Hardly a day passes without another MRSA story hitting the headlines. People are right to be concerned about this resistant superbug but sometimes the stories do not match the facts, and misunderstandings occur. I am no expert when it comes to talking about MRSA but I have learnt enough through my own experience of MRSA infection, to be able to share some facts with you.
So, what does it mean when someone says “I’ve got MRSA”?
This seems to be an area where much confusion exists. First of all, it should be clarified that a person can be either ‘colonised’ with or ‘infected’ by MRSA. People who are colonised usually have no symptoms but they still have the potential to pass on the bacteria by touch. Those who have an infection caused by MRSA are usually unwell and will require treatment.
The significance of being ‘colonised’ with MRSA is often poorly understood. Some people harbour the bacteria in their nostrils or on the surface of the skin without being aware that they are colonised, and they remain well. It is possible to pick it up on your skin by simply touching a contaminated surface or indeed from another person who is colonised but it will not cause harm unless it enters your system through microscopic breaks in the skin. When someone is found to be colonised it does not mean that they will automatically go on to develop an infection. As long as you are well there is no need to be unduly alarmed. You should remain extra vigilant for any unusual skin complaints or if you develop a high temperature and seek medical attention if in any doubt. You will be given instructions on how to de-colonise yourself with topical agents such as nasal ointment and bodywash/shampoo to eradicate nasal and skin carriage. It is important to remember however that a colonised person is a ‘carrier’ of MRSA and has the potential to colonise/infect others through contact. This is the reason why stringent infection control measures are required in hospitals as patients who are already ill, are at high risk of developing an MRSA infection. Many people are carriers without realising it and therefore it is really important that everyone takes the necessary precautions to prevent the spread of bacteria. Hospital visitors should observe good hand hygiene and use alcohol gel on their hands before and after visiting a patient. Ideally, hospital visiting should be kept to a minimum.
When somebody receives a diagnosis that they are ‘infected’ with MRSA they are usually already unwell. MRSA is not only restricted to hospital settings. Community-Acquired MRSA (CA-MRSA) is a rapidly emerging public health problem in the USA but it is rarely seen in Ireland. It causes pimples and boils and can infect wounds and grazes. A culture (swab) is required to determine the sensitivities of the bacteria and the duration of treatment will depend on severity of illness and clinical response. However the most prevalent form of MRSA seen in Ireland is Hospital-Acquired (HA-MRSA) infection. It thrives in hospitals where people are in close proximity and may have their defences already weakened by illness. Those who have had recent surgery or who are immuno-compromised are also at high risk of infection. The hospital environment also tends to be rife with multi-resistant bacteria as a result of the heavy use of antibiotics. The types of infections seen are wound infections, chest infections, bone infections or bloodstream infections and these have the potential to cause serious illness, or even death. Hospital acquired infections can be very difficult to treat and usually require long-term intra-venous treatment with a combination of antibiotics.
A reduction in antibiotic consumption levels, frequent and proper hand washing, and improved basic hygiene levels in hospitals are all essential to reduce the level of contamination. Hand hygiene is the single most effective defence against the spread of MRSA. This means that staff, patients and visitors alike all have a simple but important role to play in the fight against MRSA.