ACTERIAL PATHOGENESIS , Recent headlines have highlighted the spread of tients w

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ACTERIAL PATHOGENESIS , Recent headlines have highlighted the spread of tients who were previously healthy. MRSA is resistant MRSA infection in the United States. According to the to several commonly prescribed antibiotics that are DC MRSA is responsible for over 90,000 serious in- usually effective against gram-positive bacteria (meth ons and over 18,000 hospital stay-related deaths icillin, penicillin, and cephalosporins), and an infec vear in the United States. These MRSA strains are ponsible for many serious skin and soft tissue in- tion with a MRSA strain can be deadly if left un- subcategorized as community usually treated. MRSA is ctions, as well as pneumonia. One major problem acquired (CA-MRSA) or hospital acquired HA with spread to other organs of MRSA is that occasionally the skin infection can MRSA), depending on how the infection is the body with more severe, acquired. Most CA-MRSA strains are still sensitive t life-threatening symptoms, including necrotizing fas- many antibiotics, such as trimethoprim, tetracycline, citis (hence the name "flesh-eating" bacteria) and nec- and clindamycin, but HA-MRSA strains are often re- rotizing pneumonia (tissue destruction), followed by sistant to these drugs while still sensitive to vanco- sepsis and toxic shock, and then death in up to 50% of cases. A striking finding about these infections is that they occur even in young immunocompetent pa mycin and linezolid. (continued)

Explanation / Answer

A)MRSA is a gram positive bacteria that are venetically distinct from other strain of staphylicoccus aureus. This strain develop from horizontol gene transfer and natural selection. It has resistance to beta lactum antibiotics. Antimicrobial resistance is genetically based resistance mediated by aquisition of extrachromosomal genetic element containing resistance genes. Example plasmid, transposable genwtic element etc. Presence of resistance gene, mec A which stop beta - lactam antibioticsfrom inactivating the enzyme critical for cell wall synthesis.

To overcome this particular resistance 1) we have to isolate those with MRSA from those without infection to prevent transmission. Restricting antibiotic use, handwash are the basic strategies used to overcome this resistance.

B) healthcare associated MRSA have different mechanism on different antibiotic trimetoprin resistance deveop due to mutation in gene dhfr which prevent binding of trimetoprin to particular biosynthetic pathway, clindomycin resistance develop by mutation in ermA, ermB and erm C gene which cause methylation of ribosome and decrese its binding to 50S ribosome. Tetracyclin resistance develop by active efflux and ribosome protection by competitive binding to 30S subunit by a ribosome protection protein encoaded by tetM gene. To prevent this HR- MRSA infection

1) conduct a MRSA risk assessment focusing on apportunity for transmission and the ability of the facility to contain MRSA.

2) implementing a MRSA monitering a program and track rate focusing in identifying patient with a history of MRSA and way to track cases aquired in the hospital.

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