The Mechanisms of MRSA to Evolve and Adapt
Jacob A. Mitchell
Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT 84604
Abstract:
The transmission of methicillin resistance to Staphylococcus aureus (MRSA) in hospital and community settings, with increasingly higher occurrences, is a big clinical problem for the management of serious infections worldwide. Studying how MRSA evolves is important to understand how to thwart the continued adaptation of this pathogen. In this review, I analyze two of the current hypothesis for MRSA evolution. The first is that the bacteria are first exposed to the antibiotic, but the prescription is not completed, and often results in nosocomial infections in subsequent
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S. aureus is a formidable pathogen that infects nearly every tissue of the human body. S. aureus infections include mild skin and soft tissue infections, as well as serious diseases like sepsis and toxic shock syndrome, which can result in death. The evolution of S. aureus has been seen since it was identified. Initially, S. aureus was treated by the typical antibiotic, penicillin. When penicillin resistant strains were identified in 1959, methicillin was introduced to treat these infections. In 1961 there were reports from the United Kingdom of S. aureus isolates that had acquired resistance to methicillin (methicillin-resistant S. aureus, MRSA) [1], and MRSA isolates were soon recovered from other European countries, and later from Japan, Australia, and the United States. MRSA is now a problem in hospitals worldwide and is increasingly recovered from nursing homes and the community [2, 3]. The methicillin resistance gene (mecA) encodes a methicillin-resistant penicillin-binding protein that is not present in susceptible strains and is believed to have been acquired from a distantly related species [4]. Many MRSA isolates are resistant to multiple antibiotics and are susceptible only to glycopeptide antibiotics such as vancomycin and investigational …show more content…
The first theory, and the theory backed significantly by scientific data, suggests that when a patient receives antibiotics, they are more likely to acquire MRSA than someone who has not taken the antibiotic. These occurrences increase when the patient does not complete the antibiotic prescription given to them by the doctor. This suggests that when you do not finish the antibiotic course, there is a chance that you will kill most of the bacteria, but not all of them, and the ones that survive are likely to be those that are most resistant to antibiotics [paper 1]. The second theory surfaced in 2014 and presents evidence for an unexpected route to the evolution of antibiotic resistance in staphylococcal communities that occurs without natural selection due to antibiotic treatment. It suggests that the bacteria gains resistance solely via intraclonal competitive interactions between bacterial cells [paper 5]. This review will further analyze these hypotheses and the strengths they each
However, increasing antibiotic resistance patterns among intensive care unit pathogens, cultivated by empiric-broad spectrum antibiotic regimens, characterizes the variable concerns. Recent literature point that antibiotic use before the development of VAP is associated with increased risk for potentially resistant gran-negative infections and Methcillin-resistant Staphylococcus auereus (MRSA)
Germaphobes beware: the next incurable global epidemic is already here and, to make matters worse, you may unknowingly come in daily contact with it. Methicillin-resistant Staphylococcus aureus, commonly known as MRSA, is the villain of Maryn McKenna’s book, a terrifying tale of the negative consequences of modern medicine. It’s the kind of book that keeps you awake at night, itching to read the next chapter- and worried you could become infected. Through vivid case studies and scary scientific evidence about what appears to be an unbeatable pathogen, McKenna’s book, Superbug, is one that will make you afraid to step foot in a hospital ever again.
A common healthcare acquired infection that is seen both inside and outside of the hospital is methicillin-resistant Staphylococcus aureus (MRSA). MRSA can have detrimental effects on the patient and is usually acquired within the hospital setting. The PICOT statement has many important aspects to include such as: population, intervention, comparison, outcome, and time, which is used to produce an evidence-based question. According to Schmidt & Brown (2012), the PICOT statement is used in evidence-based practice is to make decisions about patient care based on evidence with clinical expertise appraisal and current research while also considering patient preferences and values. The PICOT statement: In patients between the ages of 30 and 70 admitted
Antibiotic-resistant bacteria are created when mutations in the pathogen's genetic code occurs, changing the protein in the bacteria that the antibiotics normally go after into a shape that the antibiotic can not recognize. The average bacteria divides every twenty minutes, so if a contaminated spot has one single bacteria in the morning, there could be trillions on that same spot at the end of the day. That means that when counting all the possibilities of mutations, the amount of mutated offspring that the bacteria might have formed during those replications could be as high as in the millions. Fortunately though, this does not happen so frequently that it is normally an issue. The amount of non-mutated bacteria vastly outnumbers the mutated ones and many of the mutations occurring in the bacteria usually have either a harmful effect, or not effect at all on its function. That means that the pathogen is still relatively less harmful than it c...
