Two potentially fatal bacterial infections that are becoming more common in hospitals, doctors' offices, and nursing homes are MRSA (methicillin- resistant Staphylococcus aureus) and C. diff (Clostridium difficile), the latter being one of the most important causes of infectious diarrhea in the U.S. Using Web resources, describe causes, symptoms, treatments, and preven- tion of these two serious bacterial diseases.

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# MRSA (Methicillin‐Resistant Staphylococcus aureus)

## Causes
- **Bacterial Agent:** MRSA is caused by a strain of *Staphylococcus aureus* that has acquired resistance to methicillin and other beta‐lactam antibiotics. 
- **Transmission:** It spreads through direct contact with infected wounds, contaminated hands, or surfaces. Hospitals, doctors' offices, and nursing homes are common settings for transmission.

## Symptoms
- **Skin Infections:** Red, swollen, painful bumps that may resemble pimples or boils. These can sometimes drain pus.
- **Invasive Infections:** In severe cases, MRSA may cause pneumonia, bloodstream infections, or surgical site infections. Patients might experience fever and chills.

## Treatment
- **Antibiotic Therapy:** Although resistant to methicillin, MRSA can sometimes be treated with other antibiotics. Common options include:
  - Vancomycin $$\text{(often dosed as } 15\text{–}20\,\text{mg/kg IV every 8–12 hours)}$$.
  - Linezolid or Daptomycin, depending on the infection's severity and location.
- **Drainage of Abscesses:** In cases of localized skin infections, surgical drainage along with antibiotics is a common approach.

## Prevention
- **Hand Hygiene:** Frequent and proper hand washing with soap and water or using alcohol-based hand sanitizers.
- **Contact Precautions:** Use of gloves and gowns when interacting with infected individuals.
- **Environmental Cleaning:** Regular disinfection of surfaces in healthcare environments.
- **Screening and Isolation:** Identifying and isolating infected or colonized patients in healthcare settings to prevent spread.

---

# C. diff (Clostridium difficile)

## Causes
- **Bacterial Agent:** *Clostridium difficile* is a gram-positive, spore-forming bacterium.
- **Antibiotic Association:** It often causes infection after a patient has taken antibiotics, which disrupt the normal gut microbiota. This allows *C. difficile* to proliferate.
- **Spore Formation:** Its spores are resistant to many common cleaning agents, making it highly transmissible in healthcare settings.

## Symptoms
- **Gastrointestinal Distress:** Watery diarrhea is the most common symptom.
- **Abdominal Pain:** Cramping and severe abdominal discomfort.
- **Fever and Nausea:** Additional symptoms can include fever, loss of appetite, and general malaise.
- **Severe Complications:** In extreme cases, patients can develop pseudomembranous colitis or toxic megacolon, conditions that can become life-threatening.

## Treatment
- **Antibiotics Specific to C. diff:**
  - **Mild to Moderate Cases:** Metronidazole may be used.
  - **Severe Cases:** Oral Vancomycin is the treatment of choice, often administered as:
    $$
    \text{Vancomycin } 125\text{ mg every 6 hours (for a typical course)}
    $$
  - **Alternative:** Fidaxomicin is another option for treatment.
- **Restoration of Gut Flora:** In recurrent cases, fecal microbiota transplantation (FMT) is being used to restore healthy intestinal bacteria.

## Prevention
- **Antibiotic Stewardship:** Careful and judicious use of antibiotics to minimize disruption of normal gut flora.
- **Hand Hygiene:** As *C. difficile* spores are resistant to alcohol-based hand sanitizers, thorough hand washing with soap and water is essential.
- **Environmental Cleaning:** Use of chlorine-based disinfectants to effectively eliminate spores from surfaces.
- **Isolation Precautions:** In healthcare settings, patients infected with *C. difficile* should be isolated to prevent spread.

**MRSA (Methicillin-Resistant Staphylococcus aureus) and C. diff (Clostridium difficile): Causes, Symptoms, Treatments, and Prevention** --- ### MRSA (Methicillin-Resistant Staphylococcus aureus) - **Causes:** Caused by a strain of *Staphylococcus aureus* resistant to methicillin and other antibiotics. Spreads through contact with infected wounds, hands, or surfaces in hospitals, doctors' offices, and nursing homes. - **Symptoms:** Red, swollen, painful skin bumps that may drain pus. In severe cases, pneumonia, bloodstream infections, or surgical site infections with fever and chills. - **Treatment:** Treated with antibiotics like vancomycin, linezolid, or daptomycin. In some cases, surgical drainage of abscesses is necessary. - **Prevention:** Good hand hygiene, use of gloves and gowns in healthcare settings, regular environmental cleaning, and isolation of infected patients to prevent spread. --- ### C. diff (Clostridium difficile) - **Causes:** Caused by *Clostridium difficile*, a bacterium that thrives after antibiotic use disrupts normal gut bacteria. Spores are resistant to many cleaning agents and can survive in healthcare environments. - **Symptoms:** Watery diarrhea, abdominal pain, fever, and nausea. In severe cases, pseudomembranous colitis or toxic megacolon can occur. - **Treatment:** Treated with antibiotics like metronidazole or vancomycin. Fidaxomicin is an alternative. In recurrent cases, fecal microbiota transplantation may be used. - **Prevention:** Stewardship of antibiotic use, thorough hand washing with soap and water, use of chlorine-based disinfectants, and isolation of infected patients to prevent spread. ---

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