MRSA • Symptoms & treatment of the infection

Some bacteria are now resistant to certain antibiotics. The most well-known of these pathogens is Staphylococcus aureus (MRSA), which is resistant to methicillin. The multi-resistant germ is mainly found in hospitals – what are the symptoms of an infection and how can they be treated?

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What is MRSA?

Staphylococci naturally colonize the skin and mucous membranes, for example in the throat and nose. However, if the immune system is weakened, they can cause serious infections. Antibiotics usually help, but bacteria do Staphylococcus aureus are capable of developing insensitivity to methicillin and other antibiotics (antibiotic resistance). Then one speaks of MRSA, i.e. methicillin-resistant Staphylococcus aureus – this strain is one of the multi-resistant germs.

MRSA occur worldwide. The germs most commonly colonize patients in hospitals, especially in intensive care units. They are the main cause of so-called nosocomial hospital infections, i.e. wound infections in hospitals. Residents of old people’s and nursing homes are also infected to a small extent with this hospital germ.

Why are antibiotics no longer effective for MRSA?

One of the main reasons for increased bacterial resistance is the uncritical use of antibiotics – not only in humans, but also in livestock farming. Experts are therefore researching new groups of antibiotics and active substances. However, effective replacement antibiotics or a protective vaccine against MRSA are not yet in sight. Possibly only a more precise understanding of the defense mechanisms can enable new therapies against resistant staphlocci and other bacteria.

Symptoms of MRSA infection

Signs of infection are skin inflammation such as ulcers and accumulations of pus. The germ can cause wound infections, urinary tract infections, pneumonia or even life-threatening blood poisoning. MRSA is detected by a swab from the nose, throat or a wound.

Signs of infection:

  • Local, deep or systemic infections: The severity of an infection can be very diverse, from abscesses to meningitis to heart muscle inflammation.

  • Toxic Shock Syndrome (TSS): Life-threatening infection associated with multi-organ failure. Typical symptoms are fever above 39 °C, diffuse patchy skin rash (exanthema) and low blood pressure (hypotension).

  • Food poisoning: Consumption of contaminated food leads to theS. aureus produced enterotoxins cause food poisoning. Sudden nausea, vomiting, cramping abdominal pain and diarrhea occur just a few hours after ingestion of the food. Most poisoning is self-limiting, but in severe cases hypovolaemia (lack of circulating blood) and hypotension can occur.

Treatment of MRSA – Remediation is standard practice

Remediation should eliminate the multi-resistant germ. It cannot be predicted with certainty whether MRSA can no longer be detected after this or whether it will be infected again after some time. The doctor decides who is eligible for rehabilitation.

What happens during a renovation?

  • Cleaning the wound with disinfectant soaps and ointments.

  • If the nasopharynx is affected by MRSA, a germicidal nasal ointment (mupirocin nasal ointment) is also applied for five days.

  • Disinfectant mouthwashes are used to sanitize the mouth and throat.

  • The ear canals are treated with antiseptic preparations.

  • For full-body cleansing of intact skin including hair, patients shower or bathe for at least three days in a row for 15 minutes each. Germ-killing washing lotions or bath additives in the shower and bath should remove MRSA.

To check the success, the doctor will arrange for swabs to be taken on the affected person’s body no earlier than three days after the measures have been completed, in order to check whether MRSA has been completely eliminated.

Further measures in case of infection

As part of the treatment, far-reaching protective measures must be taken:

  • Accommodation: In the case of MRSA, infected people are housed in a single room in the hospital. The insulation is necessary to prevent the germs from spreading further. Ideally, the room has a lock. If several patients carry the same pathogen, they can be accommodated in a shared room.

  • Hygiene: If infected people leave the room, they should wear mouth and nose protection and wash their hands thoroughly.

  • Personnel protection: The staff protect themselves with disposable gowns, disposable gloves and mouth and nose protection. Hands are disinfected when entering and leaving the room.

  • Visitor protection: Visitors also wear a protective gown and mouth and nose protection and disinfect their hands.


Swab to diagnose infection with MRSA

To detect MRSA, a smear is taken with a swab. MRSA can be detected on the skin, in the throat, the mucous membranes of the nasal vestibules, under the armpits, on the hairline, in the groin, in the stool or rectum, in wound infections, in the blood and in the urine. Most commonly, a sample is taken from the nasal vestibule or throat and tested for the bacterium.

Transmission routes of MRSA

The pathogens most often get from person to person via direct physical contact, for example a handshake. But MRSA can also stick to doorknobs, handrails or other objects. If you carry the bacterium on your own body, you can theoretically infect yourself: For example, if MRSA gets from the nose through the hands into a wound and thus into the bloodstream. It is also possible to be infected via an inhabited pet.

Especially in clinics or homes, it is important to prevent the pathogen from spreading as much as possible. Careful hand hygiene and hand disinfection of staff and relatives is therefore extremely important.

Incubation period and duration of contagiousness

If MRSA is ingested orally, the incubation is only two to six hours, while infections with the hospital germ take several days (four to ten). MRSA carriers can also become infected months after colonization.

As long as there are symptoms of an infection with MRSA, there is a risk of infection for other people. In addition, the following applies: As long as the pathogen can be detected, patients are contagious. However, germs can also be transmitted by healthy MRSA carriers who do not show any symptoms.

Who belongs to the MRSA risk group?

MRSA is usually harmless to healthy people. On the other hand, if the immune system is weak, an infection with MRSA can lead to a serious illness. Vulnerable groups and risk factors include:

Preventive measures to protect against infection

There are a number of hygiene measures that can be taken to reduce the risk of transmission and infection with resistant staphylococci:

  • Take antibiotics as prescribed by your doctor.

  • Always cover wounds and injuries with a clean bandage and wash hands thoroughly before and after changing bandages.

  • Always wash your hands thoroughly after going to the toilet, changing diapers or coming into contact with animals.

  • Ventilate regularly, because the number of pathogens increases in closed rooms.

  • Do not use someone else’s towels, washcloths or toothbrushes.

  • Wash raw vegetables and fruits carefully before consumption.

  • After processing raw meat, be sure to clean cutting boards and knives thoroughly so that other foods do not come into contact with any bacteria. The germs die off when meat is heated at 70°C for two minutes.

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Source: Lifeline | Das Gesundheitsportal by www.lifeline.de.

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