Can MRSA Affect Your Kidney?
Yes, definitely MRSA can affect your kidney. For affecting any organ the infection has to be present in the blood. Similarly, when an organism is present in the bloodstream and it can easily invade any organ. Consequently, the kidneys can be easily involved in MRSA. Kidneys are usually affected by two mechanisms-
- Deposition of antigen-antibody complex which leads to an immunological mechanism. Preformed antigen and antibody complex within the bloodstream gets deposited on the endothelium lining of glomerulus which initiates an immunological reaction. Thus, damage to endothelium takes place. The patient usually presents with proteinuria and in severe cases hematuria.(1)
- Another mechanism by which renal damage takes place is through the direct invasion of the organism. Organism invades the endothelium and acts as an antigen against which an immune response is generated.
The best way of diagnosing antigen-antibody complex on endothelium is by immune fluorescence through electron microscopy.
At times methicillin-resistant Staphylococcus aureus infection can cause multisystem dysfunction ranging from infective endocarditis affecting heart valves to chronic kidney disease which eventually leads to renal failure.
What Are Its Symptoms?
Patient presents with following features-
- Proteinuria is the most evident and characteristic finding in a patient with renal disease.
- Edema- as there is protein loss from the body, oncotic pressure falls and there is shifting of fluid from intravascular compartment to extravascular compartment. This leads to edema.
- Hematuria which occurs when there is severe damage to lining epithelium. Presence of more than 3 RBC in high power field is characteristic.
- In severe cases, generalized body swelling is seen which usually starts from eyes.
Apart from glomerulonephritis other diseases are also evident in the case of renal involvement. An abscess is formed around the kidney which is known as perinephric abscess and pus start building up. Timely drainage of abscess along with antibiotic should be initiated as in severe cases it can cause damage of renal parenchyma. Slowly whole kidney is involved and end-stage renal damage sets in.
In case of renal abscess drainage should be done, also pus should be sent for culture and sensitivity testing. According to the culture reports appropriate antibiotics should be initiated. A lot of times due to false reports improper antibiotics are given and this leads to the development of resistance among the bacteria. Culture is thus gold standard investigation and hence excessive precaution should be taken. Once reports are found out to be negative no further antibiotics should be given to the patient. The most common cause of resistance in present scenario is prescribing antibiotic very frequently, incomplete dosing and giving antibiotic prior to culture. It should be kept in mind that antibiotic is life-saving drugs and their proper use should be done.
Abscess formation occurs in the immunocompromised patient, a diabetic patient, or in a patient on prolonged corticosteroid therapy. The patients who are on steroidal treatment are even resistant to a normal dose of antibiotics.
Kidney damage ranges from slight deterioration to end-stage renal damage.
Vancomycin is the drug of choice in case of methicillin-resistant Staphylococcus aureus infection. Fifth generation cephalosporin are preferred drugs. Overall parenteral antibiotics are preferred in case of kidney abscess.
It should be kept in mind that a patient with MRSA can get infected with a number of diseases. Septicemia can occur in severe cases.
Once bacteria enter bloodstream they may cause a various infection like empyema, kidney abscess, pneumonia, infective endocarditis, meningitis. This means that MRSA can affect any organ. No organ is spared. This is the reason why there are guidelines on the use of antibiotics as these resistant strains are highly virulent. If the not treated patient may lend up into septic shock. Culture is diagnostic.
MRSA infection is mostly seen in the hospital set up when parenteral antibiotics are given frequently. Community-acquired MRSA is more virulent as compared to hospital-acquired. Therefore proper use of antibiotics in hospitalized as a well-immunocompromised patient is mandatory.
Kidney disease patient who has suffered an episode of nephrotic syndrome should be more careful as there is a high chance of recurrence. Antibiotics like vancomycin should be given with care so as to prevent the development of resistance.
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