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Methicillin Resistant Staphylococcus Aureus (MRSA) Infection

 

Staphylococcus Aureus is usually a harmless bacterium that often lives on the surface of people's skin and nose. We refer to this circumstance as "colonisation". It can spread from one person to another through contact. Colonisation by a bacterium must be distinguished from infection in which case the bacterium no longer remains an innocent bystander, but has become a pathogen.

Methicillin-resistant Staphylococcus Aureus (MRSA) is a type of Staphylococcus that has acquired resistance to a number of antibiotics, including methicillin. As with regular Staphylococcus Aureus, MRSA can be an innocent coloniser, or it can act as a pathogen. Any type of Staphylococcus Aureus, whether Methicillin-resistant or Methicillin-sensitive, can under certain circumstances, become pathogenic and lead to infections such as abscesses, septic wounds, heart-valve problems and toxic shock syndrome. In extreme cases, this can even result in death.

Healthy people with strong immune systems seldom develop infection even if they are colonised by such bacteria. However, immuno-compromised patients are vulnerable to these bacteria and can develop serious complications. Staphylococcus Aureus usually requires antibiotics to clear the infection. MRSA strains require special antibiotics because of their resistance.

KTPH has implemented strategies to reduce the risk of MRSA infection. These measures include good hand hygiene practices, implementing contact precautions, active patient screening, antibiotic stewardship, and maintenance of a clean environment. All patients are screened for MRSA colonisation on admission by swabbing the nasal, axillary and groin regions. Those who are screened positive receive daily Chlorhexidine baths throughout their hospital stay. This greatly reduces the chance of developing an MRSA infection.

From July 2015 to June 2018, the mean MRSA incidence rate was 0.48 per 10,000 inpatient days. The mean MRSA bacteraemia rate was 0.22 per 10,000 inpatient days which is lower than the 2017 National MRSA bacteraemia rate of 0.38 per 10,000 inpatient days.


References:

1. Jurke, A.(2013). Reduction of the nosocomial meticillin-resistant Staphylococcus Aureus incidence density by a region-wide search and follow-strategy in forty German hospitals of the EUREGIO, 2009 to 2011. Euro Surveillance, 18(36), 1-9.

2. Nichols H., UK (2017). All you need to know about MRSA.

3. Ministry of Health, Singapore, NSHC Self-Assessment Indicators for Public Hospitals and Institutions, 2017