MARCH, 2019 | Th e HEALTH
ISSUE: SUPERBUG
Dr Christopher
explaining on
the diff erence
between
CA-MRSA and
HA-MRSA.
Places where MRSA
could be found
• On our bodies, mainly nose, back of
the throat, armpits, skin folds, the groin,
and in wounds
• Uncleaned towels, bed sheets, pillow
cases and linens
• Uncleaned furniture and walls
• Razors and shavers
• Athletic equipment (usually in gyms)
• Dust formations
Prevent MRSA infection
• Practice proper hand washing
technique
• Avoid as much contact with people
who are unwell
• If you are unwell and have an
infection, avoid contact with others as
much as possible
• Use anti-bacterial detergents and
cleaning agents to clean clothes, fl oors
and walls
• If your condition persist or worsen
after a round of antibiotics from the
doctor, go to the hospital as soon as
possible
The superbug
of staphylococcus
infections
BY REENASSRI SEKARAN
S
HEILA made an appointment for a foot massage at a nearby mas-
sage parlour. Returning home, her legs felt itchy but she brushed
it off . Th e next day, her legs were covered in seemingly innocent
looking mosquito bites. Within a few days, the bump had swelled and
pus was oozing out. It was getting harder to walk. Sheila’s regular clinic
instantly advised her to take the situation to the hospital. Th e doctor
took a sample and results came back: Staphylococcus aureus – Methicillin
Resistant (MRSA).
We speak to Datuk Dr Christopher Lee, Head of Infectious Diseases
for Hospital Sungai Buloh and the national Advisor for Infectious Dis-
eases for the Ministry of Health (MOH) on this superbug.
How the superbug evolved
“Staphylococcus aureus is a common bacteria in which we can fi nd in
many places. It’s a common infection that we see in hospitals. Normally
it starts with a skin and soft tissue injury. It’s usually quite a simple
infection to treat, the penicillin group of antibiotics does the trick.
Unfortunately over the last 20 years, staphylococcus aureus has begun
to build up resistance towards penicillin so now we have this thing called
Methicillin resistant Staphylococcus aureus. We have to use a diff erent
type of antibiotics to treat it.”
Community-acquired MRSA versus
hospital-acquired MRSA
“MRSA fi rst made its appearance in hospitals, it was a hospital-acquired
infection. It would be seen after an operation when the skin is cut and
the infection is present or when an IV line is set – the infection makes
its way through the IV lines. Hospital associated MRSA can dangerous,
it’s a potential threat because it can get into the bloodstream. However
if treated early, it can be cured,” explains Dr Christopher.
“However in the last 20 years, we have begun to see a diff erent type
of MRSA, this MRSA tends to occur within the community. People
who have never been admitted in a hospital before, never been under
the knife before – was found with staphylococcus aureus involving a
skin infection or sometimes even in the bloodstream. Th is one is called
CA-MRSA or Community-Acquired Methicillin resistant Staphylococ-
cus aureus. Th ere are some genetic diff erences between CA-MRSA and
HA-MRSA.”
trouble breathing, fever, or any infection to the ears,”
he adds.
Dr Tan also recommends that whenever you have not
feel better after a round of antibiotics prescribed by a
physician at the clinic, you should go to the hospital for
further diagnosis.
“Common antibiotics taken orally has proven to be
ineff ective for MRSA infection. For now, the most eff ec-
tive treatment is vancomycin inserted intravenously,
which are available in all hospitals across the country.”
Staying safe
Th e apparent rise of MRSA in a community setting
in Malaysia is defi nitely a cause for concern. It is found
that the bacteria can actually survive being on any
surfaces for up to six months, and any physical contact
with an infected individual or surfaces can put us at
high risk.
However, we as a member of the public should not
push the panic button so soon.
“As with any other type of bacterial infection, regular
cleaning and sanitizing of hands, towels, bed sheets,
linens, and tabletops can go a long way,” explains
Dr Tan. “Common detergents, antiseptics, and anti-
bacteria cleaning agent can help kill MRSA when it lives
on an object’s surface.”
And in terms of treatment, all hospitals are equipped
with stronger antibiotics to combat MRSA.
In the end, all we can do is to be more careful and
proactive in keeping safe. Dr Neoh advises, “If you feel
like it is safer to bring your own towel to the massage
parlour for instance, than go for it. And always remem-
ber to practice proper hand washing and limit physical
contact with your nose and mouth, as bacteria usually
exist in and around that area of our bodies.” — Th e
Health
How is CA-MRSA spread?
TREATMENT
AVAILABLE: Dr Tan
tells that although MRSA
is resistant to common
antibiotics, eff ective
treatment with stronger
ones is available
nationwide.
“CA-MRSA normally occurs in people who are active in sports. Th is dis-
ease was fi rst documented in gyms, sports complexes, training grounds
and massage parlours – places where physical contact are the norm.
Also because CA-MRSA is a skin pathogen, it spreads by contact. For
example, the risk of getting infected is possible when practicing habits
like sharing towels. Sometimes it can even cause an infection in the blood
depending on how one is exposed to the pathogen. Th e diff erence is that
some of the antibiotics that can’t be used on hospital-acquired MRSA can
be used for community-acquired MRSA. Th at’s the only major clinical
diff erence. CA-MRSA in Malaysia is not very common but there have
been a slight increase in cases over the many years. If the community’s
MRSA infection rate is low, you’ll only see it happening here and there.
But if the overall MRSA within the community level is high, then the
transmission rate is higher,” states Dr Christopher.
Dr Christopher also shares some tips on how to take extra caution
in preventing CA-MRSA. “Th e important thing to keep in mind is not
to reuse towels in gyms or sports complexes because that is how the
pathogen is transmitted. Ideally it would be good to wipe down the
equipment at the gym before using it. A simple disinfectant will do
the trick – it won’t kill all the bacteria but a good dosage actually will.
Take extra note when it comes to hygiene – ensure the masseuse at the
massage parlour properly clean their hands fi rst.
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