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Methicillin-Resistant Staphylococcus Aureus (MRSA) (Nursing)

by Rhonda Lawes

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    00:01 Okay, that is a beautiful picture of methicillin-resistant Staphylococcus aureus, isn't it? I mean, if I didn't know what it was, I'd think that was gorgeous.

    00:10 Well, I guess it can be gorgeous and deadly, all at the same time.

    00:14 But M-R-S-A, you'll hear people call it MRSA because nobody wants to say methicillin-resistant Staphylococcus aureus. So we just say MRSA.

    00:24 It's a gram-positive bacteria. Now, you know, remember, initially, we were walking through antibiotics, talked about how the gram-positive bacterium are easier to treat, but because this is a superbug, it's no longer easier to treat than a gram-negative. This is a bad mama jama, it's a big deal.

    00:44 So it's gram-positive bacterium. You can see that beautiful purple color in the picture, but it colonizes on your skin and in your nose, even in healthy people.

    00:54 So, it's really everywhere.

    00:57 Infections usually involve skin and soft tissue, but they can also be present in your lungs and in your bloodstream.

    01:03 Yay! I'm just full of good news in this video series, aren't I? So, MRSA is everywhere, even in healthy people.

    01:10 It's usually skin, soft tissue, but it can also be present in your lungs and in your bloodstream.

    01:16 Now, it is resistant to all penicillins. I know the name says methicillin, but it's the cillins, and that's a great tip, too.

    01:24 The generic names for penicillins all end in cillin.

    01:28 Amoxicillin -- you see all those names have cillin.

    01:31 But MRSA is resistant to all penicillins.

    01:35 And it's resistant to the first, second, third, and fourth generations of cephalosporins, but props to that fifth generation of cephalosporins, because now that's the first of the cephalosporin generations that can knock out MRSA.

    01:50 So, as you're wrapping up this thought here, it's gram-positive. It's the exception to the rule that gram-positives are easier to treat because it's a superbug.

    02:00 Used to be easy to treat, but now it's resistant and it's not easier to treat.

    02:05 Usually, you're going to see MRSA in skin and soft tissue, but it can also be in your lungs and bloodstream. Really bad deal.

    02:12 It's resistant to all the penicillins and all the cephalosporins, except fifth generation.

    02:19 Okay, the majority of the MRSA that we're going to talk about is Health Care associated.

    02:26 So you'll see that like (HCA) MRSA.

    02:28 It's transmitted by person to person contact.

    02:31 So when we say health care associated, it's probably picked up somewhere in like a hospital setting.

    02:37 There's also community acquired. We'll talk about that in just a minute, but this is the more serious version of MRSA.

    02:44 Now, the risk factors are like anything else, our older clients -- usually, some -- even our younger clients can be at risk if they've been exposed.

    02:52 Patients who are on dialysis, people who are in critical care, hospital admissions have been there for a long, long time and people in long-term care facilities.

    03:02 Now, instead of just looking at that as a list of things to remember, I want you to ask yourself, why? Why would an older person be at a higher risk to get MRSA? Well, we know that the older population, that their organ systems are usually somewhat challenged, right, including their immune system.

    03:22 Your immune system doesn't work as well as it did when you were younger.

    03:26 So, with an immune system that's kind of struggling or having a harder time, you're going to be more vulnerable to something like MRSA.

    03:35 Why dialysis? Hey, that is a really significant -- that's a significant procedure.

    03:41 It really overtakes their life.

    03:43 There are lots of different medications, so they have very complex other disease processes going on, and that makes it more vulnerable for them to pick up a bug, like MRSA.

    03:54 Now, if they're in critical care, wow, we're talking like an intensive care unit, we've got them -- no one sits in critical care, like in a chair with nothing going on.

    04:04 If you're in an intensive care unit, you've got IVs and catheters and chest tubes, and you've got all different spots where your body has been penetrated.

    04:12 So your host defenses have been penetrated.

    04:15 Because you're in critical care, it has to be some type of serious illness as to why you're there.

    04:20 So you've got lots of other complex comorbidities, we call them.

    04:25 Rarely are you in critical care with just 1 diagnosis.

    04:28 You have multiple diagnoses, and the more diagnoses and the more diagnoses that you have, the more vulnerable you are to pick up a bug like this.

    04:35 Well, sadly, just being in the hospital also puts you at risk.

    04:39 You're around more bugs, there's a reason you're in the hospital, so you're not at your full strength self, so that's another reason it puts you at risk.

    04:47 Now, if you've ever been to a long-term care facility, those patients -- that means when you check in, we know you're going to be there for a very long time.

    04:58 They've had some type of debilitating event or disease process.

    05:02 That means they can't go back to their homes, and they need some place to be where they can recuperate.

    05:07 We can try to get them to a place where they can go to a lower level of care, or hopefully, back to their home.

    05:14 e give lots of drugs in those sittings just like we would in the hospital, because a lot of times, long-term care facilities have IV access, etc.

    05:22 So, those patients have multiple complex diagnoses.

    05:26 They're very ill, they're somewhat immunocompromised, and that's why they're at an increased risk for picking up these bugs.

    05:34 So, I want to talk about a study tip.

    05:36 What we just did together, that's what you want to do. Instead of trying to memorize lists, like, risk factors, 1, 2, 3, 4, 5.

    05:44 You don't want to do that.

    05:45 You will overwhelm your brains, and you won't really have those things stick.

    05:49 If you just act like a 2-year old, "Why? Why? Why? Why?" that's what you want to ask yourself.

    05:56 "Hey, I see they listed this risk factor there.

    05:58 Why is that a risk factor?" "Hey, I see they listed this.

    06:02 Why? What is the connection?" Now what you're doing is teaching your brain to make those new neuronal connections.

    06:09 And when you first learn information, did you realize that your synapses have these new pathways? I mean, it is awesome.

    06:16 But that relationship is just kind of like on a first dating relationship, it's fairly weak. You have to keep reminding yourself and thinking about those concepts, and then that bond will be very, very strong, and you'll own that information.

    06:29 Like when a test question comes up, or more importantly, when you're preparing to care for our patients.

    06:36 Now, there's some Community Associated MRSA, and you'll see that as (CA) MRSA.

    06:43 What we've just talked about is healthcare MRSA, which tends to be more significant, but there is community associated MRSA.

    06:51 I don't know about you, but I don't want either one, but if I got to pick, community associated, it usually not as severe.


    About the Lecture

    The lecture Methicillin-Resistant Staphylococcus Aureus (MRSA) (Nursing) by Rhonda Lawes is from the course Anti-Infective Drugs in Nursing.


    Included Quiz Questions

    1. Methicillin-resistant Staphylococcus aureus
    2. Viridans streptococci
    3. Clostridium difficile
    4. Neisseria gonorrhoeae
    1. A 79-year-old client
    2. A client on peritoneal dialysis
    3. A client with a urinary catheter
    4. A client residing in a long-term care facility
    5. A client with germaphobia
    1. They have an increased probability of past antibiotic use.
    2. They have a weakened immune system.
    3. Long-term care stays are more common in this population.
    4. Their immobility is significantly decreased.
    5. Their skin lacks moisture.

    Author of lecture Methicillin-Resistant Staphylococcus Aureus (MRSA) (Nursing)

     Rhonda Lawes

    Rhonda Lawes


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