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Nosocomial Methicillin[1] - Robert Kim HED 430.02...

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Robert Kim HED 430.02 February 24, 2010 Nosocomial Methicillin-resistant Staphylococcus aureus Introduction & History Microbial bacterial infections were once thought to be conquered with the advent of antibiotics in the 1930’s. Just three decades later antibiotic resistant microbial infections were soon discovered. The first symptoms of methicillin-resistant Staphylococcus aureus (MRSA) was documented in 1961 (Davis, Stewart, Crouch et al., 2004). By 1968, the disease had its first documented outbreak. This virulent and potentially more dangerous form of Staphylococcal aureus (S-aureus) infection is a serious concern in public health, and is a condition associated with institutions (Davis et al., 2004; Klevens et al., 2007; Tacconelli, 2009; Skyman, Sjostrom, & Hellstrom, 2010; Wise, 2007; Solberg, 2000; Huang, Cheung, Kaatz, & Ryback, 2010). In the past 40 years MRSA is now a major problem throughout hospitals and health institutions worldwide (Solberg, 2000). MRSA infections now account for 20 to 40% of nosocomial S. aureus infections in endemic hospitals, internationally. The quality of care delivered at hospitals is now being associated with the number of MRSA infections developed during hospitalization (Tacconelli, 2010). The pervasive and potentially mortal nature of the spread of MRSA has the medical field up-in-arms to fight the spread of this infectious. Spread of Hospital Associated MRSA The spread of MRSA occurs primarily from septic lesions and carriage sites of patients (Solberg, 2000). The principal site of carriage in humans is the perineum and the anterior nares. Other sites such as the throat and axillae are far less susceptible to carrying the bacteria. Research suggests that approximately 80% of those tested from the anterior nares carry S. aureus. Nearly 20% are constant carriers of at least 1 strain, 60% are recurrent carriers, and the remaining 20% may never carry the bacteria, but is still susceptible, nevertheless. Children tend
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to be constant carriers more than adults. Groups recognized to be more likely to be an intermittent carrier include, insulin-dependent diabetics, HIV/AIDS patients, and intravenous drug abusers. Others at greater risk, independent of nares carrier status, are those exposed to recent antibiotic treatment, dialysis, those that underwent recent surgery, and residence in a long- term care facility (Huang et al., 2010).
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