MULTI DRUG RESISTANT

BACTERIA-Methicillin resistant
Staphylococcus aureus (MRSA)
What is Multi Drug Resistant Bacteria?

Multiple drug resistance (MDR), multidrug resistance

or multiresistance is antimicrobial resistance shown by a species
of microorganism to multiple antimicrobial drugs. The types most
threatening to public health are MDR bacteria that resist
multiple antibiotics.
What is Antibiotic?

Antibiotics are synthesized by microbial cells

that inhibits or arrest the growth of other
micro organisms.

Antibiotics inhibit the growth by various

mechanisms.

They inhibit Protein synthesis, damaging cell

wall, interfere PG layer synthesis, inhibit
nucleic acid synthesis and prevent the
formation of cell membrane.
Cause for Antibiotic resistant:

Over-prescription of antibiotics.

Patients not finishing the entire antibiotic course.

Overuse of antibiotics in livestock and fish farming.

Poor infection control in health care settings.

Poor hygiene and sanitation.

Absence of new antibiotics being discovered.

Staphylococcus aureus:
Staphylococcus aureus is a Gram-Positive, Round
shaped, Non motile, Facultative anaerobe, Cocci
bacteria.

It is often Positive for Catalase and Nitrate

reduction test.

S.aureus is not always pathogenic it is the common

cause of skin infection and Respiratory infections.

Pathogenic strains often promote infections by

producing virulence factors such as
potent protein toxins, and the expression of a cell-
surface protein that binds and
inactivates antibodies. 
Methicillin-resistant Staphylococcus aureus (MRSA)
Methicillin-resistant Staphylococcus aureus (MRSA) refers
to a group of gram-positive bacteria that are genetically
distinct from other strains of Staphylococcus aureus.
MRSA is a type of staph bacteria that is resistant to
certain antibiotics called betalactams (eg., Penicillins,
Carbapenems).

Staph was usually be treated with antibiotics but over

the decades some strains of staph like MRSA have
become resistant to antibiotics that once destroyed it.
MRSA Bacteria on SEM
MRSA was first discovered in 1961.It is now resistant
to Methicillin,Amoxicillin,Penicillin,Oxacillin and many
other antibiotics.
Mechanism of Resistance:
mecA is a gene found in bacterial cells which allows a
bacterium to be resistant to antibiotics such as Methicillin,
Penicillin and other Penicillin like antibiotics.

mecA is located on the Staphlococcal chromosome cassette

(SCCmec)gene.

This gene encodes the protein PBP2A (Penicillin binding

protein 2A).

PBP2A has a low affinity for Betalactam antibiotics such as

Methicillin and Penicillin.

This enables transpeptidase activity in the presence of

Betalactam, preventing them from inhibiting cell wall
synthesis.
Virulence Factors of MRSA bacteria:
MRSA expresses many potential virulence factors:

Surface proteins that promote colonization of host tissues.

Invasins that promote bacterial spread in tissues (leukocidin, kinases, hyaluronidase)

Surface factors that inhibit phagocytic engulfment (capsule, Protein A)

Biochemical properties that enhance their survival in phagocytes (carotenoids, catalase

production)

Immunological disguises (Protein A, coagulase, clotting factor)

Membrane-damaging toxins that lyse cell membranes (hemolysins, leukotoxin,leukocidin)

Exotoxins that damage host tissues or otherwise provoke symptoms of disease (SEA-G,
TSST, ET)

Inherent and acquired resistance to antimicrobial agents.

Clinical Manifestation:
Cellulitis–a
Folliculitis–an
“flat” skin
infection of the
infection which
hair follicles.
can make the skin
red, painful and
warm but does
not have pustules.

Impetigo–
Boils–an abscess, pustules (bulbous
bump, or swelling impetigo) or
within the skin. honey colored
Also called a crusted lesions
furuncle. on the skin
Detection methods of MRSA:
Disc diffusion Test:
Colony suspension prepared from 5 colonies and plated on
Muller hinton agar containing 2-4% Nacl at neutral pH.
Oxacillin disc placed and incubated at 35 C for 24 hours.
<10mm is considered to be resistant and >13mm as sensitive.
Any growth within the zone of inhibition indicates Oxacillin
resistance.

MRSA resisting Other Detection methods are:

Oxacillin on Muller Oxacillin agar Screen
hinton agar plate Broth Microdilution
PCR method (Detection of mecA gene)
Latex agglutination(Detection of PBP2a)
Treatment:
Some infections may only need to be drained, cleaned,
and covering. Oral antibiotics can treat MRSA, but
because it doesn’t respond to many common drugs like
methicillin, amoxicillin, penicillin, oxacillin, and
cephalorsporins, alternatives may be used (clindamycin,
trimethoprim-sulfamethoxazole, or linezolid).

Prevention:
Frequent hand washing with soap and water and using an
alcohol-based hand sanitizer are great ways to avoid MRSA.
 Don't touch other people's wounds or bandages or share
personal items.
During a hospital stay, remind staff members to wash
their hands before they touch us.
Control of Multi drug resistant bacteria:
Only use antibiotics when they are needed and as
directed.

Complete take course of antibiotic even become

healthy.

Maintain good hygiene such as hand washing.

Control of antibiotic usage for non-therapeutic

purposes.

Use masks,gloves and other safety measures before

visitng any infected persons.

Avoid usage of antibiotics without prescription.

Conclusion:
Increasing antibiotic resistance in the world with the emergence of varied
infections of MRSA should be seriously considered.

The extensive use of antibiotics and improper health care settings are
involved in the development of such strains.

The diagnosis and management of all these infections should be considered

with care to prevent any further complications arising from it.

Extensive research should be initiated in this aspect to develop a new range of

antimicrobial agents and control these infections.

The use of antibiotics needs to be set up with proper guidelines and certain
parameters for their prescription.
THANK YOU..!
FOR YOUR
ATTENTION..!