Description of MRSA
MRSA is a pathogen that causes problems to public health concern throughout the world, because of its associated mortality, morbidity as well as the elevated costs of healthcare. The pathogen occurs due to acquisition of mecA gene, by methicillin-susceptible Staphylococcus aureus (MSSA). S. aureus usually exists as normal flora in human bodies and in some instances; it leads to diseases such as pneumonia (CK., 2009) . The pathogen causes both hospital-based and community-based infections. The infections caused by the bacterium attacks different parts of the body. Symptoms are dependent on the locality of the infection, but the pathogen mostly infects the skin where it causes sores and boils. It can however cause more serious infections in the blood stream, urinary tract, and in the lungs. The pathogen also infects surgical wounds.
The symptoms of hospital-acquired MRSA are rash, muscle aches, chills, fever, chest pain, fatigue, headaches, shortness of breath and cough. Symptoms associated with community-acquired MRSA are usually due to skin infections that lead to cellulitis, and swelling on the area of infection. The main mode of transmission of MRSA is human hands, in healthcare setting healthcare providers may touch a patient’s wound with unhygienic contaminated hands hence causing the disease (McBryde, 2004) . The most serious MRSA complication because of skin infections is tissue death (necrosis). Other complications associated with MRSA include cellulitis, toxic shock syndrome, thrombophlebitis, joint infections, throat infections, endocarditis, sinusitis, septicemia, brain and spinal cord abscess, osteomyelitis and organ failure. The treatment for MRSA is through intravenous antibiotics, since they provide a higher bloodstream drug concentration when compared to oral antibiotics (CK., 2009) . The most commonly used antibiotics are vancomycin, dalbavancin, tedizolid, linezolid, and oritavancin.
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Demographics of Interest
The prevalence of infections caused by MRSA is double that of diseases caused by MSSA. It is in association with over half of the infections caused by S. aureus in the United States. They lead to increased in-hospital complications, hospital-acquired MRSA significantly contributes to community-acquired infections. The mortality rate for MRSA is 20-50%. The epidemic of MRSA comes in many and different forms. Therefore, the rates of morbidity and mortality depend mainly on the type of infections, the age of the infected person as well as the presence of co-morbidities. Severe MRSA infections are normally associated with the increase in hospitalization as well as hospital charges. The result translates to higher in-hospitals and after hospital mortality rates. The mortality rate becomes higher for the individuals who are 65 years and beyond when in comparison to the youth and middle age (Ho KM, 2009). In the year 2005, the estimated number of invasive MRSA infection in the United States killed about 18500 people.
The invasive MRSA infection cuts across all the age groups meaning that neonates, middle-aged as well as old individuals can be able to contract the infection. However, the rate of prevalence increases as individuals becomes older. The disease is the highest in the individuals who are at the age of 65 years and above. The infection is also common in the black people when in comparison with the white people affecting males more than females (Hiroyuki T, 2001).
Determinants of Health: Host Factors Agent Factors, and Environmental Factors
Both social and individual factors normally influence the development of the disease. The socioeconomic status of an individual, race, gender, and age influences the frequency of MRSA exposure. For instance, different age groups engage in various activities that have different probabilities of disease exposure. The hospitals and health care providing facilities have been the leading breeding places for the infection. These facilities form a perfect reservoir and a ground for transmission of the disease especially by the health care providing officers. MRSA pathogen thrives very well in unsanitary conditions. Places where there are overcrowding, for instance, prisons dormitories can enhance the spread of the infection (Aiello AE, 2006). The farmers who also do pig farming are at the higher risk of contracting the disease of MRSA because sometimes the sanitary condition of their working place is terrible and can support pathogens to thrive.
In some cases, not all the individuals having the MRSA infection will develop to full-blown. Many of the individuals will act as the carriers contribution to the dissemination of the disease to other people and places. The individuals who usually carry the infection do not have the prior risk for the infection. The colonization of the MRSA infections happens typically in the nose but can affect other parts of the body for instance axillae, digestive tract, and the perineal regions. The prevalence of the infection among different populations is always challenging to configure because of the issues to do with the sanitary practices. A study in the United States estimates that the prevalence of the MRSA infection of patients at the hospitals is at seven percent (Hidron AI, 2005).
Role of the Primary Care FNP to the Management of Infectious Diseases
Nurses play a significant role in the prevention of the MRSA both in the hospital at the community level. The prevalence of the infection demands more awareness and sensitization of all the people who participate in health provision. Nurses have many duties when it comes to health provision. They usually act as the caregivers, advocates managers, and even counselors to mention a few. As health care becomes more complex and the health care physicians become less many people seek health care service from family nurse practitioners (FNP) for the primary care they need. Family Nurse Practitioners can help patients during acute and chronic illness. They are capable of conducting diagnosis and physical examination and can administer treatment from childhood to adulthood.
FNP can play significant roles in managing the MRSA infection. First, the nurses can work outside hospitals meaning that they can handler patients at their premises reducing the chances of the spread to other people who usually visit the hospital. Family nurses can also monitor the health of an individual for an extended period and therefore can be able to predict health issues and prepare accordingly. Handling infectious diseases, for instance, MRSA away from the hospital is important because it minimizes the chances of spread, therefore, enhancing the management. FNP is very efficient in handling such issues by visiting patients in their premises eradicating the possibility of the infection to spread to other people (CK., 2009).
In conclusion, MRSA has been a significant problem for health providers worldwide. It is an infection caused by a bacterium and can affect both the hospitalized and those in the community. The prevention and the control of the disease depend mainly on the approach and standards at which the health workers handle the matter. There is a need to develop well-structured and clear policies on the control of the infection in the hospitals and educational facilities to stop the spread of the epidemic including other bacterial diseases. The nurses who often handle the patients should maintain a high standard of hygiene to minimize the spread of the infection.
References
Aiello AE, L. F. (2006). Methicillin-resistant Staphylococcus aureus among US prisoners and military personnel: Review and recommendations for future studies. Lancet Infect Dis. (6) , 216-221.
CK., N. (2009). Staphylococcus aureus bacteremia: Epidemiology, pathophysiology, and management strategies. Clin Infect Dis. (48) , 231-237.
Hidron AI, K. E. (2005). Risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to an urban hospital: emergence of community-associated MRSA nasal carriage. Clin Infect Dis. (41) , 159-166.
Hiroyuki T, Y. H. (2001). A clinical study on gender difference in the incidence of postoperative infection and the isolation of MRSA after gastrointestinal surgery. Jpn J Chemoth (49) , 645-648.
Ho KM, R. J. (2009). Risk factors and outcomes of methicillin-resistant Staphylococcus aureus bacteraemia in critically ill patients: A case control study. Anaesth Intensive Care (37) , 457-463.
McBryde, E. S. (2004). An investigation of contact transmission of methicillin-resistant Staphylococcus aureus. Journal of Hospital Infection, 58(2 , 104-108.
