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What Is MRSA?
MRSA is Methicillin Resistant Staphylococcus aureus
Objective
To gain a broader understanding of the resistance mechanisms and virulence factors involved with MRSA and how this disease impacts on a physical and global level
Research
History of MRSA The basic Biology of Staphylococcus aureus Molecular Basis For Virulence factors And Resistance Clinical Presentation Of Disease Detection Of pathogen Biotechnology Treatments Public Health Strategies Political And Social Consequences
1941 Penicillin 1943 Streptomycin 1945 Cephalosporins 1950 Tetracycline 1952 Erythromycin 1956 Vancomycin 1960 Methicillin 1962 Lincomycin 1962 Quinolones
1970 Penems
1980 Monobactams 2010 Could this be the end of an antibiotic era???
Gram positive Non-motile Spherical Grows in chains Resembles clumps of grapes img/staph_em.jpg Golden color Hemolytic pattern on blood agar Produces coagulase and catalase enzymes
www.aic.cuhk.edu.hk/ web8/mrsa.htm
Mechanism Of Resistance
http://www.jci.org/cgi/content/full/114/12/1693/F1
http://www.jci.org/cgi/content/full/114/12/1693/F1
http://www.bioteach.ubc.ca/Biodiversity/AttackOfTh eSuperbugs
Staphylococcus aureus
http://textbookofbacteriology.net/sta ph.html
http://textbookofbacteriology.net/staph.html
Cell Wall
Cytoplasmic membrane- Osmotic barrier prevents disequilibrium of ionic content. Preventing cell osmotic
instability and susceptibility to lysis Polysaccharide capsule-slime layer; adhesin. Inhibits phagocytosis
Invasive enzymes
Coagulase Complex-Seals off infection, preventing phagocytic engulfment Protease, lipase, & DNase provide nourishment for MRSA bacterium
FAME-(Fatty acid modifying enzyme) modifies the anti-bacterial lipids side chain-inactivating antibiotic action
Superficial Infections
www.aafp.org/afp/ 20000815/804.html
S. aureus Impetigo
www.web.net/terrafemme/ cashnightmare.htm
Accuracy of medium in discriminating S. aureus and CoNS Sensitivity (%) Specificity (%) 100 98.0 98.0 100 100 95.4 63.5 100
S. chromogenes produced a natural carotenoid (orange or red) pigment and gave a slightly pink color. The isolate was identified by API20 Staph. b All coagulase testing was confirmed by the standard tube method.
http://jcm.asm.org/cgi/content/full/38/6/2378
Linezolid-Protein synthesis inhibitor Daptomycin-Causes membrane depolarization in bacteria-so no membrane transport Vancomycin-Acts by interfering with the construction of cell wall. Still works well with other antibiotics Alternatives: Synercid, Rifampin Third-Line agents: TMP-SMX (Sulfa)
S Aureus
Development of StaphVAX, a polysaccharide conjugate vaccine against S. aureus infections The results of the phase 3 clinical trials of the vaccine (Staph VAX) will be presented 2006 according to the NIH.
Technical help for healthcare professionals National program of surveillance Evidence-based educational campaigns National resource library
Prevention
Draining infections must be kept covered Talk to your physician about wound management techniques Wash hands frequently with soap and water
Summary
Multiple MRSA isolates are circulating in your local hospital and community MRSA has many mechanisms resistance and virulence factors MecA gene is the gene responsible for methicillin resistance Many of the MRSA isolates are encoded with the Sccmec mobile element in them MRSA must be isolated and treated aggressively to prevent secondary infections and spread
Staph
References
1 Mitchell, David.MRSA.whats New. Inoculum. Volume 8, number 2 (1999) 1-12. 2 textbookofbacteriology.net/resantimicrobial.html 3 healthsciences.columbia.edu/ dept/ps/2007/mid/2006/transcript_02_mid22.pdf 4 http://www.bioteach.ubc.ca/Biodiversity/AttackOfTheSuperbugs 5. Foster, Timothy. The staphylococcus aureus superbug.J. clin Ivestigation Volume number114 (2004) 1693-1696. 6. www.channing.harvard.edu/4a.htm 7. ww.ncbi.nlm.nih.gov. 8. www.aafp.org/afp/ 20000815/804.html 9. Journal of Clinical Microbiology, June 2000, p. 2378-2380, Vol. 38, No. 6 0095-1137/04.00+0 10. www.FDA.com (FDA archives) 11.www.postgradmed.com/issues/2001/10_01/hoel.htm 12. www.cdc.gov/ncidod/hip/aresist/mrsa_CDCactions.htm 13. www.medscape.com 14 http://www.nabi.com/images/factsheets/fsStaphVAX.pdf