Question:
Title : MRSA Outbreak Treatment and Implications
Your assignment will include the preparation a review/report, excluding figures and pictures, as well as references.
The goal of this exercise is to compile a selection of articles from recent journals that focus on one element of your title.
Avoid giving a brief overview, and instead consider any questions that you may be asked by your review of cutting-edge literature.
Answer to Question: PHPH10003 Pharmacology 1A
IntroductionMethicillin-resistant Staphylococcus aureus (MRSA) is an infection caused by Staph or type of Staphylococcus aureus bacteria that is resistant to antibiotics naturally residing on the skin and nose.
This bacteria can spread quickly from infected people by direct contact.
This infection affects people who have been in hospital for extended periods. It can also cause severe health problems and spread the disease to others.
MRSA infection is classified as either hospital-acquired (HAMRSA) or community-acquired CA-MRSA.
HA-MRSA is a result of infections that occur in hospitals and nursing homes (1).
CA-MRSA infections are spread by direct contact with infected people.
HA/MRSA can cause severe complications such as pneumonia or sepsis. Urinary tract infections can also lead to complications such as sepsis or infection of the urinary system. Symptoms include rash, headaches and fevers.
CA-MRSA can lead to skin infections such as cellulitis, a painful, woollen bump that forms on the skin.
MRSA in hospitals is a serious problem because it mostly occurs in people who have spent a lot of time in hospitals.
MRSA infection can be resistant to antibiotics and cause severe side effect. However, it is treatable with only limited antibiotics which are more powerful than the usual (2).
These effects have grave consequences for the public’s health. This report addresses the implications of MRSA, treatment methods, and potential consequences.
Only 26 out of the 116 articles found were reviewed.
Ten articles were selected for inclusion in the current review because they met the inclusion criteria.
The following articles were selected: 3 for the study of MRSA outbreaks; 2 for the presentation of MRSA treatment methods; 5 for the assessment of MRSA-related consequences.
MRSA Outbreak: What Does It Mean?
MRSA has serious implications for public health, both in acute and long term health settings.
Because it is resistant to treatment, MRSA can spread quickly in hospitals and can cause severe illness.
This infection can spread via direct contact. Patients with open wounds or people who are in close proximity to it are most at high risk.
Centres for Disease Control and Prevention (CDC) estimates that 33% of individuals are carriers of this staph bacterium. 21% of 100 are MRSA-carriers (3).
MRSA is a drug-resistant bacteria that has limited treatment options. It is threatening the lives and health of patients through the spread of the infection in hospitals, communities, and the community.
Because MRSA can survive antibiotics and is contagious, it’s becoming increasingly difficult to eliminate infection.
MRSA outbreaks are most common in hospitals. This was confirmed by a study conducted in Orange County, California.
The hospital wards were surveyed for data on hospital stays, intraward transmission rates (beta), time to readmission and loss.
Based on the severity of the outbreak, it affected all hospitals in the network.
The transmission rate averaged between 5% and 15% from one hospital to the other.
This shows that MRSA infection isn’t limited to one hospital.
It spread to all the hospitals within that region.
The strength of the paper lies in the fact that the results highlighted the need for prevention strategies and infection control policies and policies accounting to interconnectedness in healthcare facilities.
It is possible to use the obtained data in other regions as well, since it may not be unique.
However, there are some limitations to this paper.
The study focused on adults only and excluded neonates in long term facilities or nursing homes.
A nursing home patient being transferred might have a high risk of infection.
Researchers used Regional Healthcare Ecosystem Analyst to (RHEA) to study the possibility of MRSA outbreaks occurring in California’s hospitals.
Results showed that nursing homes play an important role in hospital infection spreading, even though they are not directly involved with patient transfer.
The spread of MRSA is a result of patients sharing between nursing homes and hospitals. This can have serious consequences on the hospital staff, patents, and the whole community.
The strengths of the study are the clear and understandable information provided by the main findings. These important data can be used to control the spread and control MRSA in hospitals and nursing homes.
The paper’s main flaw is that it only examined hospitals. This underestimated the MRSA prevalence in nursing homes. Additionally, there was no data available on emergency department visits.
MRSA has serious consequences and is still above the provincial benchmarks.
MRSA-hospital acquired infection (HAI), can have a significant impact on the work life of healthcare professionals and their health.
Nursing professionals face difficulties in their work, due to increased documentation and time pressures.
Healthcare organizations face increased costs due to the increased responsibility for infection control.
There are also strict hygiene procedures and cleaning that must be done to prevent infection from spreading to others.
The nosocomial epidemic can result in disruptions in patient care and increased hospital costs. These outbreaks require aggressive efforts to prevent spread to other healthcare settings.
Results (MRSA Treatment).
MRSA infections must be prevented. There are very few options to treat it.
However, MRSA can be treated with caution.
MRSA can be resistant to antibiotics like penicillin, methicillin, and oxacillin.
MRSA treatment by antibiotics has been proven effective in treating the infection.
First, MRSA infections are incised. Next, the affected area is drained.
MRSA infections can be treated using IV antibiotics. Vancomycin, at a dosage of 30 mg/kg, is given as first-line therapy. It is gradually reduced to 90 minute intervals for hypersensitivity.
