Accepting his Nobel Prize in 1945, Alexander Fleming, said,

“The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily under-dose himself and by exposing his microbes to non-lethal quantities of the drug, make them resistant”. 

A warning that we failed to take heed of; finding ourselves now exposed to a race of ‘superbugs’.

A small injury that went bad

It all started with a simple toe injury, followed by a second injury to the ankle.  But then, for a professional footballer, such injuries were a part of life; New York Giants footballer Daniel Fells was not unduly worried; having taken a cortisone shot, to treat the injuries.  However, when the pain did not subside even after a week, his wife took him to the hospital.  The medical staff at the emergency room found that Fells temperature was 104 degrees, but even more alarming, his ankle was infected with MRSA.  After undergoing seven surgeries and managing to avoid foot amputation, Fells was finally discharged from the hospital at the end of the month.

What is MRSA?

Referred to as a ‘superbug’, MRSA, (methicillin-resistant staphylococcus aureus) is a bacterial infection.  It has earned its place in the bacterial hall of fame due to its resistance to numerous antibiotics, which include amoxicillin, methicillin, oxacillin and penicillin.  The name MRSA is derived from – ‘methicillin’, the antibiotic that was at one point used successfully against staphylococci (staph) and ‘staphylococcus aureus’, a bacterium that commonly resides inside human nose and skin.

Around 33% of the US population carries staph, i.e., bacteria is present but does not cause infection.
However, about 2% of the population carries MRSA.

The bacterium, that causes staph skin infection, multiplies (or divides) at an alarming rate – roughly double every 30 minutes.

This means that a single cell can form a colony of more than a million cells in about 10 hours.

Staphylococcus aureus can cause skin infections like boils, pimples, impetigo, abscesses and wound infections.  It can also enter the body through broken or damaged skin, invade the bloodstream and cause problems like Septicemia, bone infections, Endocarditis, lung infection, urinary tract infection and Septic bursitis.

Annually, around 94,000 invasive MRSA infections are diagnosed in the US, leading to 19,000 deaths.

What causes MRSA?

MRSA is caused by bacterium strains that are resistant to particular antibiotics.  MRSA infections are classified into two types – health care associated and community associated.  Approximately, 86 percent of invasive MRSA infections are health care associated.  MRSA spreads from person to person (skin to skin contact) or through person to object to person contact.

Health care associated MRSA (or hospital acquired MRSA) frequently effects people with a compromised immune system, who in the course of their treatment, interact with or reside in health care facilities.  People with open wounds, burns, those recovering from surgery, being administered intravenous drip or a catheter, or taking frequent antibiotics are at high risk of contacting health care associated MRSA.

Community associated MRSA is caused mostly due to factors; such as living in places that are crowded like camps, campus housing, military bases etc., skin to skin contact in sports like rugby and soccer, injecting drugs, contaminated surfaces, or lack of personal hygiene.

What are the symptoms of MRSA?

MRSA symptoms differ according to the area of infection.  Infections on the skin may take the form of a bump or a sore.  Generally, the infected area would be inflamed and painful, showing red coloration, hot to the touch and filled with pus.  This would be accompanied by fever.  MRSA infection in the blood or deep tissue results in fever (100.4 degrees or higher), chills, dizziness, malaise, confusion, muscle ache, swelling of the infected part, chest pains, breathlessness, rashes, headaches and wounds that do not heal.

How can MRSA be prevented?

Health care centers have a series of protocols to prevent the spread of MRSA, which include isolating MRSA patients, ensuring cleanliness, wearing of gowns and gloves by medical staff as well as visitors, disposal of the gowns and gloves, and MRSA swabbing.  Community associated MRSA can be reduced by regular hand washing, not sharing toiletries and cosmetics, not sharing towels and other clothes, maintaining personal hygiene, and only taking medication on the advice of a doctor.

The hospitalization of Daniel Fells saw the Giants working with infectious disease specialists, who defined protocols that the team needs to follow.  Scrubbing and sanitizing of the locker room, training rooms and meeting rooms are now done regularly.  The players and the support staff have been briefed on precautions to be taken and methods to prevent the spread of MRSA.

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