Can MRSA Be A Sign Of Cancer?

MRSA (Methicillin-resistant Staphylococcus aureus) like symptoms cannot be a sign of cancer, but an individual suffering from symptomatic or asymptomatic cancer may develop MRSA. The published data1 indicates symptomatic MRSA infection was observed in patients who have erythrodermic cutaneous T-cell lymphoma (CTCL). The incidence of MRSA was high in erythrodermic CTCL patients.1

An individual suffering from undiagnosed cancer often suffers from low immunity. Such a patient may develop severe MRSA infection. The literature indicates MRSA infection of the biceps tendon was observed in patients who have lung cancer and diabetes.2

The question is can MRSA be a sign of undiagnosed cancer. MRSA infection in patients who have blood cancer was frequently observed, resulting in severe symptoms needing treatment.3 Occasionally patients suffering from early cancer symptoms of MRSA may suggest possible underlying undiagnosed cancer.

Can MRSA Be A Sign Of Cancer?

MRSA, Antibiotic Resistance And Cancer

MRSA stands for Methicillin-resistant Staphylococcus aureus, which refers to a group of an organism that does not respond to beta-lactam antibiotics.MRSA infection is often seen in an individual who has developed resistance to the antibacterial effects of antibiotics. Antibiotics are prescribed for a bacterial infection that causes upper respiratory disease and gastrointestinal infection. Upper respiratory viral and bacterial infection causes running nose, cough, and fever. Similarly, viral, parasite and bacterial infection of the digestive tract causes symptoms like nausea, vomiting, and diarrhea. Viral and protozoa parasite infection does not respond to antibiotics. In several cases, signs of viral and parasite infection are treated with single or multiple courses of antibiotics. Use of antibiotics to treat the viral and parasitic infection that does not respond to such antibiotics often causes staphylococcus aureus resistance to these antibiotics. The parasite bacteria like staphylococcus aureus in human body when exposed to frequent antibiotic treatment changes genome pattern. Such microbiological changes results in resistance to standard dose of antibiotics.Such changes are also observed when individual does complete the prescribed course of antibiotics during respiratory tract or gastrointestinal infection. The staphylococcus bacteria in few cases develop resistance to broad-spectrum antibiotics when these antibiotics are frequently prescribed for viral or other bacterial infection. Occasionally antibiotic-resistant MRSA infection is observed in an asymptomatic patient suffering from early stages of cancer. The Staphylococcus aureus bacteria are opportunist bacteria. Bacteria rapidly multiply in low immune cancer patients and causes MRSA infection. The infection become very difficult to treat if staphylococcus aureus bacteria are resisting the antibiotic treatment. High mortality rate and resistance to vancomycin treatment is observed in a patient who has cancer and MRSA infection.4

MRSA Infection And Antibiotics

MRSA can be a hospital-acquired or community-acquired disease.5 The word“hospital-acquired” means infections that occur when the patient had recent exposure to a hospital facility, nursing home, or rehabilitation center. The strains which are isolated from the hospital are less virulent as compared to those isolated from the community. No matter how virulent the strain is, they hardly got any carcinogenic potential. So neither hospital-acquired nor community-acquired MRSA can cause cancer. Staphylococcus Aureus develops resistance to methicillin and many other antibiotics due to the presence of a genetic element known as the mecA gene.6 The mecA gene alters the penicillin-binding protein and hence does not allow binding of any beta-lactam antibiotics.The research and published data suggest mecA gene is not a cause of cancer. As of recent days, there is no evidence or direct co-relation between staphylococcus infection and cancer.

MERSA, Atopic Dermatitis And Cancer

Atopic dermatitis or skin eczema is observed in several patients suffering from MRSA.7 Similarly, these conditions are also seen in patients who have skin cancer and lymphoma. There are few studies that suggests eczema is a premalignant lesion.8 There is not any research evidence that suggests MRSA causes skin eczema that is followed by skin cancer or lymphoma. But literature does suggest patients suffering from lymphoma and skin cancer may show signs of eczema and also MRSA.1,8 Several published scientific papers suggest patients suffering from MRSA had shown skin lesions like Eczema and also skin cancer.

MRSA, T Cell Lymphoma, And HTLV-1 Viral Infection

The published literature indicates adult T cell leukemia-lymphoma (ATL) is caused by human T-cell lymphotropic virus type 1 (HTLV-1).9 The HTLV-1infection also causes infective dermatitis, eczema, and superimposed skin infection. The superimposed secondary bacterial skin infection is often caused by MRSA.10 Though there is no evidence that MRSA infection triggers any cancer growth. Viral infection caused by HTLV-1 virus, triggers T cell lymphoma cancer that follows decrease in immunity and then develops secondary MRSA infection.. So, it is more likely that a cancer patient who has skin cancer and T cell lymphoma may suffer from secondary staphylococcus related infection.1,8 Very often, skin infections, which are mostly caused by Staphylococcus aureus, are considered to be most severe among individuals suffering from eczema and lymphoma.

