MRSA Infection: History, Symptoms, Treatment & Costs
This paper provides a comprehensive overview of Methicillin-resistant Staphylococcus aureus (MRSA), tracing its evolutionary origins from the discovery of penicillin through the emergence of resistant strains in hospitals and communities worldwide. It examines the biological differences between community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA), including transmission patterns, at-risk populations, symptoms, and diagnostic challenges. U.S. infection rates and mortality statistics are analyzed, followed by a discussion of existing treatment strategies and CDC prevention guidelines. The paper concludes with an assessment of the economic burden MRSA places on the healthcare system and the cost-effectiveness of surveillance and decolonization strategies.
- Evolutionary History of MRSA: Origins of MRSA from penicillin resistance to global spread
- Nature of MRSA Infection and Transmission: How MRSA spreads and differs by community vs. hospital strain
- Diagnosis, Symptoms, and Progression: Risk factors, vulnerable populations, and symptom presentation
- Rates of MRSA Infections in the United States: U.S. infection statistics and the scale of the epidemic
- Treatment Strategies, Prevention, and Control: Available antibiotics and CDC prevention recommendations
- Economic Implications of MRSA Infections: Costs of containment, screening, and decolonization strategies
- Conclusion: Summary of MRSA challenges and recommended health interventions
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- Draws on a range of peer-reviewed sources — including CDC reports, microbiological studies, and clinical journals — to build a well-supported, multi-dimensional argument.
- Clearly distinguishes between the two primary MRSA variants (CA-MRSA and HA-MRSA), using empirical data from the Huang et al. study to highlight their differing epidemiology and treatment challenges.
- Moves logically from scientific history and microbiology through epidemiology, clinical presentation, and finally to policy and economics, demonstrating strong organizational discipline.
Key academic technique demonstrated
The paper exemplifies evidence-based synthesis: rather than relying on a single source, it integrates findings from genetic studies (Enright et al.), clinical comparisons (Huang et al.), and health-economics analyses (Nelson et al.) to build a cohesive narrative. This technique — drawing on complementary studies to triangulate claims — is a hallmark of effective health science writing.
Structure breakdown
The paper is organized into seven clearly labeled sections. It opens with a brief contextual introduction before proceeding through: (I) evolutionary and genetic history of MRSA; (II) transmission mechanics and strain differences; (III) diagnosis, symptom presentation, and at-risk groups; (IV) U.S. infection rate statistics; (V) treatment and prevention guidelines; (VI) cost-effectiveness of containment strategies; and (VII) a concise conclusion synthesizing all sections.
Evolutionary History of MRSA
In 1929, Fleming discovered penicillin, and it was immediately put to use in fighting Staphylococcus aureus (SA) (Barnes & Sampson 2010, p. 23). Within a decade, resistant strains of SA began to emerge. Methicillin is an antibiotic that was used to treat staph infections which had become resistant to penicillin (Enright 2002, p. 7678). Within two years of methicillin's introduction, the first report of a strain of Staphylococcus aureus that had "acquired resistance to methicillin" was documented in England (Enright 2002, p. 7678). Similar strains were soon identified across Western Europe and in the United States. Of particular note, methicillin resistance was found in both the hospital variant and the community-based infection.
The prevalence and ubiquity of MRSA is now global, posing a significant and often intractable problem for health professionals worldwide. In their review of the emergence of MRSA isolates in different countries, Enright et al. examined bacterial samples collected over 38 years and representing 20 nations. A troubling finding from their genetic analysis was that many MRSA isolates are "only distantly related to each other," which poses significant problems for treatment (Enright, 2002, p. 7689). In the United States, the first reported incident of hospital-variety MRSA occurred in 1968; the first community-based strain was reported in 1980 (Huang et al., 2006, p. 2423).
Part of the difficulty in treating and eliminating MRSA lies in the wide variety of strains that exist, the uncertain relationships between their origins, and the bacterium's continually evolving nature. The Enright study focused on the ancestral genotype origins of the most common strand, including ST250 — considered the "original MRSA clone" (Enright, 2002, p. 7689). The data suggest that mutations may have developed separately; in other words, the bacteria acquired the methicillin-resistance gene while already possessing the capacity to cause staph infections (Enright, 2002, p. 7691). The authors conclude that the gene conferring methicillin resistance was acquired by staph infections "that were already common within hospitals" (Enright 2002, p. 7692). This conclusion is troubling because it suggests that the true locus of the problem is the staph infections already present in hospitals — in effect a ticking time bomb capable of acquiring resistance at random.
