MRSA

MRSA is an increasing health threat all over Europe. The goal of all efforts must primarily be to avoid MRSA colonization or infection. Beside consistent hygiene measures as well as control of antibiotic use the introduction of MRSA screening based on faster and more reliable diagnostics is necessary. Effective prevention of outbreaks within a few hours and reduction of unnecessary costs is only possible through rapid identification of MRSA carriers. Thus, the spread of MRSA can be effectively reduced.

Based on the Hain Lifescience GenoType and FluoroType^® technologies, our MRSA test systems enable fast and cost-effective MRSA diagnostics. Depending on the sample material, the time to result required and the result differentiation we offer different solutions.

Besides the growing significance of S. aureus as pathogen of nosocomial infections, its resistance against a number of antibiotics has become increasingly worse. MRSA is not only resistant against all beta-lactam antibiotics, but is also often multi-resistant against several classes of antibiotics. MRSA infections involve the skin or deeper areas of the body in the form of, for example, wound infections, lung inflammation or sepsis. The disease-causing properties of MRSA are not differentiated from those of antibiotic-sensitive staphylococci.

Because of its multi-resistance infections with MRSA however, are generally very difficult to treat. MRSA infections must therefore be treated with special antibiotics which in part can only be administered upon suspicion, have more side effects, and are additionally very expensive. For therapy, antibiotics such as, for example, linezolid, synercid, vancomycin and teicoplanin are available.

MRSA is still a consistent problem in shared facilities such as hospitals, healthcare facilities and nursing homes. Studies indicate that the incidence of MRSA in the past few years has extensively increased worldwide. An increase in antibiotic use (human and animals) and global travel supported these developments. According to the WHO globally some countries show higher MRSA rates: United states, Japan and southern European countries; others were able to control it like the northern European countries (Netherlands and Scandinavia).

After a dramatical increase of MRSA infections in Germany the number of infections has currently slightly decreased. Nevertheless, MRSA as a nosocomial infection is still a severe problem for intensive care units. The prevalence of MRSA varies between hospitals and even between different wards within the same hospital. Along with non-critical antibiotic use, the insufficient implementation of prophylactic hygiene measures and inadequate staff training are the main reasons for MRSA colonization. Insufficient MRSA management thus leads to the continued spread of MRSA in our hospitals. Urgently needed measures are the introduction of standard hygiene and adequate outbreak management, as well as control of antibiotic use. In particular, however, an MRSA screening based on rapid and reliable diagnosis during or even better before inpatient admission is indispensable.

Along with hospital-acquired MRSA (HA-MRSA), which is a particular hazard for elderly and weakened persons, there are also MRSA infections, which are acquired outside the hospital.

These so-called CA-MRSA (community-acquired MRSA) are characterised by the fact that they are also transmitted independently of medical facilities within the population itself (e.g. within the family, at sports, etc.). In this case, it is primarily younger people without prior illnesses who are affected, and who generally contract recurrent skin and soft tissue infections – often without a recognisable point of entry.

One indication of CA-MRSA is the presence of the so-called Panton-Valentin leukocidin, known as PVL for short. This virulence factor is a cytotoxin, which causes lysis of macrophages through pore formation and leads to tissue necrosis. PVL is coded by the lukS-lukF gene. Staphylococcus aureus strains equipped with this gene often cause invasive skin and soft tissue infections, in particular multiple recurrent abscesses, which can initially appear to be skin eruptions related to insect bites. More rarely, necrotising pneumonia develops, which however, often has a very rapid course and high mortality rates.

In recent years livestock-associated MRSA (LA-MRSA) are getting more and more important. These strains are found in various species worldwide. Especially people working in animal husbandry (e.g. pig breeding) are at risk of being colonised with these LA-MRSA strains.