Therapy
Apart from treatment with the special antibiotics mentioned above, such as clindamycin, further measures must be taken in a patient with MRSA. Not only when the germ has become symptomatic, but also when an asymptomatic colonization is proven, the sanitation of patients (and personnel!) should be carried out.
This means that, depending on the location of the contamination, a special antiseptic soap (Skinsan Scrub) or a nasal ointment (Mupirocin) must be used daily to get rid of the germ. The success of this treatment can be determined by means of a smear taken by the doctor from a previously colonized area at the earliest 3 days after the beginning of the treatment. Furthermore, any work surfaces or equipment with which the MRSA patient has come into contact must be disinfected at regular intervals.
In addition, the patient is isolated. This means that the patient is usually given a single room in the hospital. This room may only be entered by people who wear a mouth guard and a protective gown.
Before and after leaving the room it is absolutely necessary to carry out a hygienic hand disinfection correctly. Disposable items from the patients must be removed in a special waste bin. There are also special guidelines for operations on MRSA patients which must be observed. While an extra operating room is not required, surgery should be performed at the end of the day if possible and special disinfectants must be used. Through all these rules of conduct one tries to keep the spread of the multi-resistant germ as low as possible.
MRSA Test
To perform a test for MRSA, the appropriate samples must first be taken. For this purpose, a swab of the affected skin areas is taken with a cotton swab. In many clinics this is already done routinely at the time of admission to hospital.
In most cases, the sample is taken from a few representative body regions, especially the nose and throat area and the groin area.If MRSA colonization of bladder or venous catheters is suspected, a sample is taken directly from them, or parts of the removed catheter are simply sent in directly. For the actual detection of MRSA there are then various methods. The classical method is the cultivation of the samples in the lab.
However, due to the incubation time until the bacteria colonies grow, this takes a few days. In microbiological laboratories, bacteria are cultivated on a blood-containing agar medium. Initially, only an infection with Staphylococcus Aureus can be detected, which is characterized by a certain colony shape and growth behavior.
However, whether it is then an MR Staphylococcus Aureus, i.e. a Staphylococcus Aureus strain that is methicillin-resistant (or colloquially multi-resistant), must then be determined by further tests. The resistance of the cultivated pathogens is then determined with the help of antibiotic platelets and the so-called agar diffusion test, or by making dilution series. Alternatively, one can also use nutrient media that already contain an appropriate antibiotic, so that only resistant Staphylococcus strains grow on them.
The disadvantage of this method is clearly that the cultivation takes several days, but it is comparatively cheap and easy to perform. Alternatively, there are newer developments that detect MRSA directly, by means of so-called PCR. In this polymerase chain reaction (PCR), DNA fragments of the bacterium are amplified and then detected.
This allows direct detection of the bacterial DNA of the MRSA pathogen without the need to cultivate colonies. This method is much faster and provides a result after only 2-3 hours. It is therefore mainly used to quickly rule out colonization. This is especially helpful when people have had contact with MRSA infected persons, in order to quickly rule out an infection.
