Methicillin-Resistant Staphylococcus aureus: Prevention and Intervention

When antibiotics were first discovered, one of their primary targets was the bacteria Staphylococcus aureus. Over the years, misuse of these medications has lead to strains of the bacteria that are resistant to medication, often referred to as “superbugs”. These resistant bacteria are called Methicillin-Resistant Staphylococcus aureus (MRSA). Approximately one fourth of the population has colonies of these bacteria in their nose; however, less than 2% of these people carry MRSA. In fact, until recent years MRSA was primarily considered a hospital acquired infection and was very rarely seen in the community. Unfortunately, this is no longer the case and these community acquired infections have been increasing exponentially each year. As children ranging in age from infants to 18-years old are the most vulnerable population, this has become an issue of great concern in schools.

Fortunately, there are many simple steps that the faculty and students can take in order to prevent contraction and spread of this disease. The Centers for Disease Control sites factors referred to as the 5C’s that make it easier for MRSA to be transmitted: crowding, contact, compromised skin, contaminated items and surfaces, and cleanliness. By targeting these factors within schools, prevention of MRSA is possible. As athletes, especially football players and wrestlers, have a significant amount of skin-to-skin contact and use of public equipment, they are at higher risk. Thus, it is important to implement prevention strategies and ensure that coaches and athletes are aware of them.

Such strategies include cleaning exercise equipment and sports equipment, such as wrestling mats, with detergent-based cleaners or disinfectants that the Environmental Protection Agency has recommended. Furthermore, all other frequently touched surfaces within schools should be cleaned with these products routinely. It is important that the directions on the label of the products be followed. Taking such steps will kill the bacteria that may be living on these surfaces, preventing transmission.

A seemingly obvious method of prevention is to encourage staff and students to practice good hygiene. Hand washing is a simple, but effective, tool at preventing many infectious diseases. It is important to encourage proper hand washing techniques, such as ensuring that they rub their hands vigorously for at least 20 seconds. Also, be sure to scrub the wrists, between the fingers, and under the fingernails. Antibacterial soap is not necessary as studies have shown that it is no more effective at killing germs than regular soap. Athletes should also shower immediately after sporting events.

It is important to note that MRSA is not contracted by simply coming into contact with the bacteria; to cause an infection it must enter the skin. Thus, students must take appropriate precautions when they have cuts or abrasions. It is through these skin breaks that the bacteria can enter, so they must be covered with a clean dry bandage until healed. In particular, athletes should be certain to check for cuts or abrasions often, and to cover them accordingly before participating in sports. Finally, students with active MRSA infections may still attend school as long as their wounds can be sufficiently covered. However, these students should be prevented from participating in contact sports or activities.

Treatment of MRSA often includes drainage of the infection and/or prescription of antibiotics. If prescribed an antibiotic it is essential that all of the doses are taken. MRSA is resistant to many antibiotics, including: oxacillin, penicillin, methicillin, and amoxicillin. The two primary antibiotics used in the treatment of these infections are vancomycin and linezolid. Unfortunately, there are even strains emerging that are resistant to those antibiotics. Therefore, much research is being conducted in search of an alternative to present remedies. One such alternative may be anti-pathogenic drugs. These do not kill the bacteria but block the activation of proteins essential for toxin release by the bacteria. Another promising discovery lies in the brains and nervous systems of cockroaches and locusts. Molecules from these tissues were shown to kill 90% of MRSA bacteria in a study at the University of Nottingham. Though these and other discoveries show potential in fighting antibiotic resistant bacteria, they are not yet available to the public. Therefore, it is important that healthcare professionals prescribed antibiotics wisely and that patients use them as directed.

References
“Definition of MRSA”. Centers for Disease Control and Prevention. August 2010. 8 September 2010. http://www.cdc.gov/mrsa/definition/index.html
“Do Cockroaches Hold the Key to MRSA Treatment?”. Food Consumer. August 2010. 8 September 2010. http://www.foodconsumer.org/newsite/2/other_diseases/do_cockroaches_hold_the_key_to_mrsa_tretretre_090820101153.html
“MRSA in Schools”. U.S. Department of Education. October 2007. 8 September 2010. http://www2.ed.gov/admins/lead/safety/emergencyplan/mrsa.doc
“MRSA Overview for Schools: Methinillin-Resistant Staphylococcus aureus”. Department of Health and Senior Services. 10 September 2010. http://www.dhss.mo.gov/MRSA/MRSASchools.pdf
“Researcher Discovers New “Anti-Pathogenic” Drugs to Treat MRSA”. PhysOrg. September 2010. 16 September 2010. http://www.physorg.com/print/203871637.html
Rowson, Kevin.”Staph Infections Growing Exponentially in Children”. September 2010. 16 September 2010. http://www.11alive.com/cleanprint/?1284680888450
“Treatment of MRSA Infections”. Centers for Disease Control and Prevention. August 2010. 8 September 2010. http://www.cdc.gov/mrsa/treatment/index.html