Each 24 hour, Daptomycin or Cubicin are administered at a dose of 4-6 mg/kg.
Although this drug is safe, it can have side effects like an increase of creatine kinase.
Linezolid may be used as a second-line therapy. It can be taken at a dose of 600mg once per day. Linezolid also acts as a monoamineoxidase inhibiter, which means that it has a bioavailability level of 100%.
Vancomycin has been the best option for MRSA infections in hospitalized people. However, this is due to antibiotic resistance and dosing problems, poor activity, low cidality and clinical failure. A study conducted to show the treatment and resistance of MRSA illustrated that vancomycin-intermediate S. aureus (VISA) contribute to the treatment failure due to vancomycin and increased in MRSA related death rates.
Heteroresistance is a reduction in MRSA responses without any effect on the mortality rates.
Linezolid in soft tissues is superior to vancomycin with 87% or 49% efficacy.
Daptomycin also works against MRSA infection in patients with oxazolidinones that are newer.
The study is very useful, as it contains a lot of information regarding MRSA treatment. It highlights the significant advances in treatment and resistance in MRSA infections.
The paper did however not address the molecular mechanisms of the development of new anti-MRSA antibiotics.
Tygacil, a fourth-line treatment, can be used at a dose of 100 mg IV one time followed by 50mg IV every 12 hours. It is effective and broad-spectrum in antimicrobial activity.
MRSA treatment may be performed with fifth-line therapy using quinupristin (Synercid), or dalfopristin.Oral antibiotics (first-line therapy) can also be used for MRSA treatment like trimethoprim-sulfamethoxazole having 95% efficiency.
Cleocin, which is clindamycin, is the second line treatment. However the organism might develop resistance to this drug if they have erythromycin resistant.
MRSA infections require new targets to be treated.
According to a study, fifth-generation antibiotics such carbapenems as monobactams or cephalosporins, carbapenems, glycopeptides and Tetracyclines were effective in curbing MRSA resistance.
However, the study did NOT address the necessity of using new antibiotics for the management of antimicrobial resistance.
Discussion:
MRSA infection is a serious problem that can impact the quality and life of inpatients. This happens because it affects people with various life-threatening diseases, including those in ICUs, emergency bars, palliative, and paediatric settings.
It is a significant burden on patients’ quality of lives, and can cause isolation and disease burden in the community as well as hospitals.
MRSA infection is a serious problem in patients with cancer. The first study to examine the impact of this infection on patients and their families (9)
It can cause distress and make it difficult for patients to find effective coping mechanisms.
MRSA infection in cancer patients can lead to stigmatization, anger, and frustration.
It can also negatively impact their relationships and overall health as they are isolated from patients who are not at fault.
Although the study has limitations due to its small sample, it is not applicable to larger populations of cancer patients.
The study’s limitation was the comparison of cancer perceived impact to MRSA infection. This may have implications for future studies that will evaluate the psychiatric impacts of MRSA on advanced cancer patients.
Staph bacterium antibiotic resistant is another reason for the rising spread and transmission of infections.
MRSA has both a clinical and financial impact on the patient, healthcare facilities, and the local community due to its high infection rate (10).
This results in a large number of infections that are resistant to the hospital. Cost parameters related to the infection episode can be analyzed.
In addition to rising costs for antimicrobial treatment, there is an increase in drug acquisition costs.
S.aureus can also lead to an increase in hospital stays, which is another result.
Hospital stay increases, leading to hospital discharge late in the day. This inefficiency and financial cost increase (11).
MRSA infection has severe consequences for patient health and quality life.
Patients can feel embarrassed, humiliated and angry when they encounter ignorant staff while seeking care.
MRSA infection makes patients feel isolated, traumatic, and insecure. Patients also feel like they are being held captive by poor rehabilitation.
Patients feel stigmatized when they encounter fearful or unprofessional behavior from medical staffs.
The hospital staff is not taking effective infection measures, which can have severe consequences for patients’ suffering.
MRSA infection can spread quickly in a hospital or community, posing a significant clinical and financial burden to the overall health and quality of care of patients, as well as healthcare systems in general (12).
Conclusion
MRSA infection can spread from one community or hospital to the entire region. It has serious consequences.
It has serious economic, clinical, social, and financial consequences for the patients and their families as well as hospital staff and nurses.
MRSA causes antibiotic resistance which means that there are few treatment options.
There are some antibiotics that work, including second-line therapy like Linezolid (IV) and Daptomycin (IV).
In certain cases, oral antibiotics may be used with 95% efficiency.
MRSA infection spread is serious. There are many treatment options.
It reduces the quality and well-being of patients because of stigmatization.
The patients feel ashamed, afraid, guilty, and agitated. But, the patients aren’t to blame.
It can also affect the lives of healthcare workers and cause financial hardships.
Nurses and other healthcare professionals need to find effective infection control measures to decrease the spread of the disease.
MRSA is also resistant to antibiotics using novel genetic strategies.
There is a need for effective infection control and antibiotics to target the new genetic mechanism which causes resistance to anti-MRSA antibiotics.
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