Effects of MRSA on Elderly Patients in Hospitals
Bacteria Develop Resistance to Traditional Antibiotics
Jun 14, 2009
The bacteria, called methicillin-resistant Staphylococcus aureus (MRSA), have adapted to "killer" drugs such as penicillin, amoxicillin, and methicillin which were the standard (and only) treatments for nearly a century. A population of patients most vulnerable to acquiring MRSA infections is the elderly, whose immune systems are often weakened by illness, and who compose one of the largest and most frequent users of healthcare facilities such as hospitals and long-term skilled nursing and residential homes.
"Today, 63 percent of bacteria don’t respond to traditional antibiotics, and MRSA in the elderly is becoming a growing problem, especially among seniors who are treated in healthcare facilities." (Nursing-homes.aplaceformom.com "MRSA in the elderly") This is a concern for healthcare providers in the institutional settings where many elderly are present in significant numbers, and in at-home care as well.
How MRSA Develops in the Patient
MRSA is most often seen as a skin infection, since the skin harbors many common bacteria. They cause infection whenever they enter the skin through a cut or sore, oxygen tubing, or catheter. If the infection is not discovered or is neglected, potential problems range from mild rashes to serious bloodstream infections and pneumonia.
Recognizing the symptoms of a staph infection will include noting a low-grade fever, drainage of pus or other fluid from a wound that is not healing, or warmth and redness around the area; more advanced signs will range from "rash, shortness of breath, higher fever, chills, chest pain, fatigue, muscle aches, general malaise, and headache." (ibid, "Mrsa in the elderly") Unfortunately, these symptoms are also found with other underlying diseases and conditions, which makes the diagnosis of MRSA a more complicated process.
Healthcare providers will look for information regarding the patient's most recent hospital visits, whether the home or residential facility has reported other MRSA-infected patients, and whether there are, in fact, untreated wounds or sores, before making a firm diagnosis of MRSA.
Patients Acquire MRSA During Hospital Stays, Studies Find
Around 90% of admitted patients with MRSA appear to have acquired the bacteria from recent hospital stays. The infection may reside unnoticed for several weeks or months before appearing, presumably because of the patient's already-weakened or compromised immune system. Studies have been conducted to determine whether some patients are bringing the bacteria into the hospital from the community without having previous hospitalizations.
Treatment of MRSA-Infected Patients
While early recognition of such wounds may require only treatment in a doctor's office of the infection, serious cases will be treated in the hospital with more recent generations of antibiotics, including vancomycin (Vancocin®, Vancoled®), trimethoprim-sulfamethoxazole (Bactrim®, Bactrim® DC, Septra®, Septra® DS), and linezolid (Zyvox®). Treatment may also be given in skilled nursing facilities such as nursing homes and assisted living centers, where residents can be isolated from the general population and given close attention.
Maintaining a Healthy Environment for Elderly At-Risk Patients
Prevention of the kinds of staph infections that may lead to MRSA in the elderly include creating an environment of good hygiene. Steps to ensure this are:
- washing of hands both before and after contact with the patient,
- immediate changing of soiled bed linens,
- not sharing towels or razors among patients,
- using alcohol-based hand cleaners on a frequent basis when entering and leaving the patient's quarters.
- Any wounds should be kept covered with clean bandages that are changed often, and soiled bandages should be disposed of in a safe manner.
More serious infections in the patient will require isolation from other residents and patients, to prevent contamination and the potential of spreading the infection to a greater number of people.
