Could we have MRSA?

star-pants

Hi there,
We got a letter in my granda's door during the week (who passed away a month & a half ago) stating that upon tests back in July - he had got MRSA. These letters were dated September (as to why we only got them now---who knows?)
Question is - none of us were aware of this until now, so what's the risk of family who've been in close contact with him having / carrying MRSA?

We will be checking with our GP but I was just curious if anyone had any experience, or knows more about the virus?
Thanks

fits

1 in 3 people carry MRSA. Its really not uncommon. It only becomes an issue when immunity is compromised as far as I know. Someone in my house carries it... how do I know? my vet found it on my dog when she took a swab of an infected wound!

Check with your GP for your own peace of mind.

Lil' Smiler

wen u say MRSA, it's ot necessarily the type that will make you extremely ill.

for example my nana has had eye infections for the past while and her swabs showed that she has mrsa but we've all been in the nursing home with her for the past i don't know how long.

As the mod said check with your gp but i'd say it's unlikely and surely you'd have had some symptoms by now!

Nonoperational

Just a few points here, MRSA is not a virus its a bacterium! A lot of poeple carry Staph aureus (SA) or the resistant MRSA. It only becomes significant if your immune system is very low (AIDS, immunosurpressed etc), or if your going to hospital for surgery of some kind. We carry lots of bacteria on us from time to time and staph or sometimes MRSA is a common one. This is in fact the same as the "bad" MRSA we hear about, there is only one type of MRSA its just not affecting you in a pathological or bad way. If you were going to hospital and your were colonised with MRSA it is quite easy to get rid of using a nasal ointment (bactoban), a powder (CX powder) and Hibiscrub wash. These contain disinfectants that get the mesure of MRSA quite easily. As it is it is nothing to worry about!

DrIndy

MRSA is a bacterium and suffers considerable hype in the media.

MRSA is a mutant version of Staph aureus and it is conferred with resistance to the common types of antibiotics used to treat staph aures infections. This means people with MRSA have to be treated with IV (Drip) antibiotics instead of the convenient tablets as normal.

Because MRSA is a mutant version of a normal skin bacterium that causes boils and carbuncles - it lives happily on the skin beside its normal brothers. People with this are MRSA colonised -but NOT infected.

Staph aureus and MRSA are not pleasant bacteria when they manage to break into the body though and both are very good at invasive disease and can stick to any organ causing abscesses as well as bone and heart infections.

However the only difference between them is the antibiotic resistance. If you are debilitated and get invasive Staph aureus or MRSA disease - you will quickly become septic due to toxins released by the bacteria and the only difference in the treatment is that you would receive one antibiotic over another in treatment.

So MRSA is not a superbug - its simply a resistant bug. More people die of normal bog standard Staph aureus infections than MRSA - but the unfortunate combination of a bacterium with the potential to be nasty and the happenstance that it is resistant to common antibiotics means the media has jumped on the band wagon and raised amazing hype over it.

Because MRSA is a happy skin living bacteria, being MRSA colonised in the community is surprisingly common, but when someone comes into hospital, they then need to be isolated to make sure that an MRSA negative patient who is recovering from a big operation does not have the chance to be infected.

The notification is undoubtedly that a skin swab came up positive - it may not be of any significance as these can themselves turn back into negative swabs on their own. Also there are many effective topical antiseptic treatments as outlined by a previous poster which can eradicate MRSA and this is used to make someone MRSA colonised negative again.

Talk to a doctor if you are worried and bring the letter with you so he/she knows the context in which the result came up.

On a slightly divergent issue, I was amazed to read in the Metro about resistant MRSA to ESBL!!!!

This is a classic example of poor editing and sensationalising. There is a different group of bacteria entirely floating around the hospital system which have an enzyme system called Extended Spectrum Beta Lactamase resistance. These gram negative bacteria absolutely unrelated to MRSA have the ability to become resistant to the common classes on antibiotics they should be sensitive to and are able to transmit this across species. They are as a group less nasty as invasive organisms than MRSA but is still worrying and requires vigilance.

However despite these being a completely different group of bacteria with a completely different resistance pathway and being completely and absolutely unrelated to MRSA - the media just lump them all in together and sensationalise the issue.

