Antibiotics Resistance the Silent Pandemic: Methicillin-Resistant Staphylococcus aureus (MRSA)

  25 May 2023

By Blessing Nkechi Emmanuel

Imagine that a pregnant woman who delivered her baby through a cesarean section. The operation went on smoothly and she was later discharged from the hospital, but a few weeks later an infection develops around the surgical wound. This infection poses difficult to treat because it the pathogen involved resists almost all the antibiotics prescribed. It turns out that the infection is caused by MRSA methicillin resistant Staphylococcus aureus. The infection is treated with stronger antibiotics, but eventually the bacteria has circulated in the blood stream and progressed and this woman eventually dies of sepsis.

Antibiotic resistance has been a looming silent pandemic that threatens to undo decades of progress in modern medicine. Again, imagine what the globe will look like when infectious diseases can no longer be treated because pathogens (virus, bacteria, parasites and fungi) have developed resistance and no longer respond to drugs, used in combating them. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most concerning antibiotic-resistant bacteria. MRSA is a type of bacteria that has evolved to become resistant to methicillin, a type of antibiotic commonly used to treat bacterial infections. MRSA is often referred to as “superbug” due to its ability to resist multiple antibiotics, making it difficult to treat, moreover, one of the main causes of antibiotic resistance is overuse and misuse of antibiotic drugs. The overuse of antibiotics creates an environment where bacteria can evolve to develop resistance to drugs.  MRSA infection originally a nosocomial infection that has find its way into the community is a major public health concern, as it can cause serious and sometimes life-threatening infections, especially among people with compromised immune system including hospital patients, or individuals with chronic illnesses.

Symptoms of MRSA

The symptoms of MRSA infections depend on the severity of the infection. The infection commonly spread through contact with contaminated wounds, bandages, inanimate objects in infected patients, contact with intact skin of colonized individuals, and inhalation of aerosolized droplet by chronic nasal carries. Risk factors includes surgical site infection, antibiotic use, prolonged hospitalization, intensive care, hemodialysis, and proximity to others colonized or infected with MRSA. The infection causes skin infection such as boils abscesses and cellulitis, which are characterized by redness, swelling and pain, also, it may be accompanied by a fever. In more severe cases, MRSA can cause pneumonia, bloodstream infection, and infections of the bones, joints and organs which can be life-threatening.

Mechanism of Resistance to Methicillin

MRSA is caused by Staphylococcus aureus bacterium, which commonly lives on the skin and nose of healthy people. However, when the bacteria get into the body through a cut, open wound, or other opening, they cause infection.  Methicillin resistance emerged in Staphylococcus aureus because of the acquisition of a penicillin-binding protein 2a (PBP2a), a chromosome-encoded protein, encoded by an acquired gene, mecA. This methicillin-resistant genetic component is carried on a mobile genetic element (MGE) called the Staphylococcal cassette chromosome mec (SCCmec). This type of resistance is transmitted between S. aureus organisms by bacteriophages which is one of the few medically relevant examples of chromosome-mediated drug resistance by phage transduction.

Positive Moves-MRSA and Nanotechnology

Rapid development of nanotechnology offers a promising solution to combat the drug-resistant trait seen in MRSA. Functional nanomaterials and particles can serve as drug carriers or antibacterial agents for antibacterial therapy. Some functional nanomaterials, such as metal nanoparticles and graphene-based nanomaterials, possess intrinsic antibacterial properties through physical destruction and phototherapy. These function nanomaterials with antibacterial properties do not induce bacterial resistance. Nanomaterials possess several unique properties such as small size, high surface area, high drug loading and targeting capabilities, and thus can be used for advanced delivery of antibiotics or other antimicrobial agents. Nanomaterials that serve as drug carriers can suppress bacterial resistance by protecting key structural unit (such as the beta-lactam ring) of incorporated antibiotics and circumventing drug resistance mechanisms. In addition, nanomaterials can enhance drug-induced anti-bacterial effects by enhancing drug pharmacokinetics, facilitating interactions with bacterial and enhancing drug targeting ability.

Draw backs of Nanotechnology

Despite the promising potential seen in nanotechnology, there are several draw backs to use nanotechnology to treat MRSA infection including; scaling up production of nanoparticles to industrial batch-size, toxicity concerns, also, nanoparticles used for treating MRSA may be subject to different regulatory requirements than tradition antibiotics, and there is a concern that bacteria may develop resistance to nanoparticles overtime. However, research is progressing to develop improved delivery platform and optimize Nano formulations to make them viable long-term strategy to overcome antibiotic resistance of MRSA.

MRSA Treatment

Treating MRSA infections can be challenging as these bacteria are resistant to many antibiotics including methicillin, which is commonly used to treat staphylococcus aureus infections. In some cases of MRSA infection, antibiotics may not be necessary, in this case doctors may instead drain the small, shallow boil caused by MRSA rather than treat the infection with drugs. While in severe cases doctor may perform emergency surgery to drain the large boils (abscesses) and in addition administer antibiotic drugs. Both health-associated and community-associated strains of MRSA are still responsive to certain antibiotics such as trimethoprim-sulfamethoxazole, clindamycin, minocycline, linezolid, or doxycycline.

The way forward against MRSA

Yes, it is possible to develop new strategies to combat drug-resistant pathogens, still it is significant to note that this silent pandemic has lingered over a decade majorly because of the misuse and overuse of antibiotics. and so, to effectively curb ARM silent pandemic we need to develop the act of appropriate use of antibiotics as well as to get actively involved in ARM stewardship.  On the other hand Preventing the spread of MRSA is critical to reducing the incidence of infections, and this can be done by following good hygiene practices such as washing hands regularly, avoiding sharing personal items like towel, razor and cleaning and disinfecting surfaces that may be contaminated with the bacterium, as well as using antibiotics only when they are needed and as prescribed by a healthcare provider.

Conclusion

In conclusion, MRSA infection is a serious and potentially life-threatening infection that has become increasingly difficult to treat with the common antibiotics. nanotechnology particularly, the use of nanomaterials and nanoparticles has shown great promise in the fight against MRSA. However, while nanotechnology offers many potential benefits in the fight against MRSA, there are also concerns about the safety and environmental impact of nanomaterial and nanoparticles, therefore continued research in this area is essential to developing new and more effective treatments for MRSA and other antibiotic-resistant infections.

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