UK Registered Charity 1122246 This website would not be possible without the kind help of Tony Martin of the “AV Martin Charitable Foundation”

When MRSA was first reported in people it was commonly identified in patients who were critically ill and those who frequented health care facilities including nursing homes, or were in contact with a person who had an MRSA infection. This type of MRSA, called health-care associated MRSA (HA-MRSA), is typically associated with resistance to multiple antibiotics in addition to ß-lactams and seriously prejudices successful treatment.

In the mid-1990’s MRSA infections began to be identified in people who did not have contact with health-care systems. The strains causing these infections were termed community acquired MRSA (CA-MRSA). These isolates are often susceptible to non ß-lactam antimicrobials. Numerous reports have suggested the transmission of CA-MRSA is more likely in environments where people are in close contact, such as households, sports facilities, prisons etc. Additionally, CA-MRSA has been demonstrated to persist on environmental surfaces in the homes of colonised or infected individuals and pets (Scott et al. 2008). There is also some concern that CA-MRSA may travel through the air and play a role in nasal colonisation or in respiratory tract infections. The emergence of CA-MRSA strains is deeply concerning due to apparent increased virulence of the bacteria, as apparently healthy humans with no risk factors have been infected.

Large animal associated MRSA (LA-MRSA) is a name used for types of MRSA believed to have arisen in and to be mainly associated with livestock. It was first described in pigs in 2004 with the recognition of sequence type 398 (see below)  but other types are now being recognised.

DIFFERENCES HA-MRSA CA-MRSA LA-MRSA
Genetic traits Various   staphylococcal cassette chromosomes. Panton Valentine gene, staphylococcal cassette chromosome IV. Sequence type 398.
Area affected Surgical sites, areas of implants. Skin lesions/wounds. Colonisation of livestock.
Who is affected? Immunocompromised   patients. Long-term   hospitalised/nursing home patients. Recent   hospitalizations.(ICU)Recent   surgery. Anyone but especially the young, otherwise healthy patients with no recent hospitalization. People in contact with colonised animals (vets, farmers etc.).
How is it transmitted? Skin-to-skin contact with someone/animal who has a staph infection. Contact with surfaces that have staph on them. Compromised   immune systems. Contaminated   equipment. Poor hand   hygiene (healthcare workers not washing their hands or using alcohol-based hands sanitizer between patients). Skin-to-skin   contact with someone/animal who has a staph infection. Contact with surfaces that have staph on them. Skin lesions/wounds. Close contact (prisons, gymnasiums). Poor hygiene. Contact (direct or indirect) with colonised animals and their contaminated environment.
Recommended treatment and management Surgical debridement;   blood stream infections, pneumonia, surgical site infections require hospitalization (usually a number of antibiotics are administered). Patient/owner education Incision and drainage. Patient may be prescribed antibiotics (not always required). Patient/owner education Infections in people are uncommon but require medical attention. Eradication of LA-MRSA is a long-term aim.
Prevention Practicing good hand hygiene by washing your hands often or using alcohol-based sanitizer. Educating staff and owners. Careful use of antimicrobial agents. Patient surveillance and post-op follow-up. Practicing good hand hygiene by washing your hands often or using alcohol-based sanitizer. Covering open wounds, cuts, and abrasions. Care with contaminated dressings. Not sharing personal items. Patient/owner education Avoidance of contact with colonised livestock; development of farm hygiene and animal involvement hygiene control strategies.

 

 

“MRSA infections in pets continue to cause concern to veterinary surgeons and owners. The work of the Bella Moss foundation has focused on providing clear and helpful information for pet owners which has made it easier for many pet owners to understand the requirements and implications of treating MRSA infected animals. The Bella Moss Foundation has also helped to promote awareness and research on MRSA in veterinary medicine.”

Anette Loeffler, DrMedVet, DVD, DipECVD, MRCVS, Lecturer in Veterinary Dermatology, Royal Veterinary College, University of London.

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