Infections could happen from many sources, mainly from the healthcare facilities, sports facilities and communities.

Infections are caused by a bacterium called Methicillin-resistant Staphylococcus aureus (MRSA). Clostridium Difficile Infection (CDI) is also widely prevalent, according to Dr M.A.Jagangeer, Consultant Gastroenterologist and Hepatologist of KG Hospital.

He made this observation while giving a presentation on “MRSA & CDI” to the post-graduate students at KG Hospital Auditorium recently. Dr Jahangeer said that MRSA had been a common health problem from 1961.

It could be classified into two types—HA-MRSA (hospital acquired) and CA-MRSA (community acquired). The bacteria could live for months in hostile environment.

People at risk

The MRSA infection puts the following people at risk: infants, elderly, chronically ill patients, burns victims, organ transplant recipients, IV drug abusers and those who are in prolonged hospital stay.

The target groups for CA-MRSA are those mainly in crowded environment such as athletes, soldiers, prison inmates and those who have got an exposure to MRSA carrier. This infection tends to affect the young and the healthy people.

Local infection would manifest in the form of abcess, cellulitis, folliculitis and furuncle; and Systemic infection (mainly hospital acquired) would acquire the form of pneumonia, endocarditis, osteomyelitis and Toxic Shock Syndrome (TSS).

Prevention

However, Dr Jahangeer said that MRSA infection could be prevented by the following measures: wash your hands, keep wounds covered, keep personal items personal (do not share personal items such as towels, sheets, razors, clothing and athletic equipment), shower after athletic games or practices; and sanitize linens.

He further said that CA-MRSA could be prevented by making the community observe basic hygienic practices, avoid sharing of personal items and do proper hand washing.

Dr Jahangeer also noted that C.Diff Diarrhoea was another risk factor for those above 65 years of age, those who underwent hospitalization and who were in prolonged hospital stay, patients with chemotherapy immune-compromised state and so on.

Nature of severity

C.Diff Diarrhoea has various forms of clinical presentations: asymptomatic, mild disease, moderate disease, severe disease and severe disease with complications.

In the mild disease the stool frequency is 3 to 5 times a day, there is no blood in the stool and no constitutional symptoms.

In moderate disease the stool frequency is 5 to 8 times a day, blood is absent but constitutional symptoms present.

In severe disease the stool frequency is more than 8 times a day, abdominal distension, blood in the stool and constitutional symptoms present with lactic acidosis.

As the disease progresses, it will present complications such as bowel perforation, toxic megacolon, electrolyte disturbances, septic shock, Disseminated Intravascular Coagulation (DIC), Systemic Inflammatory Response Syndrome (SIRS) and Acute Renal Failure (ARF).

C.Diff Diarrhoea could be prevented by avoiding contact with positive cases, isolation of positive/suspected cases, proper hand hygiene and observing barrier nursing techniques.

Dr Jahangeer added that the treatment modalities depended on the type of infection, location and severity. He also dwelt at length on the required drug therapy.

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