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EDITORIAL  
Year : 2013  |  Volume : 5  |  Issue : 1  |  Page : 1-2
State of the globe: MRSA continues to survive and sustain


Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India

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Date of Web Publication14-Feb-2013
 

How to cite this article:
Capoor MR. State of the globe: MRSA continues to survive and sustain. J Global Infect Dis 2013;5:1-2

How to cite this URL:
Capoor MR. State of the globe: MRSA continues to survive and sustain. J Global Infect Dis [serial online] 2013 [cited 2019 Aug 24];5:1-2. Available from: http://www.jgid.org/text.asp?2013/5/1/1/107163


Staphylococcus aureus is the most frequently isolated bacterial pathogen globally. It is an important cause of skin and soft tissue infections (SSTIs), endovascular infections, pneumonia, septic arthritis, endocarditis, osteomyelitis, foreign-body infections, bacteremia and toxemic syndromes. [1],[2]

Methicillin-resistant S. aureus (MRSA) isolates are resistant to all classes of penicillins and other lactam antimicrobials. Previously, they were hospital-associated MRSA (HA-MRSA), however, since the mid-1990s, there has been a substantial increase in the number of MRSA infections that reported for populations lacking risk factors for exposure to the healthcare system, these are called as Community acquired MRSA (CA-MRSA). CA-MRSA and HA-MRSA strains differ in population affected, site of infection, risk factors, transmission, gene profile, the Phanton valentine gene, toxicities, and antimicrobial susceptibility. [3],[4],[5]

This study, carried out in Kuwait, focuses on studying the prevalence, risk factors of MRSA infections in the community and hospital. The incidence and risk factors for CA-MRSA and HA-MRSA among patients of various wards and intensive care unit (ICU) were determined. Cultures for MRSA were taken from various sites in all enrolled patients upon admission. All isolates were subjected for their susceptibility to different antibiotics. The results revealed that the samples grew CA-MRSA in majority of cases. A highly significant relationship was observed between the number of CA-MRSA patients and the different sites of infections. A significant correlation between the type of MRSA and different wards, sites, and lengths of hospital stay was also seen. The level of serum albumin, iron deficiency anemia, and diabetes that are routinely measured at hospital admission, in addition to the period of hospital stay, were predictors and risk factors to CA-MRSA infection. HA-MRSA patients were found to have more multidrug resistant characteristics than CA-MRSA patients.

It is well documented that the percentage of CA-MRSA in hospital units is greater than before. This is significant because professional healthcare personnel habitually move between patient care settings and hospitals, which might lead to the spread of the pathogens. Apart from this study, many studies have emphasized that CA-MRSA strains are not replacing the HA-MRSA strains, but rather are adding to the problem of MRSA. The coexistence of both strains and protection of CA-MRSA can occur in the hospital because of the arrival of numerous colonized and infected patients. [3],[4],[5]

Information on the type of MRSA community- or healthcare-associated organism and on the place of origin of these organisms is useful for the clinical expression and for determining appropriate treatment. HA-MRSA and CA-MRSA differ clinically and biologically. MRSA strains' incidence and epidemiology are varying and have become a worldwide problem. It is important to determine the difference of these two strains to effectively prevent, treat, and handle patients. Antimicrobials such as clindamycin, doxycycline, minocycline, trimethoprim-sulfamethoxazole, and vancomycin are recommended. Several newer antistaphylococcal agents are available for parenteral therapy, including daptomycin, linezolid, tigecycline and quinupristin-dalfopristin. Certain antimicrobial drugs (fluoroquinolones, rifampicin) should be avoided as therapy for MRSA SSTIs despite susceptibility documented by laboratory testing because of the high rate of emergence of resistance on exposure. Mupirocin is recommended for local use in carriers. [5]

This study highlights that S. aureus and MRSA are crucial globally due to their increased resistance to many antibiotics. Strict infection control practices can reliably limit their spread and are needed to control outbreaks. As the CA-MRSA epidemic continues, the need for effective interventions have become of paramount importance.

 
   References Top

1.Klevens RM, Morrison MA, Nadle J, Petit S, Gershman K, Ray S, et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 2007;298:1763-71.  Back to cited text no. 1
    
2.Maree CL, Daum RS, Boyle-Vavra S, Matayoshi K, Miller LG. Community-associated methicillin-resistant Staphylococcus aureus isolates causing healthcare-associated infections. Emerg Infect Dis 2007;13:236-42.  Back to cited text no. 2
    
3.Tsuji BT, Rybak MJ, Cheung CM, Amjad M, Kaatz GW. Community- and healthcare-associated methicillin-resistant Staphylococcus aureus: A comparison of molecular epidemiology and antimicrobial activities of various agents. Diagn Microbiol Infect Dis 2007;58:41-7.  Back to cited text no. 3
    
4.Vandenesch F, Naimi T, Enright MC, Lina G, Nimmo GR, Heffernan H, et al. Community-acquired methicillin-resistant Staphylococcus aureus carrying Panton-Valentine leukocidin genes: Worldwide emergence. Emerg Infect Dis 2003;9:978-84.  Back to cited text no. 4
    
5.David MZ, Daum RS. Community-associated methicillin-resistant Staphylococcus aureus: Epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev 2010;23:616-87.  Back to cited text no. 5
    

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Correspondence Address:
Malini R Capoor
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.107163

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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008