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.