Spread Of MRSA

MRSA infection spreads in several organs resulting in pneumoniaotitis mediameningitis, carbuncle, and impetigo. But none of these infection results in cancer or associated with cancer disease. The infections caused by MRSA are carefully treated with conservative therapy and antibiotics. The outcome of treatment in most cases are satisfactory.  The MRSA disease spreads from human to human by contact and touching the infected discharge from skin lesions on surrounding objects. Thus all health care workers should wear gloves all the time and wash their hands periodically when they are in touch with patient. Currently, methicillin-resistant Staphylococcus aureus related infection are treated with the more effective antibiotic. So with advancement in medical science, methicillin-resistant infection is no more lethal. Staphylococcus species possess no carcinogenic potential. They cause very less invasive infections. Mostly these causes superficial skin infections.

Diagnosis And Treatment Of MRSA

Diagnosis of MRSA-

The individual suffering from MRSA and eczema or skin infection must be evaluated for lymphoma, skin cancer, and HIV infection,though MRSA disease is not a cancer disease. The lab test to diagnose MRSA includes microscopic examination of samples of infected material. The tissue samples are also sent to the lab to develop a culture of bacteria that are treated with various antibiotics to find out the sensitivity of bacteria to antibiotics. The samples for microscopic examination and culture are collected from urine, stool, nasal secretion, and blood.

Treatment of MRSA

    1. Conservative
      1. Rest
      2. Fluids- Oral or intravenous
    2. Antipyretics

Tylenol

  1. Antibiotics- Following antibiotics are used for the treatment depending on resistance to antibiotics. Vancomycin is the most effective drug in treating MRSA.
    1. Vancomycin
    2. Telcoplania
    3. Telavancin
    4. Deptomycin
    5. Ceftaroline

References:

  1. Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in erythrodermic cutaneous T-cell lymphoma (CTCL) patients.
    Emge DA1,2 Bassett RL3Duvic M4Huen AO4, Arch Dermatol Res. 2020 May;312(4):283-288.
  2. Infectious tenosynovitis of the long head of the biceps caused by methicillin-resistant Staphylococcus aureus in a patient with diabetes and small cell lung cancer.
    Horiuchi K1Asakura T1,2Bessho Y3Saito F1., BMJ Case Rep. 2019 Mar 8;12(3). PII: e229040.
  3. Bloodstream infection caused by S. aureus in patients with cancer: a 10-year longitudinal single-center study.
    Bello-Chavolla OY1,2Bahena-Lopez JP1,2Garciadiego-Fosass P2,3Volkow P2Garcia-Horton A2,4Velazquez-Acosta C5Vilar-Compte D6., Support Care Cancer. 2018 Dec;26(12):4057-4065.
  4. Characteristics and outcomes of methicillin-resistant staphylococcus aureus bloodstream infections in patients with cancer treated with vancomycin: 9-year experience at a comprehensive cancer center.
    Mahajan SN1Shah JNHachem RTverdek FAdachi JAMulanovich VRolston KVRaad IIChemaly RF.,
    Oncologist.
     2012;17(10):1329-36. doi: 10.1634/theoncologist.2012-0029. Epub 2012 Jun 15.
  5. What is MRSA?
    Pantosti A1Venditti M., Eur Respir J. 2009 Nov;34(5):1190-6.
  6. mecA Gene Is Widely Disseminated in Staphylococcus aureus Population
    C. L. C. Wielders,* A. C. FluitS. BrisseJ. Verhoef, and F. J. Schmitz, J Clin Microbiol. 2002 Nov; 40(11): 3970–3975.
  7. The atopic dermatitis-like lesion and the associated MRSA infection and barrier dysfunction can be alleviated by 2,4-dimethoxy-6-methylbenzene-1,3-diol from Antrodia camphorata.
    Yang SC1Huang TH2Chiu CH3Chou WL4Alalaiwe A5Yeh YC6Su KW7Fang JY8., J Dermatol Sci. 2018 Nov;92(2):188-196. doi: 10.1016/j.jdermsci.2018.09.002. Epub 2018 Sep 7.
  8. [Differential diagnosis of chronic perianal dermatitis. Premalignant and malignant disorders] [Article in German] Wacker J1Hartschuh W., Hautarzt. 2004 Mar;55(3):266-72.
  9. A Review of New Findings in Adult T-cell Leukemia–Lymphoma: A Focus on Current and Emerging Treatment Strategies
    Olivier Hermine,1 Juan Carlos Ramos,2 and Kensei Tobinai3, Adv Ther. 2018; 35(2): 135–152.
  10. Infective Dermatitis in an Adult Patient With HTLV-1
    Beatriz Di Martino Ortiz, MD,* Rosalba Riveros, MD,* Raquel Medina, MD,* and Maida Morel, MD, Am J Dermatopathol. 2015 Dec; 37(12): 944–948.

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