Staphylococcus aureus is a bacteria that is abundant in many places. It can even be found in some of our bodies. These bacteria are harmless as long as none of them are Methicillin resistant Staphylococcus aureus (MRSA). Methicillin is the name of a family of antibiotics that includes penicillin. This MRSA is the deadly superbug that has developed resistant to antibiotics. Statistics show that MRSA contributes to more US deaths than does HIV. It has become a huge threat to every country as the outbreaks can be a surprising one. This threat is caused by the evolution of the bacteria. These superbugs have evolved a resistance of antibiotics which makes them extremely difficult to treat. One article states, “In the early 1940s, when penicillin was first used to treat bacterial infections, penicillin-resistant strains of S. aureus were unknown — but by the 1950s, they were common in hospitals. Methicillin was introduced in 1961 to treat these resistant strains, and within one year, doctors had encountered methicillin-resistant S. aureus. Today, we have strains of MRSA that simultaneously resist a laundry list of different antibiotics, including vancomycin — often considered our last line of antibacterial defense.” [1]
Life History and Characteristics: Staphylococcus aureus is a gram positive bacterium that is usually found in the nasal passages and on the skin of 15 to 40% of healthy humans, but can also survive in a wide variety of locations in the body. This bacterium is spread from person to person or to fomite by direct contact. Colonies of S. aureus appear in pairs, chains, or clusters. S. aureus is not an organism that is contained to one region of the world and is a universal health concern, specifically in the food handling industries.
The role of nurses in the prevention of MRSA in the hospitals cannot be overemphasized. The prevalence of MRSA in hospitals calls for awareness and sensitization of all party involved in patient caregiving in the hospital. According to Wilkinson and Treas (2011), nurses take on many roles in the hospital: a caregiver, advocate, communicator, leader, manager counsellor, change agent and an educator. (Wilkinson &Treas. (2011) p.13.) The target of healthy people 2020 is to reduce MRSA and all other hospital acquired infection by 75% in the year 2020. (Healthy people 2020) This cannot be achieved without the maximum support of nurses because nurses have regular one on one contact with patients on daily basis.This paper will take a closer look at the role of a nurse as an educator in the prevention of MRSA in the hospital. One of the nurse’s roles in the prevention of MRSA in hospitals is patient/visitor/staff education.
Resistant strains are no joke, for years my mother has been dealing with MRSA (methicillin-resistant staphylococcus aureus). My mother has had MRSA so bad that at one time she was covered in MRSA sores much like when a person breaks out in hives. Watching her suffer the way she has worries me as I am also a healthcare worker and know what these resistant strains are capable of. I know these strains exist because of a lack of proper patient education. Proper patient education is key to the use of antibiotics and prevention of resistance-bacteria strains.
Bacterial resistance to antibiotics has presented many problems in our society, including an increased chance of fatality due to infections that could have otherwise been treated with success. Antibiotics are used to treat bacterial infections, but overexposure to these drugs give the bacteria more opportunities to mutate, forming resistant strains. Through natural selection, those few mutated bacteria are able to survive treatments of antibiotics and then pass on their genes to other bacterial cells through lateral gene transfer (Zhaxybayeva, 2011). Once resistance builds in one patient, it is possible for the strain to be transmitted to others through improper hygiene and failure to isolate patients in hospitals.
Biological evolution is defined as any genetic change in a population that is inherited over several, successive generations. (R.Bailey, 2014) The changes accumulate and over time a new species is created. One of the basic mechanisms of evolution is Natural Selection. Natural Selection is random genetic variation occurring within an organisms DNA and the beneficial mutations being preserved because they aid survival. (C.Darwin, 1859) Two notable scientists associated with the theory of evolution include Charles Darwin and Jean-Baptiste Lamarck.
This turn of events presents us with an alarming problem. Strains of bacteria that are resistant to all prescribed antibiotics are beginning to appear. As a result, diseases such as tuberculosis and penicillin-resistant gonorrhea are reemerging on a worldwide scale (1). Resistance first appears in a population of bacteria through conditions that favor its selection. When an antibiotic attacks a group of bacteria, cells that are highly susceptible to the medicine will die.
There are many medical professionals who believe that the rise of antibiotic resistance is a result of the overuse and misuse of antibiotics. Dr. Jim Wilde, a paediatric emergency medicine physician at the Medical College of Georgia believes that the medical profession is losing the war against resistance...
Infection control is very important in the health care profession. Health care professionals, who do not practice proper infection control, allow themselves to become susceptible to a number of infections. Among the most dreaded of these infections are: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Another infection which has more recently increased in prevalence is methicillin-resistant Staphylococcus aureus (MRSA). These infections are all treated differently. Each infection has its own symptoms, classifications, and incubation periods. These infections are transmitted in very similar fashions, but they do not all target the same population.
What if there were no treatment for strep throat? Or pneumonia? Or sinus infections? It is hard to imagine life without medicine for these illnesses. But what if the antibiotics used to treat bacterial infections such as strep throat and pneumonia stopped working? What if the bacteria were stronger than the antibiotics? The threat of antibiotic-resistant bacterial infections is an increasing concern for healthcare providers, and it is important to reduce the misuse and overuse of antibiotics to maintain control of bacterial diseases.
Currently 700,000 have died from antibiotic resistance, which is a lot higher than the statistics for deaths caused by measles, cholera and tetanus combined. This is showing that already, it has already caused a lot of damage, and it continues to spread.(Walsh, 2014)