Nature of MRSA Infection and Transmission
MRSA can spread between individuals through direct skin-to-skin contact with an infected person, by sharing personal objects, or by touching contaminated surfaces (Zeller 2011, p. 1828). According to the CDC, rates of infection may be linked to the nature of the strain involved. There are three identified strains of community-based MRSA in the United States. Community-acquired MRSA is referred to as CA-MRSA, as opposed to the nosocomial variety referred to as HA-MRSA (CDC, 2012). The biological differences between the two infections lie not merely in location but also in their spread and effect: the CDC suggests that CA-MRSA may spread more easily and cause a higher rate of skin infections than the hospital-based strain.
The majority of staph infections occur in soft tissue such as the chest, arms, and legs; studies conducted by Huang et al. found that between 55% and 61% of infections occur in these regions (Huang et al., 2006, p. 2424). Community-based CA-MRSA infections were found in upwards of 45% of the population tested in Sacramento, California. While CA-MRSA responds better to certain drug combinations, it also exhibits high resistance to several antibiotics, including erythromycin. The Huang et al. study established that "CA-MRSA is not a nosocomial strain which originated in local healthcare facilities" (Huang et al., 2006, p. 2426).
Other characteristics unique to CA-MRSA include a higher incidence among urban and low-income communities, which the authors of the Huang et al. study attribute to higher rates of intravenous drug use (Huang et al., 2006, p. 2426). Particularly concerning to researchers is the possibility that the community-based and nosocomial versions might exchange genetic material (Huang et al., 2006, p. 2426). Given that the CA variant already displays significant resistance, such an exchange could produce an exceptionally virulent strain.
Rates of MRSA Infections in the United States
The rates of infection are staggering. In the United States in 2005 alone, there were over 94,000 MRSA infections resulting in more than 18,000 deaths (Barnes & Sampson 2010, p. 24). Among hospital infections that year, MRSA accounted for over 50% of all hospital-related infections (Barnes & Sampson 2010, p. 24). Studies presented by Barnes & Sampson show that in any given sample of 1,000 admitted patients, nearly 46 will already be infected with MRSA — a rate approximately ten times higher than CDC estimates prior to the 2006 study (Barnes & Sampson 2010, p. 24). The difficulty of containing and accurately counting infections defines a central part of the challenge.
The relationship between hospital and community variants of MRSA is troubling. Barnes & Sampson note that patients who contract MRSA in the hospital are often discharged — frequently undiagnosed — back into the community, where they can serve as unknowing sources of transmission (Barnes & Sampson 2010, p. 24). Although the situation for HA-MRSA is serious, the authors use the word "epidemic" to describe the rate of CA-MRSA in some U.S. states (Barnes & Sampson 2010, p. 24). Alarmingly, 60% of emergency room patients who present due to infections are afflicted with MRSA (Barnes & Sampson 2010, p. 24). This is especially concerning given the close quarters and long wait times common in emergency rooms across the country.
Cities such as Atlanta and Chicago are experiencing upwards of 100 infected individuals per 100,000 admitted patients (Barnes & Sampson 2010, p. 24). Even more concerning is the increase in infections in pediatric wards; even in clinics with low admission volumes, the authors predict that MRSA infections in primary care clinic patients will grow more severe over time (Barnes & Sampson 2010, p. 24).
Conclusion
MRSA is a bacterial staph infection that has become highly prevalent in the modern world. Healthcare practitioners and the CDC are actively working to develop antibiotics capable of addressing both the nosocomial variant and the community-based version. The symptoms of an MRSA infection typically present as boils on the skin. Treatment options remain limited to a small number of still-effective antibiotics, combined with physical drainage of abscesses. Researchers are working to develop new and more potent antibiotics to stay ahead of the bacterium's evolution.
In the meantime, CDC guidelines and national health surveys suggest that hospitals can take significant steps toward reducing infections. Recommended measures include screening all admitted patients, isolating those who test positive, implementing precautionary contact protocols, and administering antibacterial nasal treatments. These combined strategies offer the most promising path toward reducing the significant human and economic toll of MRSA infections in both hospital and community settings.
Always verify citation format against your institution’s current style guide requirements.