Introduction
Methicillin-resistant Staphylococcus aureus (MRSA) is caused by the Staphylococcus aureus (staph) bacteria found on people’s skin. According to the CDC (2019), despite the bacteria being harmless, it is difficult to treat due to some antibiotics’ resistance. Based on Siddiqui and Koirala (2022), MRSA refers to an oxacillin minimum inhibitory concentration (MIC) equal to or more fantastic than four micrograms/mL, based on antibiotic susceptibilities. Infection is one of the leading hospital-acquired causes commonly linked to the critical length of stay, sepsis, burden cost, mortality, and morbidity cases (Siddiqui & Koirala, 2022).
MRSA can be divided into; community-associated (CA-MRSA), hospital-associated (HA-MRSA), or livestock-associated MRSA (Lakhundi & Zhang, 2018). The difference between the two is relative to their molecular biology and clinical features and the treatment and antibiotic susceptibility (NHS, 2020). In this case study, the report highlights the risk factors for Carol’s MRSA diagnosis and provides infection control measures against her condition.
The significant risk factors commonly associated with MRSA infection constitute intensive care admission, recent antibiotic use, prolonged hospitalisation, HIV infection, invasive procedures, and MRSA colonisation. The other risk factors include open wounds, admission to nursing homes, discharge with a long-term indwelling urinary catheter or central venous access, and haemodialysis (Stacey et al., 2019, p. 908).
In the case of Carol, who has been diagnosed with MRSA, the significant risk factor for MRSA colonisation is her diabetes. According to Stacey et al. (2019, p. 908), diabetic patients encounter increased MRSA colonisation due to multiple risk factors. Further, diabetic patients are prone to more invasive and frequent infections with staph due to elevated tissue/blood glucose, a hallmark feature among patients with advanced diabetes (Stacey et al., 2019, p. 908). Further, Carol is 59 years old, and as she advances with age and diabetes, she is at significant risk of being hospitalised. Based on her medical report, she had been admitted to the hospital for one week with a severely infected leg ulcer.
Infection Control Measures for MRSA
The empirical antibiotic MRSA infection control measure relies on the patient’s disease type, drug availability, local staph, patient’s profile, and side effect profile. Nurses can use several nursing interventions for patients with MRSA. In the case of Carol, the nurse will consider the following options to control MRSA infection. First, depending on the type and cause of MRSA, the most common being skin and subcutaneous tissue infections (SSTI), the nurse will use oral antibiotics (Siddiqui and Koirala, 2022). SSTI is a CA-MRSA-related infection that is a predominant organism linked to a diabetic foot ulcer, necrotising fasciitis, and cellulitis (Lakhundi and Zhang, 2018). SSTI is also increasingly linked to more invasive diseases compared to those resulting from non-MRSA. Such multidrug-resistant infections lead to increased hospitalisation, frequent recurrence, and mortality.
For most SSTI-related MRSA infections, cases are uncomplicated, and the nurse will use oral antibiotics, as mentioned, to control the infection. The therapy’s duration should last between one and two weeks, depending on the infection extent and management response. Second, if the MRSA infection is bacteremia-related, source control becomes the most effective management option alongside empiric MRSA coverage. Controlling the infection will require the nurse to consider this option only until susceptibility outcomes are available.
Managing MRSA can be approached from a medical, pharmacological, or nursing perspectives. The illustrated approaches have been the former two where clinicians consider differential SSTIs and bacteremia diagnosis compatible with S. aureus infections, which are purulent (Belleza, 2021). Alternative techniques applied in medical and pharmacological management methods of MRSA are incision and drainage or the use of oral regimens that can be used only in combination with other agents (Belleza, 2021).
Samples used for MRSA tests are collected upon running a cotton bud over the patient’s skin. The nurse can use swabs to take samples from several places. Carol was tested by checking her nasal secretion or tissue sample for drug-resistant bacteria, a test that nurses use to screen for MRSA among patients (NHS, 2020). Through MRSA screening culture test, the nurse detected colonisation with MRSA in Carol’s sample and the tool was used in the prevention and infection control.
MRSA early detection is significant in preventing the spread of the infection since it helps to accelerate the isolation process. In Carol’s case, the nurse will ensure contact transmission and isolation precautions since her infection was detected at its starting stages. Further, performing hand hygiene, using PPEs are significant measures to use when controlling the spread of MRSA (Belleza, 2021). Further, maintaining clean environments, decontaminating the patient’s equipment, and monitoring infection signs, by checking vital signs and lab results are critical in helping Carol control MRSA infection.
Conclusion
Through illustrating what MRSA is, the case study has highlighted Carol’s condition by linking it to the risk factors that lead to MRSA among diabetic patients. For diabetic patients, the case points out that MRSA colonisation as the significant risk factor and argues that diabetic patients are prone to more staph infections that are frequent and invasive. Three infection control measures from three perspectives have been established, medical, pharmacological, and nursing intervention approaches to stop the spread of MRSA.
Reference List
Belleza, M. (2021) Methicillin-resistant Staphylococcus aureus (MRSA). Nurseslabs. Web.
Centers for Disease Control and Prevention. (2019) Methicillin-resistant Staphylococcus aureus (MRSA). Centers for Disease Control and Prevention. Web.
Ko J.-H. and Moon S. M. (2018) ‘Evaluation of methicillin-resistance rates among community associated staphylococcus aureus infections in Korean military personnel.’ Journal of Korean Medical Science V33 N39. Web.
Lakhundi, S., and Zhang, K. (2018) ‘Methicillin-resistant staphylococcus aureus: Molecular characterization, evolution, and epidemiology.’ Clinical Microbiology Reviews, 31(4), e00020-18. Web.
NHS. (2020) MRSA. NHS choices. Web.
Siddiqui, A. H., and Koirala, J. (2022) Methicillin Resistant Staphylococcus Aureus. In: StatPearls Internet]. Treasure Island (FL): StatPearls Publishing. Web.
Stacey, H. J., Clements, C. S., Welburn, S. C., and Jones, J. D. (2019) ‘The prevalence of methicillin-resistant Staphylococcus aureus among diabetic patients: a meta-analysis.’ Acta Diabetologica, 56(8), pp. 907–921. Web.