MRSA - Methicillin Resistant Staphylococcus aureus

Staphylococcae - also called Staphylococcus aureus - belong to the normal colonizers of skin and mucous membranes. Approximately 20 - 60% of the people harbor this germ in relatively large numbers in the nasopharyngeal area. Even higher carrier rates must be assumed for medical personnel. On the other hand, Staphylococcus aureus can also cause life-threatening infections under certain circumstances. As a typical pyogenic pathogen it can be involved in abscesses, furuncles, wound infections and impetigo contagiosa. Osteomyelitis (inflammation of the bone marrow), pneumonia (pneumonia), sepsis (blood poisoning) and endocarditis (inflammation of the heart muscle) can also be caused by this germ.
After penicillin was no longer suitable for the therapy of Staphylococcus aureus infections in the 1950s due to the occurrence of penicillinase-forming strains, penicillinase-resistant penicillins (e.g. oxacillin, methicillin) became available again in the early 1960s. But already at the beginning of the 60's methicillin resistant strains were reported from England. In the following time there were numerous similar reports worldwide.
In Germany it must be assumed today that about 5% of the population is populated with such a strain - with a clear accumulation in old people. In nursing homes, even higher carrier rates are therefore to be expected.
The problem with methicillin-resistant Staphylococcus aureus strains is not that they are particularly dangerous compared to sensitive strains, but that very few antibiotics (such as vanomycin or teicoplanin) are available for the treatment of life-threatening infections.
Healthy persons who are only colonised with methicillin-resistant Staphylococcus aureus strains or who are only in contact with the corresponding carriers are therefore not themselves at risk. There is therefore no reason to refuse to admit MRSA carriers to a nursing home from the outset or to refuse the return of a hospitalised nurse from the hospital to the home. However, tracheostoma patients should be given special attention. In these cases, a possible MRSA carrier should be clarified. However, it is of utmost importance to prevent the spread of these resistant germs in the nursing home by consistently implementing hygiene measures in the care of all residents.
Various measures recommended for the hospital sector cannot be applied in the nursing home for the elderly because its residents live permanently in this facility and are not only temporarily accommodated here. Recent studies have shown that the permanent rehabilitation of hospitalised MRSA patients can only be achieved under very specific conditions. In the opinion of the Stuttgart Health Office, routine screening of all nursing home residents is therefore not advisable and should only be carried out in the event of an epidemic.
However, it is indispensable to prevent the spread of these potential pathogens in the nursing home through appropriate hygiene measures. Also the mutual information about corresponding patients contributes to defuse the problem.

Source: Health Office

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