What is MRSA?

About 30 - 40% of all people is a carrier of the Staphylococcus aureus bacterium. This bacterium can be found in the nasal mucous membranes as well as on the skin. In the Netherlands  0.5 - 1% of the population is carrier of the mutated bacterium Meticillin Resistant Staphylococcus aureus (MRSA). The bacterium is difficult to fight as it is resistent to most common antibiotics. In case of a weakened immune system the bacterium may cause serious infections that are sometimes lethal. Therefore, the bacterium is a big hazard in hospitals and other health care facilities.
 
In France, Spain and Italy 30% of the population is carrier of the MRSA bacterium and in the United States the percentage is 40%. In the Netherlands there is a much more strict protocol for fighting the bacterium and antibiotics are prescribed with caution in order to avoid or prolongate resistance. But despite these measures the bacterium is rearing its head more often in the Netherlands as well because people who have been treated in hospitals abroad often carry the bacterium.

Origins of an MRSA infection
It is hard to determine exactly where an infection with MRSA originates. Most of the time it is transmitted by patients/clients or employees who have been in a contaminated area. Not only the patient/client, but also his/her surroundings can become infected. The bacterium resides in fibers of bed-clothes, curtains, clothes and shoes. It also resides in dust, on floors, walls and ceilings and it even feels at home on bed frames, water taps, TV remote controls, door knobs and light switches. The bacterium spreads through air shafts, dust, skin scales and contact with contaminated persons and objects. Therefore new infections can start fairly easily.

The bacterium

Where does MRSA occur?
MRSA can be found around the globe. The bacterium mostly found in places where many antibiotics are used, like health care facilities. Thanks to a rigid national policy ‘only’ 0.5 – 1% of all hospital patients gets infected with the bacterium. The antibiotics policy in hospitals outside the Netherlands is less strict and there 20 to 50% of the hospital patients run the risk to become infected with MRSA. Patients who have been treated in a foreign hospital can bring the bacterium into the country. A further spread of the infection can often be prevented with the use of a strict isolation policy. However, due to an increasing number of patients that are treated in foreign hospitals the chance of a spread is increasing.

Prevention is better than cure
With a rigid antibiotics policy it is avoided that the Staphylococcus aureus becomes resistent. Beside of this other prevention measures are set up to try to limit the spread of MRSA as much as possible. Patients meeting a number of risk criteria are tested on the presence of MRSA. Employees are also tested in case they have been in contact with a MRSA positive patient. Also, daily thorough cleaning of contact areas, and most of all removal of dust, decreases the risk of spreading this bacterium.

Consequences

Infection: isolate, clean, desinfect
When a patient is suspected of having MRSA or is infected with MRSA, the patient it directly isolated from the other patients. Rooms and objects that are possibly contaminated are immediately cleaned and disinfected, if necessary. The patient can receive visitors but visitors will have to wear a bonnet, nose/mouth mask, a visitor coat and gloves. After the visit they have to thoroughly clean and desinfect their hands. After this they have to leave the building immediately. As long as they are healthy themselves there is no risk for them to become infected. But without knowing it, they can carry the bacterium and contaminate people with a weakened immune system or people who have recently had surgery. And those people can become ill from infection with this bacterium.

Symptoms
People with a weakened immune system or people who have recently had surgery can become infected with MRSA. This can lead to all kinds of infections. MRSA can also spread through the entire body when it enters the bloodstream. In that case the bacterium can cause serious damage to vital organs. This could cause the patient to go into shock and it could even cause death. The symptoms are not always visible and are not always the same. That makes it difficult to recognize an MRSA infection. In order to determine whether a patient is infected with the bacterium samples are taken from the mucous membranes (throat, nose and buttock seam) and, if present, from the wounds. These samples are cultivated and tested for MRSA.