Methicillin Resistant Staphylococcus Aureus (MRSA) UTIs are increasing throughout the United States, and transmissions acquired in hospitals and care facilities are of particular concern. A MRSA UTI cannot be treated with traditional antibiotics and the prevalence of antibiotic resistant bacteria is a growing problem, especially for the elderly living in residential care facilities, as more strains of bacteria adapt to commonly used antibiotics.
Elderly residents are likely to have taken antibiotics over the years, allowing for the development of some resistant bacteria, and the combination of debilitated patients with compromised immune systems, and a certain level of antibiotic resistance places them at greater risk of MRSA infections.
Several specific factors contribute to the likelihood of contracting a MRSA urinary tract infection (UTI) in a nursing home or other long-term care facility.
MRSA UTI Risk Factor #1: Exposure to Carriers
Studies have shown that residents in long-term care facilities are more likely to be carriers of MRSA in general. It is believed that patients often contract MRSA during a stay at a hospital or acute care facility, rather than in a nursing home or long term care residence, however, facilities where many people are living in close proximity to one another can be prime areas of contagion. While infection control protocols are in place in most facilities, research has indicated that none are substantially effective in reducing the spread of infections, partially due to the highly contagious nature of MRSA and also to the fact that it may be unreasonable to attempt to limit residents’ mobility and social interactions given that the facility is their home.
MRSA UTI Risk Factor #2: Invasive Medical Devices
Use of invasive devices like urinary catheters: Since MRSA, like other staph organisms, can live on the skin, hygiene is the first line of defense in controlling spread of infection. While healthy people can carry staph on their skin without being infected by it, elderly residents have a much harder time fighting off stubborn organisms like MRSA. Urinary tract infections are common in nursing homes and long-term care facilities. Many elderly patients have poor bladder control and depend on a urinary catheter which can provide bacteria a direct route into the body, particularly if the catheter is left in place for long periods of time without being replaced.
MRSA UTI Risk Factor #3: Impaired Cognitive Function
Increasing the amount of fluids in the person’s diet will help to flush out bacteria from the bladder and urinary tract, but elderly residents may not remember to drink enough without close monitoring. In addition to being incontinent, long-term care residents may be mobility-impaired and confused which contribute to the possibility of a UTI. Patients who do not have a catheter but still have issues with incontinence may refrain from drinking larger amounts of fluids in an attempt to avoid accidents, and this provides an opportunity for bacteria in the bladder and urinary tract to thrive.
MRSA UTI Risk Factor #4: Impaired Immune Function
If poor clinical status and chronic illnesses are the norm in residences for the elderly, endemic infections may not be preventable. Residents may have chronic medical conditions that decrease the effectiveness of their immune system, and this makes MRSA infections more dangerous and potentially even life-threatening. The inability of many elderly patients to communicate adequately with staff, combined with a high frequency of asymptomatic MRSA UTIs may create a nearly impossible situation. The use of high-power antibiotics that are effective on resistant bacteria like MRSA can be very hard on the patient in treatment, and may affect kidney function as well.
MRSA UTI Risk Factor #5: High Potential for Contagion
MRSA is highly a highly contagious organism that can be transmitted by direct contact with infected persons, towels, wash cloths, bedding, drinking glasses or any other items handled by infected residents, especially if cognitive changes are present that prevent patients from being fully aware of things like proper and frequent hand-washing. MRSA that may begin as a nasal or respiratory infection can easily be transferred to other parts of the body.