Overview (Microbiological Features and Global Epidemiological Situation)

MRSA, Methicillin-resistant Staphylococcus aureus, is one of the multidrug-resistant organisms that is resistant to several antibiotics including penicillin and detected in most countries in the world. S. aureus is a common organism found in 33% of the human nose. According to the WHO report on antimicrobial resistance, almost all WHO regions reported proportion of MRSA existence in S. aureus at more than 20% while some regions revealed more than 80% of MRSA in S. aureus.

High prevalence of MRSA infections is a major global concern regarding antimicrobial resistance. Thus globally, research and development of new antibiotics are desired to tackle against MRSA while also implementing proper infection prevention and control.

Transmission Route

Frequently reported route of transmission of MRSA is contact through contaminated hands of healthcare workers. In addition, contaminated environmental surfaces such as beddings and curtains are also regarded as sources of infection since they provide organisms a chance to disperse.

Symptom

There are no symptoms in case healthy people are colonized or carry MRSA, including in the nose and armpits. However, it causes infections such as in wound, lower respiratory tract and urinary tract when it gets into the body.

Prevention Methods in Healthcare Facilities

Standard and contact precautions should be applied to address MRSA infections as with other multidrug-resistant organisms. The following principles to prevent MRSA were introduced by the WHO:

• Establish or strengthen infection prevention and control management through making a committee or team, producing policies and training staffs
• Avoid transfer of patient and healthcare workers or inform about the infection in advance
• Detect MRSA cases as soon as possible
• Place infected or colonized patients in an isolated room or implement patient cohorting
• Strongly promote hand disinfection; alternatively, hand washing after touching infected or colonized patients
• Use gloves and wear a gown or apron when there is a risk to touch contaminated items or infected patients
• Provide medication for MRSA carriers in nose and daily bathing by antiseptic detergent for infected patients
• Conduct appropriate care for line and waste disposal as well as disinfection of used isolation room

Reference List

Centers for Disease Control (2017) General Information about MRSA in Healthcare Settings. Available at: https://www.cdc.gov/mrsa/healthcare/index.html (Accessed on: 9th March 2018)

Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices Advisory Committee (2007) 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Available at: https://www.cdc.gov/infectioncontrol/pdf/guidelines/isolation-guidelines.pdf (Accessed on: 9th March 2018)

World Health Organization (none) Recommendations for the Control of Methicillin-Resistant Staphylococcus aureus (MRSA). Available at: http://apps.who.int/medicinedocs/documents/s16211e/s16211e.pdf (Accessed on: 9th March 2018)

World Health Organization (2014) Antimicrobial resistance Global Report on Surveillance. Available at: http://apps.who.int/iris/bitstream/10665/112642/1/9789241564748_eng.pdf (Accessed on: 9th March 2018)

World Health Organization (none) Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. Available at: http://www.who.int/medicines/publications/WHO-PPL-Short_Summary_25Feb-ET_NM_WHO.pdf (Accessed on: 9th March 2018)

National Health Service (2017) MRSA. Available at: https://www.nhs.uk/conditions/mrsa/#preventing-mrsa (Accessed on: 9th March 2018)