MRSA among burn patients: Relevance, epidemiology and control

Abstract

Burn wounds provide ideal conditions for colonization and infection with several bacteria. This, alongside with the extensive use of antimicrobials in burn units, facilitates the spread of multidrug-resistant organisms (MDROs). Methicillin-resistant Staphylococcus aureus (MRSA) stands out as one of the most threatening MDROs. The burn wound site, degree and extension are associated with greater risk for the acquisition of MRSA. Other factors, such as invasive procedures, prolonged hospitalization and antimicrobial therapy have been associated with MRSA colonization or infection. MRSA-infected patients are at greater risk of death, and may transmit the pathogen to others. The recognition of the clinical importance of MRSA in burn patients highlights the need of appropriate infection control measures that aim to minimize transmission among vulnerable patients. In that setting, the ever changing epidemiology of this microorganism makes it necessary to apply molecular epidemiology methods, in order to identify the circulation of specific clones, the spread of resistance phenotypes and the virulence of strains. Active surveillance of MRSA colonization and infection is an essential part of any strategy aimed at preventing or controlling that agent. In this chapter we will discuss aspects of MRSA epidemiology, antimicrobial resistance and virulence, and their implications for burn patients. We will also address the current recommendations for surveillance and control of MRSA among that population.