VA: The Road Ahead.  Stiefel offered a detailed description of the initiative, established in 2007 at the Cleveland VA Hospital in northeastern Ohio in order to prevent and more effectively treat MRSA within the hospital community.

According to Dr. Stiefel, the MRSA Initiative grouped four practice components into a “bundle.”  This bundle included:

1. Active surveillance of all patients
2. Isolation precautions for both infected patients and non-infected patients
3. Hand hygiene (providing hand sterilizer, hand-wash reminders, etc.)
4. Culture change within the hospital

Once full implementation took place, the study found that the initiative had an enormous impact.  MRSA infections were reduced by 80-85 percent by patient discharge said Stiefel.  The doctor applied this approach in her hospital to universal precautions hospitals, farms, workplaces, and so on can take to prevent the spread of disease.       

The final Symposium 5 presentation, Diagnosis, Treatment and Prevention of MRSA Infections in Children was given by Dr. Kaplan.  Kaplan urged practitioners to acknowledge that community Staphylococcus aureus infections are dramatically increasing.

He touched on the problem of CA-MRSA and antibiotic susceptibility citing data indicating a steep rise in Clindamycin resistance rates for CA-MRSA Isolates in US Children.  Dr. Kaplan presented his findings on which antibiotics and practices worked more effectively in his experiences to treat CA-MRSA in children.     

(1) Source – The MRSA-net Project

Read more about the conference here.

Abstracts from the MRSA Symposium or the rest of the conference are also available here (pdf).

© Food Safety News
  • Jodi Rauth

    I acquired MRSA in May of 2006. I went to the hospital with a small spot on my jar line. I was told it was a spider bite and sent home. With in 6 hours it was 5 times bigger and throbbing. I returned to the hospital and was told again it was a spider bite. I was sent home with penicillin. The next morning my neck chest and lower jar where swollen to the point I had no neck and my skin was on fire and very red. My heart rate was 130 beats per minute resting and a fever of 103. The doctor working at the ER assumed I was having a heart attack. The doctor argued with my husband that the swelling in my neck had nothing to do with my condition. The doctor put me on nitro and morphine and told me I was having heart problems. I laid on a gurney in the ambulance bay area for 9 hrs till my husband talked a nurse into checking for any lab results. With in minutes I was in ICU and in critical condition for several days. I have permanent damage to my heart. I am unable to work in my medical profession due to risk. I acquired this infection from a patient at a nursing home. No where in her records did it say she had MRSA or were any alerts given to the staff or other residents. This patient was my next door neighbors mother and she and I had the same infection doc. This patient died 10 weeks later. Her family was never told of any risk or restrictions. I have had MRSA several times since I first acquired it. In Ohio nursing homes are not required to report infections to the staff or other residents. Nursing homes are not required to have sinks in the halls for staff to wash. Laws need to be implemented.

  • when will the medical profession stop prescribing oral antibiotics. there is way to much excreted. like killing a fly with a sledgehammer. they need to be injected or given by iv and only after all else fails. or we are going to lose them before we have a suitable replacement.

  • Lana

    Jodi – I am so sorry that you went through this. I went through something similar after gallbladder surgery. MRSA changed my life and left me with some major disabilities and it was so frustrating to have to deal with a host of healthcare people who didn’t care who came in contact with me while I was admitted and who never even placed me on contact precautions. It’s no wonder that I got it at that hospital to begin with. These infections can be prevented but the hospitals are fighting the proposed legislation at every turn simply because they don’t want to pay for it. The bottom line is more important than people’s lives.

  • Peter Davies

    Some of the statements attributed to me in this article do not accurately convey my opinions.
    a) “Conditions in which animals are being raised today have created a quantum shift in MRSA epidemiology”.
    I did not make this statement or anything approximating it. As stated in the abstract, I did say “the global emergence community-acquired MRSA has been described as a quantum change MRSA epidemiology.” This does not refer to livestock associated MRSA.
    I also did say that reports of high prevalence of asymptomatic MRSA carriage in some livestock populations have brought a ‘quantum shift in PERCEPTIONS about the potential importance of animal reservoirs of MRSA.’
    b)”Davies noted the prevalence of occupational exposure to MRSA not only for farm workers, but for veterinarians as well. In these professions, the risk of inter-species transmission of bacteria which require no host adaptation is extremely high, thus requiring workers to be on antibiotics more often than the general population.”
    Again, this misrepresents my statements. Certainly livestock farmers and veterinarians have a higher prevalence of MRSA COLONIZATION than other groups (i.e. having bacteria in their nostrils). Currently there is no evidence that they are at elevated risk of MRSA infections. I definitely made no comment that these groups receive antibiotics more often than the general population (I have seen no data on this).
    The comment on host-adaption has also been wrongly portrayed. Based on data until now, it is my opinion that livestock associated strains of MRSA appear to be somewhat host adapted to animals, and may have less potential to cause disease in humans. More data are required. Furthermore, I stated that any public health risks associated with livestock MRSA are essentially limited to groups with occupational exposure (farmers, veterinarians) with minimal if any risk to the general community. Even in these ‘at risk’ groups, thus far this is little to indicate that this is a serious health concern.

  • juvy

    My son contracted staph MRSA at 5 months. He was in ICU for 1 1/2 months. The infection is different for him since the bacteria localized in his lungs. It was such a life changing experience for me and my husband.
    I wrote about it in my blog.
    http://juvyann19.blogspot.com/2009/10/miracle-first-hand.html
    I personally consider it a miracle that he survived and is now a very healthy 2 year old.