Mrsa Pneumonia

MRSA pneumonia is a serious and potentially fatal condition that requires aggressive antibiotic therapy in a hospital setting.

What is MRSA pneumonia?

MRSA is short for methicillin-resistant Staphylococcus aureus. It is now considered one of the most leading causes of pneumonia, including community-acquired and hospital-acquired pneumonia, which are discussed in greater detail later in this article.

Explanation:

MRSA pneumonia is a critical infectious disease – one with a high mortality rate. Though treatment exists, not all patients respond favorably to these therapies.

Other terms that are used to describe this condition include:

  • Staphylococcal pneumonia
  • Aureus pulmonary infection

Based on medical research, there are two groups of patients that are more susceptible to MRSA pneumonia. They include:

  • Aging patients
  • People who are chronically ill

In the past, community-acquired pneumonia was directly linked to the influenza virus – it is a serious side effect of the infection.

In recent years, however, medical centers have observed a rapid increase in MRSA pneumonia diagnosis in people outside these predetermined criteria.

There are two main contributing factors to the surge of cases reported, which include:

1. Strains of staphylococcal infections that are resistant to methicillin treatments, particularly the Staphylococcus aureus group of infections. MRSA has even been given the nickname “superbug” – and for good reason: it’s super hard to treat.
2. Patients’ long-term use of ventilatory support, especially in chronically ill and aging patients

These two circumstances are the perfect breeding ground for the development of MRSA pneumonia, according to the Oxford Academic. Consider the following settings, for example, where hospital-acquired MRSA pneumonia is most prevalent:

  • Hospitals
  • Nursing homes
  • Assisted care facilities

Nevertheless, it’s important to note the MRSA pneumonia is a highly infectious disease, which can be spread to unsuspecting patients, including the younger populace.

Causes of MRSA pneumonia

Pneumonia is considered a secondary infection of other conditions, the most common being influenza. Today, however, there are increasing cases of pneumonia resulting from an MRSA infection.

About one-third of the world’s population have MRSA pathogens living on the skin or in nasal passages. If the lungs aspirate MRSA, however, this can progress to pneumonia, in which case it would be labeled as MRSA pneumonia.

For the purposes of this guide, there are two additional subgroups of MRSA pneumonia we’d like to explore including:

  • • Community-acquired MRSA pneumonia – A new and hard to treat hybrid of S. Aureus has emerged and involves SCCmec type IV. This is increasingly gaining prevalence among young and healthy groups, and mostly in groups of people who share close contact with each other on a regular basis. Think army camps, children in daycare centers or athletes in locker rooms, for example.
  • Hospital-acquired MRSA pneumonia – MRSA which now causes 20-40% of all hospital-acquired pneumonia cases.

Prevention

In some cases, MRSA infections can be prevented by practicing good healthcare protocols, including regular hand washing with soap and hot water to stop the spread of the bacteria.

Decontamination can also be attempted by providing high-risk patients with oral vancomycin, including patients receiving ICU care or feeding tubes.

Symptoms of MRSA pneumonia

Some of the most common signs of MRSA pneumonia include:

1. Fever – one of the common warning signs of MRSA pneumonia, as is the case with many infections, is a fever. However, it is worth noting that as the body begins to fight off MRSA pneumonia, some patients may get:

  • Chills – as the body temperature drops when patients have a lower or weaker immune system
  • Hot flashes – this is generally observed in older patients.

As a result, medical teams usually factor in a patient’s age and health condition when factoring in temperatures that are higher or lower than 100.5 – and when patients have other symptoms of MRSA pneumonia.

2. Thick mucus – depending on the stage of the infection, the mucus or phlegm can be clear, yellow or green. A clear thick mucus indicates the early onset of MRSA pneumonia while a yellow color specifies that the patient is currently fighting off the infection. Finally, when the mucus turns green, this means that patients are ridding the body of the infection – and coughing may help. In extreme cases, patients may even cough up bloody or blood-tinged mucus.

3. Respiratory distress – another clear indicator of MRSA pneumonia is respiratory difficulties that may be accompanied by:

  • A non-stop cough
  • Difficulty breathing
  • Shortness breath
  • Wheezing
  • Pain in the chest, especially during bouts of coughing

These respiratory issues are generally more severe than your typical cold or flu-like symptoms. For example, the patient’s cough may sound more deep and boisterous – and is unrelenting.

How to treat MRSA pneumonia

MRSA pneumonia can prove fatal. Aggressive and early treatment is needed in most cases, for a better chance at survival. However, there are many limitations faced by physicians on duty. For one, it’s generally challenging to pinpoint that patients have MRSA pneumonia at face value because many of the symptoms can present as other conditions. Secondly, aggressive measures such as lung biopsies discussed later in this section, are needed to isolate MRSA as the main cause of the patient’s pneumonia.

When MRSA is diagnosed, however, patients must be hospitalized to receive adequate treatment.

How it’s diagnosed:

Before treating patients with MRSA pneumonia, cultures are taken to test for the pathogen. Lung biopsies and/or chest x-rays may also be performed for the most accurate diagnosis.

If MRSA pneumonia is suspected and all testing results point to this diagnosis, medical teams act fast to administer the standard treatment of choice: antibiotic therapy.

Examining the Shorr Score

As a result of the increasing concern for patients who arrive at the hospital with pneumonia symptoms and the high probability of an MRSA infection, this has led to the over-prescription of anti-MRSA therapy. A scoring system has now been put in place in many medical settings to analyze patient’s risk factors for MRSA pneumonia. It’s called the Shorr Score and involves the analysis of the following variables to determine risk:

  • If the patient is between the ages of 19-29 or older than 79 years of age
  • If the person is enrolled in a long-term health facility, such as nursing home or assisted living facility, for example
  • If the patient has recently received antibiotics via IV
  • If the patient was hospitalized for more than two days
  • If the patient was previously admitted to the ICU department
  • If the patient has any neurological disorders, including dementia
  • If the patient has diabetes and is female

With advances in technology, the responses can be inputted quickly into an online Shorr Score calculator, where algorithms check the probability that the patient indeed has MRSA pneumonia. Patients with a low-risk score may receive antibiotics while those with a moderate to high-risk are immediately admitted and provided treatment – based on the best judgment of the physician/s on duty.

Best treatments

In times past, the only available treatment for MRSA pneumonia used to be vancomycin, but poor results and high mortality rates led to creation and FDA approval of Linezolid. There are ongoing debates in the medical community regarding which treatment is better. For now, the recommended doses of treatment for each drug are based on several variables, including:

  • The patient’s age
  • The patient’s health
  • The existence or non-existence of renal failure
  • If additional therapies are needed

Another concern for patients undergoing antibiotic therapy for MRSA pneumonia is the possibility of the development of new resistant and dangerous organisms. When patients respond favorably to the initial treatment, the antibiotic therapy should be reduced, per the consensus of the global medical community.