Methicillin-resistant Staphylococcus aureus (MRSA) is a staph bacteria resistant to several antibiotics, which makes these infections more difficult to treat. When contracted in healthcare environments like hospitals or nursing homes, it is identified as hospital-acquired MRSA (HA-MRSA).
HA-MRSA is a concern because it affects individuals who are already in a vulnerable state of health. The presence of these infections in facilities where patients have weakened immune systems or are undergoing invasive procedures complicates patient care.
Acquiring MRSA in Hospital Settings
The transmission of MRSA within a hospital often begins with direct contact. Healthcare workers can carry the bacteria on their hands, moving it from one patient to another or from a contaminated surface to a patient. Medical equipment and surfaces like bed rails can also harbor the bacteria, serving as reservoirs for infection if not properly disinfected.
Certain factors increase a patient’s susceptibility to acquiring HA-MRSA. Individuals with compromised immune systems, open wounds, or recent surgical incisions are at risk because these conditions provide an entry point for the bacteria. Invasive medical devices, such as intravenous lines or urinary catheters, create a direct pathway for MRSA to enter the body. Prolonged hospital stays or residing in a long-term care facility also elevate the risk.
Symptoms of Hospital-Acquired MRSA
The signs of an HA-MRSA infection depend on its location in the body. On the skin, it can appear as swollen, red, and painful bumps that might resemble pimples or spider bites. These areas may feel warm, be filled with pus, and can be accompanied by a fever, potentially progressing to more serious conditions like abscesses or cellulitis.
When HA-MRSA enters the bloodstream, it can lead to sepsis. If the bacteria infect the lungs, it can cause pneumonia, with symptoms including coughing, shortness of breath, and fever. Infections can also develop at a surgical wound site, characterized by redness, swelling, pain, and drainage from the incision.
Diagnosing and Treating HA-MRSA
Diagnosing an HA-MRSA infection begins with collecting samples from the suspected site, such as a tissue sample from a wound, blood, or urine. These specimens are sent to a laboratory for analysis. In the lab, the sample is cultured to grow the bacteria, which is then identified as Staphylococcus aureus.
Once S. aureus is identified, further tests determine its susceptibility to various antibiotics, confirming if the strain is MRSA. Treatment involves antibiotics effective against resistant strains, such as vancomycin or linezolid. In cases involving skin abscesses, medical procedures to drain the pus or remove compromised tissue may be necessary.
Hospital Prevention Strategies
Preventing the spread of HA-MRSA in healthcare facilities involves several strategies. Strict hand hygiene is required, with staff washing their hands with soap and water or using an alcohol-based hand sanitizer before and after every patient interaction. Routine cleaning and disinfection of patient rooms, medical equipment, and high-touch surfaces also reduce environmental contamination.
Hospitals often screen high-risk patients to identify those carrying MRSA without showing symptoms. These colonized patients are then placed under specific precautions to prevent transmission, which may include housing them in a single room or with others who have the same bacteria (cohorting). Healthcare workers entering these rooms are required to wear personal protective equipment (PPE), such as gowns and gloves, to prevent spreading the bacteria.