No wonder people fear coming to hospital. No wonder people worry when their loved ones go into isolation despite not being sick. I do in part point a strong finger at the media on this one. Its inappropriate to scare people more when they are already worried about their loved ones.

Tree

i think the problem w/ esbl is when they occur in conjunction w/ bacteria suceptible to penicillins. the esbl's break down the penicillins so they dont bother the other bacteria and all the little bugs are happy and growing on.

Schlemm

Scary as MRSA is, it's not hard to avoid problems from it if you're careful.

Washing your hands thorougly is the most obvious step! As is general good hygine.

If anyone in your house is sick or under the weather or has just had surgery, etc. etc. (including pets - they can pick it up too) you should be extra vigilant but generally if you practice good hygine it shouldn't be a problem and will clear on it's own if you're healthy, as the other posters have been mentioning.

Nonoperational

Some nice educated input here. Contrary to popular belief, MRSA can be treated with a number of antibiotics including with linezolid (Zyvox) tablets and even more conventional preperations like rifampicin and fusidic acid tablets. I imagine the mortality associated with it is as much to do with the population of people that get it ie older and other generally sick individuals rather than an inability to treat.

DrIndy

gpf101 wrote: »

Some nice educated input here. Contrary to popular belief, MRSA can be treated with a number of antibiotics including with linezolid (Zyvox) tablets and even more conventional preperations like rifampicin and fusidic acid tablets. I imagine the mortality associated with it is as much to do with the population of people that get it ie older and other generally sick individuals rather than an inability to treat.

Glycopeptide antibiotics such as Vancomycin or Teicoplanin would be first line in the therapy with Linezolid kept in reserve for severe infection - particularily lung infection where it has better penetrance. Linzeolid is also horrificaly expensive and cannot only be given for a few weeks due to side effects and this reduces its usefulness despite being available orally.

Also most MRSA is actually sensitive to tetracycline antibiotics which can be given by mouth - however, tetracyclines are bacteriostatic meaning they arrest the growth but don't kill the bug so are not ideal in someone who is fulminantly septic.

Rifampicin works and so does Co-Trimoxazole. Rifampicin resistance develops rapidly if only given as unitherapy but it is particularily good at getting to deep seated abscess infections. Co-Trimoxazole is part of the formulary but is only occasionally used.

There is a phenomenon of community-MRSA or cMRSA which is resistant Staph aureus but only to penicillins and as such are sensitive to macrolides. These are a different species that have evolved in the community from antibiotic use and are a different mutation from its hospital cousin. They can be treated with Clindamycin.

There are also new agents out there which also work such as Daptomycin, Quinupristin/Dalfopristin. I think the new tetracycline analogue - Tigecycline can also be used to treat MRSA.

The bottom line is that MRSA is not an unstoppable superbug as the media makes it out to be. It is eminently treatable with a wide range of antibiotics - but the inconvenience of it is that the only means of effective therapy is with IV treatment and not convenient oral.

DrIndy

Tree wrote: »

i think the problem w/ esbl is when they occur in conjunction w/ bacteria suceptible to penicillins. the esbl's break down the penicillins so they dont bother the other bacteria and all the little bugs are happy and growing on.

ESBL is a plasmid chain of extended spectrum penicillin resistance and the problem here is that the bacteria can conjugate and tranfer the plasmid across gram negative species.

This means that Klebsiella can transmit this resistance to E coli and this is why it is particularily troublesome.

Nonoperational

Dr Indy, can I ask are you indeed a medical doctor yourself? I presume from both the name and the nature of the replies you are!

DrIndy

I am and by happenstance doing an infectious diseases rotation too!

kifi

Someone in my household developed a sort of boil on his skin. His doctor advisedd him to have it drained in the hospital. After about 3 weeks of regular visits to the outpatients to have it drained with a wick, the wound hadn't healed. He was later informed that he has MRSA.

What does this mean for him? Will this wound ever heal? What are the other implications to his health? Is it life threatening? I know it's contagious, but how easily is it spread? Can he be cured?

As you can see, I know very little about this, can anybody here answer some of my questions?

Thanks

DrIndy

it will heal, just not with the conventional antibiotics in the arsenal. it is only life threatening if it gets into the blood stream and people with a normal immunity and not undergoing major surgery can fight it off readily.

The specifics of this are best discussed with the team looking after him though.