Methicillin Resistant Staphylococcus Aureus MRSA and Lyme Disease

Lyme Disease and Methicillin-Resistant Staphylococcus Aureus (MRSA) Introduction This text will concern itself with Lyme disease and methicillin-resistant staphylococcus aureus (MRSA). In so doing, it will not only give the description and epidemiology of the concerns, but also the etiology and prevention strategies. Further, diagnosis as well as treatment options and prognosis will be highlighted. 1.

Lyme Disease Description and Etiology Described as an illness that is often debilitating, Lyme disease, as the Centers for Disease Control and Prevention- CDC (2018) points out, “is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks.” It is important to note that in addition to the bacterium Borrelia burgdorferi, blacklegged ticks are capable of transmitting what are commonly referred to as coinfections, i.e. a variety of other disease-causing parasites as well as viruses and bacteria.

Those living in wooded areas have a high likelihood of getting Lyme disease, as are persons whose domestic animals loiter around areas that are wooded. Diagnosis CDC (2018) points out that Lyme disease is diagnosed on the basis of “symptoms, physical findings (e.g.

rash), and the possibility of exposure to infected ticks.” In essence, according to Murray and Shapiro (2010) the disease’s clinical manifestations are grouped into the following brackets: a) Early localized disease b) Early disseminated disease c) Late disease During early localized disease, which is often 7 to 14 days after an individual is bitten by a tick, the said person could develop rash (erythema migrans) which is typically located on the tick bite site (Murray and Shapiro, 2010). The rash often disappears within a period of approximately 1 month.

The second stage of the disease, i.e. early disseminated disease, is occasioned by the spread of bacteria and could present a number of symptoms that are flu-like. These include fever and chills. Other symptoms include, but they are not limited to, fatigue and enlarged lymph nodes. According to Murray and Shapiro (2010), an individual will also present multiple erythema migrans and other manifestations such as carditis and meningitis. Lastly, we have stage 3, i.e. late disease, which comes about after failure to treat the infection during the first two stages.

For this reason, stage 3 could take a long time to develop. The clinical manifestations at this stage, according to Murray and Shapiro (2010), include encephalitis and arthritis. An individual could also experience limb numbness, memory loss (short-term), and severe headaches. Treatment According to CDC (2018), antibiotics are in most cases effective in the treatment of the disease. Towards this end, “patients typically take doxycycline for 10 days to 3 weeks, or amoxicillin and cefuroxime for 2 to 3 weeks” (WebMD, 2018). On the basis of clinical manifestations, treatment could either be administered orally or intravenously.

For instance, during the early localized stage where the patient presents erythema migrans, antibiotics could be administered orally, while during stage 3, whereby a patient presents encephalitis, intravenous administration of antibiotics is adopted (Murray and Shapiro, 2010). Prognosis Antibiotics are quite successful in the treatment of Lyme disease. This is more so the case if the said disease is diagnosed early enough, i.e. during the first two stages. Fatalities are rare.

It is, however, important to note that even after treatment using antibiotics, a certain percentage of people may still not show any improvement. According to Aucott (as cited in WebMD, 2018), “ten percent of people don’t get better after antibiotics.” In such cases, there exists no other viable treatment options (WebMD, 2018). It should also be noted that reinfection could still occur even after successful treatment. Towards this end, the relevance of prevention efforts cannot be overstated. These will be highlighted elsewhere in this text.

Epidemiology In essence, Lyme disease is regarded to be Europe and America’s most prevalent tickborne infection (Domino, Baldor, Golding, and Stephens, 2017). In the words of Mead (2015), the specific species of lxodes ticks that transmits the etiologic agent to humans “are found widely in temperate regions of the Northern hemisphere” (Mead, 2015, p. 187). More specifically, in the U.S., a significant percentage (up to 95%) of Lyme disease cases was reported in a total of fourteen states in the year 2016.

CDC (as cited in WebMD, 2018) identified these states as “Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin.” It should be noted that amongst the fourteen states identified above, New Jersey and Pennsylvania were the most affected – with both reporting a huge number of infection cases. According to the CDC (as cited in WebMD, 2018), each year, the U.S. experiences approximately 300,000 of Lyme infection cases. The rate of infection is expected to keep increasing going forward.

