MRSA - What Causes MRSA in Nursing Homes?
MRSA represents a significant danger to nursing home residents, but many people outside the medical field haven’t heard of it. MRSA stands for methicillin-resistant Staphylococcus aureus. The disease is an antibiotic-resistant staph infection.
According to the Centers for Disease Control & Prevention (CDC), healthcare facilities like nursing homes are particularly vulnerable to the disease because nursing home residents frequently receive inpatient medical care or surgery and have weakened immune systems due to age.
Further CDC data indicates that around 120,000 MRSA infections occur each year and that approximately 20,000 deaths result from those infections. Many of those infections occur in health care settings like nursing homes.
What is MRSA?
Methicillin-resistant Staphylococcus aureus (MRSA) infections occur when a nursing home resident comes into contact with the bacteria. The disease typically spreads by touch between human beings or when someone comes into contact with an item contaminated with the bacteria.
Sharing a razor, for example, may result in spreading the infection. MRSA skin infections don’t usually cause significant harm, but the illness may cause serious complications when it’s allowed to enter the body. At that point, the infection becomes known as invasive MRSA, and health care personnel have a tough time treating it.
Does MRSA affect nursing homes?
MRSA frequently spreads in health care facilities such as nursing homes, and it’s a worsening problem because of the increase of nursing home residents in the past several years. MRSA preys on individuals with weakened immune systems, and nursing home residents are elderly people, many of whom have weak immune systems.
Further, nursing homes are particularly vulnerable because of the frequent use of antibiotics in health care settings. People who are already fighting infections and taking antibiotics may be resistant to the antibiotics used to treat the infection.
Causes of MRSA in Nursing Homes
Many nursing home residents have health conditions such as heart disease, arthritis, diabetes, and high blood pressure. These and other illnesses are risk factors for MRSA in nursing homes.
Additional risks include the following:
- Recent antibiotic treatments
- Medical devices, such as catheters, in the body
- Presence of wounds or bedsores
- Recent surgery or procedures such as dialysis
Diagnosing MRSA in Nursing Homes
To diagnose MRSA, health care professionals will conduct one or more tests, which will help the medical team determine the extent of the infection.
Those diagnostic tools include the following:
- Blood cultures
- Material drained from the point of infection
- Cultures gathered from saliva
- Urine cultures
- Skin biopsy or swab from the affected area
The doctor will look at saliva cultures when there is a suspected pneumonia infection. If the doctor believes a urinary tract infection (UTI) is present, they will take urine cultures. It usually takes about two days to receive the test results.
Early Signs and Symptoms of MRSA
Staph infections are quite common, and the signs of a MRSA infection are similar to a typical staph infection. A nursing home patient may experience red or swollen areas on the skin that are painful to the touch.
Additional symptoms of MRSA include:
- Skin abscesses
- Pus draining from the infected area
- Warmth surrounding the infection site
When not treated quickly, the red areas may turn into significant abscesses that require surgical draining. Early treatment of MRSA infections is the best way to prevent serious injury and death.
Treatment for MRSA in Nursing Homes
Treatment for MRSA in nursing homes depends on the level of the infection. If the disease is still in the skin and hasn’t spread internally, a medical professional can drain an abscess in their office. However, more severe infections require antibiotics, such as vancomycin, or a sulfa drug, such as trimethoprim-sulfamethoxazole.
In severe cases, doctors may need to transport a nursing home resident to a hospital where they will receive additional treatment, including intravenous medication and supplemental oxygen. Some severe cases result in kidney failure, which may require dialysis.
When MRSA in elderly nursing home patients doesn’t respond to initial treatment, they may experience a spreading of their initial rash, a worsening fever, or a lack of progress in fighting the infection despite several days of antibiotic treatments.
What happens in an advanced case of MRSA in a nursing home?
Severe MRSA infections require a trip to the hospital, and the infection may spread to virtually every part of the body, including the bloodstream, lungs, bones, heart, and joints. Nursing home residents will exhibit additional symptoms when the infection spreads.
For example, a MRSA infection that spreads to the lungs will result in a fever, chills, cough, and shortness of breath. When the infection settles in the heart, it can cause endocarditis, a heart valve infection. Abscesses may form in the body in the spleen, spine, or kidneys. MRSA can lead to necrotizing fasciitis in very rare cases, which is a terrifying flesh-eating bacterial infection.
Is MRSA always fatal?
Some nursing home patients die from MRSA, but it’s not always a fatal disease. However, a study conducted at the University of Florida concluded that older adults and elderly people who carry MRSA on their skin are twice as likely to die within ten years as people who don’t have the bacteria.
A study conducted in the United Kingdom between November 2006 and February 2009 by a group of researchers on the effectiveness of cleaning in nursing homes found a “high rate of MRSA colonization in elderly residents of care homes during the study period.”
The study, published in the British Medical Journal, found that methods used for sterilization and cleaning weren’t effective in reducing MRSA colonization.
Preventing MRSA in Nursing Homes
The easiest way to prevent MRSA in nursing homes is to keep an absolutely spotless environment. Good hygiene is essential for patients and staff who work in residential care centers where patients routinely have open wounds or other vulnerabilities to contracting MRSA.
The nursing home should have rules barring the sharing of personal items like razors. The nursing home should also discourage the sharing of towels. Frequent cleaning and the use of antimicrobial hand sanitizers help keep surfaces free of bacteria.
Facilities should create a schedule for cleaning rooms and all equipment. No health care worker should visit a patient until they have cleaned their hands, and they shouldn’t see a second patient until they’ve rewashed their hands.
Further, regularly changing bandages and wound dressings is essential for reducing the spread of MRSA in nursing homes and health care settings. Health care workers should limit how often they touch patients and educate residents on the importance of basic hygiene as a way to prevent the spread of MRSA.
Filing a Nursing Home Abuse Lawsuit
Nursing home abuse and neglect are a real threat to thousands of nursing home residents around the country. MRSA in nursing homes is a growing problem, and the families of MRSA victims may want to explore legal action in the event their loved one contracts the disease and suffers permanent harm or death.
Dr. Patricia Shelton, MD
Dr. Patricia Shelton, MD, is a medical content creator. She holds a Doctor of Medicine degree and a Bachelors degree in neuroscience, both from the University of Washington in Seattle. Her career is now focused around medical communications. She primarily writes content for health-related websites, but has also written test prep materials, white papers, court documents, and more. She also teaches anatomy and physiology at the college level for the National Institutes of Health, as well as at the general public level in yoga teacher training programs. Her book, The Yoga Doctor, was published in 2015.