Question

As a health care provider in LA County you will often run into infections caused by both MRSA and O157:H7 E. coli. For this clinical correlate, write a one-page essay on comparing MRSA and O157:H7 E. coli infections in LA County. For this information you need to go to the LA County Acute Communicable Disease Control Website:

http://www.publichealth.lacounty.gov/acd/index.htm

and search for the two infections using the search box.

Explain what the infections are and how common they are in LA Country. Also include any suggestions on how to decrease infection over the next years.

Answer 1

Escherichia coli O157:H7 (E. coli)

Escherichia coli (abbreviated as E. coli) are bacteria found in the environment, foods, and intestines of people and animals. E. coli are a large and diverse group of bacteria. Although most strains of E. coli are harmless, others can make you sick. Some kinds of E. coli can cause diarrhea, while others cause urinary tract infections, respiratory illness and pneumonia, and other illnesses.

Escherichia coli O157:H7, a Gram-negative bacillus, is a specific serotype of the shiga toxin producing class of E. coli (STEC) and the most common such serotype in the US. Incubation period is 2-8 days. Shiga toxins cause abdominal cramps and watery diarrhea, often developing into bloody diarrhea; fever is uncommon. Likely modes of transmission include foodborne (e.g., undercooked ground beef, fresh produce, unpasteurized juice, raw milk) and person-to-person (e.g., day-care settings). There also have been outbreaks associated with exposure to animals and their environments and recreational water exposure. All E.coli O157:H7 isolates are confirmed by the Los Angeles County Public Health Laboratory.

Hemolytic uremic syndrome (HUS) is a clinical diagnosis and may or may not be associated with E. coli O157:H7. Children younger than 5 years of age are at highest risk for hemolytic uremic syndrome (HUS), a clinical complication consisting of hemolytic anemia, thrombocytopenia, and kidney failure. Adults may acquire thrombotic thrombocytopenic purpura (TTP) after STEC infection.

Most E. coli are harmless and actually are an important part of a healthy human intestinal tract. However, some E. coli are pathogenic, meaning they can cause illness, either diarrhea or illness outside of the intestinal tract. The types of E. coli that can cause diarrhea can be transmitted through contaminated water or food, or through contact with animals or persons.

E. coli consists of a diverse group of bacteria. Pathogenic E. coli strains are categorized into pathotypes. Six pathotypes are associated with diarrhea and collectively are referred to as diarrheagenic E. coli.

• Shiga toxin-producing E. coli (STEC)—STEC may also be referred to as Verocytotoxin-producing E. coli (VTEC) or enterohemorrhagic E. coli (EHEC).
• Enterotoxigenic E. coli (ETEC)
• Enteropathogenic E. coli (EPEC)
• Enteroaggregative E. coli (EAEC)
• Enteroinvasive E. coli (EIEC)
• Diffusely adherent E. coli (DAEC)

MRSA (methicillin (antibiotic)-resistant Staphylococcus aureus)

MRSA is a type of bacteria that causes skin infections. MRSA is resistant to many types of antibiotics, but it’s still treatable. MRSA skin infections can happen when the bacteria enters a scrape or cut. These MRSA skin infections can look like a spider bite or an infected sore. The bump or infected area on the skin may be:

• Red and swollen
• Painful or warm to the touch
• Full of pus or other liquid

It is advised to see a doctor right away if anyone have these symptoms and especially if the infection becomes worse or if he/she also have fever.

"Staph" or Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA), Staphylococcus aureus, commonly referred to as “Staph,” are bacteria found in the nose or skin. Staph are the most common cause of skin infections. Some Staph have developed resistance to the most common family of antibiotics that treat skin and blood infections. These Staph are called methicillin (antibiotic)-resistant Staphylococcus aureus (MRSA). MRSA infections are common in hospitals and other healthcare settings, like dialysis centers or nursing homes. MRSA infections in hospitals often affect the very old and the very young or the very sick. However, recently MRSA infections have been found in healthy people outside of the hospital. Most of these MRSA infections are found in the skin and soft-tissue (muscle, fascia, fat). Since they occur in people in the community, they are referred to as community-associated MRSA (or CAMRSA) infections.

CAMRSA is clinically and genetically different from MRSA infections that people acquire in healthcare settings. The information below should help consumers and healthcare professionals understand CAMRSA as a new and emerging disease.

People in Los Angeles County, the United States and around the world are getting skin infections caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). The Los Angeles County Department of Health Services, Public Health is working with the public, doctors and nurses to understand why this is happening and how to prevent these Staph/CA-MRSA skin infections from spreading.

Most MRSA infections can be treated with drainage of pus (removing liquid) and antibiotics, if needed. Sometimes MRSA can cause serious infections, even death. Contact your doctor right away if you think you have a MRSA infection. Getting appropriate care early can prevent these infections from becoming more severe. Don’t try to treat the infection yourself by picking or popping the sore.

MRSA can spread through skin to skin contact with an infected wound, or from contact with surfaces contaminated from skin infections like sports equipment or benches. It can also spread by sharing personal hygiene items like towels, razors, or soap that have come in contact with infected skin.