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Dorothy MacEachern, MS, MPH October 2007 509.324.1569 What is MRSA? Methicillin-resistant Staphylococcus aureus Staphylococcus aureus, often called “staph” is a bacteria commonly found on skin and in the nose. A person can self-inoculate cuts or wounds. (A staph infection that is) resistant to methicillin and other common antibiotics. Spectrum of Staphylococcal Effects Harmless inhabitant of nose/skin (colonization)> Auto inoculation of cuts or wounds > Skin infections, folliculitis, impetigo, boils, etc.> Abscesses, cellulitis, sinusitis > Osteomyelitis, arthritis, pneumonia > Endocarditis, meningitis, septicemia History of MRSA Penicillin resistant staph appeared in 1942. Methicillin introduced in 1959. Methicillin resistant staph appeared in United Kingdom in the 1960s. United States saw first MRSA cases in 1968, usually in hospital settings, and it spread through health care facilities in the 1970s. Healthcare acquired (HA-MRSA) HA-MRSA Associated Risk Factors • prolonged stays in hospital settings (esp. ICUs or Burn Units) or long term care settings. • broken skin, from surgical wounds or pressure ulcers. • recent use of antibiotics, especially prolonged or broad spectrum antibiotics. • severe underlying illness. Generally transmitted by health care workers. MRSA Shows up in the Community 1980 1990s 1990s 1990s 1999 Injection drug users Children in child care Native Americans Prison and jail populations Urban homeless populations Usually these were people who had no recent contact with health care facilities. CA-MRSA Associated Risk Factors • Recent antibiotic use • Injection Drug Use • Incarceration • Contact Sports close skin-to-skin contact openings in the skin such as cuts or abrasions contaminated items and surfaces crowded living conditions poor hygiene sharing personal items Transmission within households is common. MRSA Infections Most often occur in skin and soft tissue. How are MRSA skin infections treated? At home: Wash with soap and water Apply an over-the counter antibiotic cream Cover with a bandage, if possible If wound is not healing, see a health care provider: A health care provider may: drain the infection and/or prescribe an antibiotic based on culture results MRSA spreads 2 ways: Direct contact – skin to skin contact, or contact with drainage Example: Shaking hands Indirect contact – touching contaminated objects and then touching skin or membranes Example: Touching a door handle, then touching broken skin Hand Hygiene The single most effective practice to reduce the spread of infection. Use warm water and soap. Wash for 20 seconds. Use a paper towel to turn off water and open door. Antiseptic gels are great when soap and water are not available! Use one with a concentration of >60% ethyl alcohol. Clean & Disinfect Surfaces Clean first – remove soil w/soap and water Disinfect – wipe down surfaces with an EPAapproved disinfectant effective against staph, such as: Solution of 1 T bleach in 1 quart of water Clorox or Lysol wipes Help reduce the spread of MRSA at home Do not share personal items (razors, clippers, towels, etc.) Care for and cover wounds. If a wound is not healing, see a health care provider. If a wound is draining and cannot be covered and contained, stay home! Wash your hands well. Wash your hands often. Clean and disinfect surfaces often, especially in high traffic areas. Take prescribed antibiotics appropriately. Help reduce the spread of MRSA in public settings Shower After using public gym equipment After using sauna/pool benches After participating in sports practice or competition Use barriers Gloves for cleaning Towels on equipment/benches Clean and disinfect surfaces Help reduce the spread of MRSA in school Encourage students & staff to wash their hands regularly Clean and disinfect: Sports equipment such as wrestling gear (after each use), floor mats (before and after each practice session) AND Surfaces that come in direct contact with skin such as phones & keyboards, desktops, tables, door knobs, light switches (daily) So, remember Wash your hands well. Wash your hands often. Do not share personal items. Keep cuts covered. Seek medical care for non-healing skin infections. Take prescribed antibiotics as directed. Clean and disinfect surfaces regularly. Great resources for MRSA info: http://www.tpchd.org/page.php?id=12 http://www.doh.wa.gov/Topics/Antibiotics/MRSA http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html Your local health department!
