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).