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Healthcare-Acquired Methicillin-Resistant Staphylococcus aureus, or HA-MRSA

Deadly Superbug on the Rise in Hospitals

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Updated December 22, 2008

Healthcare-acquired methicillin-resistant Staphylococcus aureus, or HA-MRSA, is a potentially deadly strain of Staph aureus that is resistant to several antibiotics. This superbug has been appearing more and more in hospitals and other healthcare settings, representing a growing public health problem in the United States.

Species Name: Staphylococcus aureus

Type of Microbe: Gram-positive bacteria

How it spreads: Many patients in hospitals are carriers of HA-MRSA, but do not have disease symptoms. While these patients are the most common source of the bacteria, transmission occurs when healthcare workers’ hands touch other patients who are HA-MRSA carriers. Failure to wash contaminated hands can foster spread of the bacteria.

Other sources of transmission in healthcare settings include open wounds, catheters, or breathing tubes.

Who’s at risk? HA-MRSA infections occur frequently in hospitals and healthcare facilities, where patients undergo invasive medical procedures or have weakened immune systems. HA-MRSA is a growing health problem, increasing from 2% to 63% of total Staph infections between 1974 and 2004.

Symptoms: HA-MRSA infections may include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia.

A HA-MRSA skin infection may appear as a red, swollen, painful area on the skin. It can also take on the form of an abscess, boil, or pus-filled lesion, and may be accompanied by fever and warmth around the infected area.

More serious HA-MRSA infections have symptoms that include chest pain, chills, fatigue, headache, muscle aches, and rash.

Diagnosis: Depending on your symptoms, your doctor may recommend tests, such as blood culture, drainage from the infection, skin culture, sputum culture, or urine culture, to diagnose HA-MRSA.

Prognosis: HA-MRSA-related pneumonia and bloodstream infections can be life-threatening, especially without treatment.

Treatment: Antibiotics (not including methicillin) are usually the first choice of treatment for HA-MRSA infections. Antibiotics that your doctor could select include clindamycin, linezolid, tetracycline, trimethoprim-sulfamethoxazole, or vancomycin. The choice of antibiotic will depend on the nature of the infecting bacterial strain (local patterns of antibiotic resistance and information from cultures)and severity of illness. It is important to complete your entire prescription according to doctor’s orders to avoid further complications. The choice of antibiotic depends on local resistance patterns, culture data (if available) and the severity of the illness. More serious infections may require hospitalization, during which treatments may include intravenous fluids and medication, kidney dialysis (in case of kidney failure) and oxygen therapy (increasing oxygen supply to the lungs).

Prevention: Wash your hands frequently with soap and water, especially at hospitals or other healthcare facilities. Make sure your healthcare providers wash their hands with soap and water before examining you.

How it causes disease: Staph aureus causes an array of diseases, and it is believed that each disease manifestation depends on many factors. In general, Staph aureus sticks to different kinds of tissue within the body and has ways of evading the immune response. For example, it can make proteins that interfere with and destroy white blood cells during an immune response.

Many symptoms of Staph aureus infections occur as a result of tissue destruction by bacterial enzymes. For example, Staph aureus produces toxins, known as superantigens, that can induce septic shock.

In hospital settings, Staph aureus can form a slimy material, called a biofilm, on certain solid surfaces (catheters and prosthetic devices); the biofilm serves as a protective barrier against the immune system and antimicrobial agents.

Sources:

Community-Associated MRSA Information for the Public. Centers for Disease Control and Prevention.

Healthcare-Associated Methicillin Resistant Staphylococcus aureus (HA-MRSA). Centers for Disease Control and Prevention.

MRSA. Medical Encyclopedia. MedlinePlus. US National Library of Medicine and National Institute of Health.

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