Limiting Use Of Antibiotics Stems MRSA
Q: A friend of mine was diagnosed with methicillin-resistant Staphylococcus aureus, or MRSA. How does a person even contract such a disease — and what does it do to you? A: Methicillin-resistant Staphylococcus aureus, or MRSA, is a bacterium that is resistant to methicillin and other penicillin-related antibiotics. These drugs normally bind to a specific protein on the bacterium, leaving it unable to produce a cell wall. MRSA, however, has a gene that produces a protein that doesn’t bind to methicillin or its cousins, making it harder to defeat. People can acquire MRSA in two ways. One is through a health care setting, either in a hospital, nursing facility, surgical center or dialysis facility. Infections acquired in those settings can manifest between 48 hours and a year after exposure. They’re more likely if a patient is overprescribed penicillin-related antibiotics (making them more resistant to the drugs); is in a room or setting next to somebody with a MRSA infection; or is on dialysis. Although hospitals take painstaking measures to ensure a sterile environment free from harmful bacteria, MRSA forms a biofilm that attaches to inert objects, such as catheters and breathing tubes. From there, it can more easily invade the body. It can also attach to the hands of health care workers and many surfaces. The second way to acquire MRSA is within the community. Outbreaks have been noted among sports teams, in child-care centers, among military personnel and in prison populations. Even animals can carry the bacterium and pass it on to a human host. Such cases are predominately skin infections, including cellulitis, folliculitis and abscesses. The bacterium can also be passed among household members. In humans, MRSA colonizes within the nose, within the throat and upon the skin. That doesn’t mean it causes infections, but rather that it’s lurking there, ready to cause an infection should a person’s immunity be compromised. From there, it can also spread to others, who may be more susceptible. MRSA not only causes skin infections, but can lead to pneumonia, infections of the bone and within joints, infections of the heart valves, and urinary tract infections. The spread of MRSA can be controlled in hospitals and outpatient clinics if health care workers wash their hands after seeing patients, and if they use gloves and masks when seeing patients with MRSA. In households with a MRSA-infected family member, residents should be extremely diligent about hand-washing. Also, I’ll say it again: Limiting the use of antibiotics will decrease the chance of bacterial resistance to them — and decrease the chance of MRSA. ASK THE DOCTORS is written by Robert Ashley, M.D., Eve Glazier, M.D., and Elizabeth Ko, M.D. Send questions to askthedoctors@ mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.