However, the black-legged tick, as various experts have pointed out, appears to be expanding its range particularly towards “the southern and western U.S. and into Canada”, effectively meaning “that the number of Lyme disease cases in North America will climb” (WebMD, 2018). Prevention There are various prevention efforts that could be adopted in an attempt to keep Lyme disease at bay. Most prevention efforts are focused on minimizing exposure to tick bites (Domino, Baldor, Golding, and Stephens, 2017).

To begin with, when in the outdoors, persons in areas deemed as high risk zones should ensure that they minimize exposure by covering their limbs as appropriate, i.e. by being clad in long-sleeved shirts as well as long pants. Further, wooded areas and undergrowth around habitable areas ought to be cleared so as to reduce tic habitat. Insect repellants, according to CDC (2018), could also be used in efforts to prevent the disease.

It should also be noted that attached ticks must be removed as soon as they are noticed because the transmission of the disease usually takes place after a tick has been attached in the body for several hours (Domino, Baldor, Golding, and Stephens, 2017). 2. Methicillin-Resistant Staphylococcus Aureus (MRSA) Description and Etiology Methicillin-resistant Staphylococcus aureus (MRSA), in basic terms, is an infection causing bacterium that could “cause a variety of problems ranging from skin infections and sepsis to pneumonia to bloodstream infections” (CDC, 2016).

Its treatment is often a challenge because, as the name suggests, it happens to be resistant to a wide range of antibiotics. It is the penicillin-binding protein’s mutation that, as Siddiqui and Whitten (2018) observe, brings about or occasions the S. aureus methicillin resistance. As the authors further point out, “this type of resistance is transferred between S. aureus organisms by bacteriophages” (Siddiqui and Whitten, 2018). The National Institute of Allergy and Infectious Diseases – NIAID (2009) points out that MRSA remains one of the most common hospital-acquired infections.

This is more so the case given the contagious nature of MRSA and the fact that the bacterium is capable of surviving for a significant period of time on various surfaces including, but not limited to, fabric, taps, door handles, as well as sinks and floors. In recent times, strains of MRSA have been witnessed with greater frequency in community settings (NIAID, 2009). In the past, as Boswihi and Udo (2018) point out, elderly patients in various healthcare settings were almost solely prone to MRSA-caused infections.

As time went by, however, “the emergence of strains in patients with no previous history of hospitalization which were known as community-associated MRSA (CA-MRSA)” was witnessed (Boswihi and Udo, 2018). Skin-to-skin contact remains a prime avenue through which the spread of staph germs occurs. Diagnosis It is important to note that staph could be found on the skin of healthy people. In most instances, this does not present any infections or adverse symptoms.

When the skin is broken, however, this allows staph to gain entry – thereby causing swelling, reddening, and presence of pus in the affected skin area (Domino, Baldor, Golding, and Stephens, 2007). Apart from skin infections, MRSA infections could occur in other sites such as the surgery area, organs, or the bloodstream. Towards this end, when infections are severe, patients could experience headaches, chills and fevers, fatigue, and chest discomfort (NIAID, 2009). To determine if an individual has MRSA infection, a sample of sputum, pus, or blood could be collected.

It is the said sample that is assessed so as to determine whether MRSA is present or not. Treatment When it comes to skin MRSA (mild to moderate infections), NIAID (2009) points out that draining the abscess is often sufficient in instances where the said infection has not spread. When the infection affects persons with a weakened immune system, it may prove difficult to treat. This is also the case when the occurrence is in the blood or lungs.

According to NIAID (2009), beta-lactam antibiotics are often not taken into consideration as a treatment option in MRSA cases. This is more so the case given their documented ineffectiveness in tackling the bacteria. Towards this end, “for severe infection, doctors will use vancomycin intraveneously” (NIAID, 2009). Prognosis As would be expected, in comparison to those with MRSA infections, the outcomes of persons infected with staphylococcus aureus that is methicillin-sensitive are often better.

Generally, however, “prognosis is dependent on disease severity and the condition of the person’s general health” (Beltz, 2011, p. 136). Epidemiology In the words of Boswihi and Udo (2018), “MRSA has become a problem in many hospitals and healthcare settings worldwide.” In that regard, therefore, healthcare workers in constant contact with patients who are infected have a higher likelihood of MRSA infection. According to Siddiqui and Whitten (2018), the first description of MRSA infections was done in 1961.

There has been a well-documented increase in not only the prevalence, but also the incidence of the infection in the U.S. since then (Siddiqui and Whitten, 2018). In recent times, however, a number of.