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mrsa_overview_2010

MRSA (Methicillin-resistant Staphylococcus aureus) Infection 

Animal group affected Transmission Clinical

Signs

Severity Treatment Prevention and Control Zoonotic
Mammals

People

Direct contact with contaminated surfaces,

contact with contaminated surfaces

Minor to severe: skin redness, pustule red lesions, boils, rash fever, headache, malaise Typically mild, but may be fatal in the immune compromised.  There are no reports of mortality rates in animals, but this is becoming more common in foals in ICU. Wound care, and susceptible antibiotics as determined by testing, if needed Personal/ environmenthygiene.   Wear gloves when working with known infected animal/

equipment

Yes

 


 


Fact Sheet compiled by:   Tara M. Harrison
Sheet completed on:
Fact Sheet Reviewed by:

Julie Napier, Kathryn Gamble, Dalen Agnew, Christine Fiorello, and Donald Janssen

Susceptible animal groups

Mammals, avian (+/-)

Causative organism

Methicillin-resistant Staphylococcus aureus, also Methicillin-resistant Staphylococcus pseudointeritidis

Zoonotic potential

Yes

Distribution

Crowded living conditions, group work and gyms, closely shared work and locker spaces, long-term care or rehabilitation facilities, hospitals.

Incubation period

1-10 days

7% of people in hospitals and 2% of people in the community can have MRSA colonization with no clinical signs.  It is thought that <10% to up to 90% of dogs and cats can be non-clinical carriers as well.

Clinical symptoms

Healthy people and animals typically do not develop disease under normal circumstances.

Humans

Skin redness, “pimple-like” red lesions, boils, rash, fever, headache, malaise

Animals

Primarily skin infections or skin wounds although necrotizing pneumonia or other general infection may occur.

Post mortem, gross, or histologic findings

This bacterium can produce a wide spectrum of clinical disease, particularly of the skin.  In humans these diseases including impetigo, folliculitis, furunculosis, cellulitis, abscesses and wound infections.  Other diseases include necrotizing pneumonia, endocarditis, septic arthritis, osteomyelitis, meningitis, and septicemia.  In animals abscesses, dermatitis, fistulas have been reported; as well as pneumonia, rhinitis, bacteremia, septic arthritis, osteomyelitis, omphalophlebitis, metritis, and mastitis.  Post-mortem lesions are similar to any other purulent bacterial infection and vary with the organ or tissue involved in the infection.

Diagnosis

Bacterial culture and antibiotic susceptibility testing

Material required for laboratory analysis

Culture swab or tissue sample of the affected area

Relevant diagnostic laboratories

Any laboratory capable of bacteriologic culturing is capable of diagnosing MRSA

Treatment

Typically resistant to all ß-lactam agents, including cephalosporins and carbapenems. Hospital-associated MRSA isolates often are resistant to multiple commonly used antimicrobial agents, including erythromycin, clindamycin, and tetracycline, while community-associated MRSA isolates are often resistant only to ß-lactam agents and erythromycin.

Treatment specifically depends on the specific MRSA isolate, and its antibiotic sensitivity profile.  This will require sensitivity testing on ALL isolates (and possibly repeated testing on isolates from a single case).

In humans:  Vancomycin and two newer antimicrobial agents, linezolid, and daptomycin are used for severe Hospital-associated MRSA infections

Prevention and control

Follow all wound care procedures recommended by veterinarian or physician.  Practice good hygiene; wash hands often.  Keep cuts and scrapes clean and cover with bandages, avoid direct contact with cuts and scrapes, use gloves to treat wounds, replace and disinfect items in holding or exhibit frequently.  Porous surfaces such as blankets need to be washed in hot water using bleach and a hot air dryer to help kill bacteria.  Alcohol-based hand cleaners are effective when hands aren’t dirty.

Isolate the patient if possible to minimize staff contact and exposure. Animal cages should be clearly marked with the diagnosis and preventative measures required.  Maintain infected animal in isolation or away from other animals until wound(s) are healed or cultures are negative.  If treatment of the animal is not possible, humane euthanasia of infected animal may be warranted to minimize risk of infection to staff and other animals.

Suggested disinfectant for housing facilities

After cleaning gross contamination, 1 tablespoon of bleach to one quart of water, fresh daily, leave solution on to dry, or wipe dry after 10 minutes. Other disinfectants effective against Staphylococcus aureus or Staph are also most likely also effective against MRSA.  Check the disinfectant product’s label on the back of the container to verify it is effective against it.

Notification

Public health officials may need to be notified if zoonotic transmission occurs, depending on the state.

Measures required under the Animal Disease Surveillance Plan

Currently none

Measures required for introducing animals to infected animal

Maintain infected animal in a quarantine situation until the wound is healed. Do not introduce infected animal to an animal with a compromised immune system. 

Conditions for restoring disease-free status after an outbreak

Clean infected environment with diluted bleach to the extent possible.  Minimize contact of infected staff with animal.

Experts who may be consulted:

J. Scott Weese DVM DVSc DipACVIM

Dept of Pathobiology

Ontario Veterinary College

University of Guelph

Guelph, Ontario

jsweese@uoguelph.ca

http://www.wormsandgermsblog.com

http://www.equidblog.com

References

http://www.cdc.gov/ncidod/dhqp/ar_mrsa.html 

http://www.wormsandgermsblog.com/articles/diseases/test-subcategory/ 

1.  Diana, A., C. Guglielmini, M. Pivetta, A. Sanacore, M DiTommaso, P. F. Lord, M. Cipone.  2009.  Infection with methicillin-resistant Staphylococcus pseudointermedius masquerading as cefoxitin susceptible in dogs.  J. Am. Vet. Med. Assoc.  235: 1064-1066.   

2.  Dvorak, G., A. Rovid-Spickler, J. Roth (eds.).  2008.  Handbook for Zoonotic Diseases of Companion Animals.  The Center for Food Security and Public Health.  Iowa State University, College of Veterinary Medicine, Ames, Iowa.  Pp: 177-184. 

3. Janssen DL, Lamberski N, Donovan T, Sugerman DE, Dunne G. Methicillin-resistant Staphylococcus aureus infection in an African elephant (Loxodonta africana) calf and caretakers.. In: 2009 Proceedings AAZV AAWV Joint conference.; 2009:200-201.  

4. Methicillin-resistant. Staphyococcus aureus skin infections from an elephant calf -. San Diego, California, 2008. MMWR. 58:194-198. 

5.  MRSA:  What you should know.  Michigan Department of Community Health. 

6.  MRSA control and prevention at home for people with pets.  County of San Diego. Community Epidemiology Branch. 

7. National Association of Public Health Veterinarians. Compendium of veterinary standard precautions for zoonotic disease prevention in veterinary personnel.   J. Am. Vet. Med. Assoc.  2008; 233:415-430.

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