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MRSA - page 4
Keywords: MRSA, infection hospital superdrug infection methicillin resistant staphylococcus aureus
By Einstein10 on 30/12/2009
Level: Foundation Degree
Page Number: 4 of 6 pages: 1 2 3 4 5 6bacteria and the DNA for the resistant gene is transferred over 27 ( Figure 4).
Figure 4. The process of Transformation, Transduction and Conjugation in Bacterial Resistance 18
Antibiotics like penicillin are very specific to target sites on the bacterial cell walls. For example some penicillin’s have a conformation similar to the transition site conformation taken up by the amino acid portion D-Ala-D-Ala involved in the cross-lining reaction of Peptidoglycans. 15
The resistant Methicillin gene mecA in SA, is believed to code a Methicillin resistant penicillin protein that causes a mutation of the cell wall.However, mecA has passed it resistant DNA, the staphylococcal cassette chromosome mec (SSC mec). Four types of these chromosomes exist and each differ in size and amount of resistant DNA. 2
Minimising further spread of MRSA
SA is spread to direct contact or droplet spread and hence hospitals are using the standard precautions and contact isolation to minimise spread of SA. Three principle methods include, using anti-bacterial gel between co-workers, appropriate use of antibiotics and the detection and isolation of colonised patients. 1
The main source of cross contamination is healthcare workers. 21 Alcohol based hand rubs are being used throughout the worlds as this method works and is costeffective.21 However, studies show that only 48% of hospitals in Switzerland are complying with the hand hygiene protocols and if this figure went up to 70% then the risk of further spread could reduce by a third. 21 In the U.K, special ward staff called hand hygiene champions encourages staff and visitors to constantly cleanse their hand with anti-bacterial.22 This implementation of hand hygiene and the usage of bed side alcohol rinses improved hand hygiene compliance from 48% in 1994 to 66.2% in 1997 and consequently reduced the transmission of MRSA. 29
Screening on admission and the isolation of patients is one of the best ways to reduce transmission. 21 A new pre-screening technology of produced by Swiss scientists reduces the spread of MRSA in the ICU by 70% due to quicker diagnosis and isolation.24 Furthermore, the Dutch have managed to implement isolation measures and this has reduced MRSA transmission. Isolation wards have been prepared specifically for colonised or suspected patients with designated nurses who care for these patients only. 27 The U.K need to take into consideration these methods of isolation as they work but isolation methods are very expensive and need to be used in combination with antibiotics.21 (Figure
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