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Methicillin-resistant
Staphylococcus Aureus
- MRSA Sharon Walker, RN, BPS
Ingham County Health Department
MRSA
• Bacteria staphylococcus aureus (staph)
• Resistant to certain antibiotics
– Methicillin
– Oxacillin
– Penicillin
– Amoxicillin
• Very common occurrence
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Nosocomial
Community Acquired
• Nosocomial
– Acquired in a healthcare setting
• Community Acquired
– Non-hospitalized persons
– No recent medical procedures
– Otherwise healthy
3
Colonization
• Organisms are found but not causing
infection
• In general – colonization is not treated
Determinants of Resistance
• Organism
• Infection Control Practices
• Antimicrobial Use
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Optimizing Antimicrobial Use
•Decreases Resistance
•Reduces Costs
•Decreases Antimicrobial Adverse Events
Current Antimicrobial Use
• 20-50% of pharmaceutical costs
• $1.2 billion spent in hospitals
• Broad spectrum antibiotic use is increasing
• 100 million courses of Antibiotics prescribed
annually – up to 80% are viruses
Treatment of MRSA Infection
• Sometimes no treatment is the best
treatment
• Removal of a devise (tube)
• Appropriate antibiotic selection
• Will treating the infection help the patients
quality of life?
Infection Control Practices
Standard Universal Precautions is sufficient
unless it is an outbreak situation or there is
evidence of transmission via HCW.
Contact Precautions
1.
2.
3.
4.
5.
6.
7.
Hand washing
Patient placement
Hand washing
Barrier protection
Hand washing
Environmental cleaning
Hand washing
Housekeeping
1. Routine terminal cleaning
detergent/disinfectant
2. Discard water when done and wash the
bucket
3. Trash is not regulated medical waste
4. Environment is not routinely cultured
Laundry - Dietary
1. Gown and glove for dirty linen as usual
2. Launder items as usual
3. No need for red bags
4. Regular food trays can be used
Collecting Lab Specimens
In General
1. Collect specimens before starting antibiotic
2. Don't culture during antibiotic therapy
3. If follow up cultures are needed - wait 72
hours after treatment completion
Strategic Goals
1. Prevent Infections
2. Diagnosis and treat infections effectively
3. Use Antimicrobials wisely
4. Prevent transmission
Other Resistant Pathogens
1.
2.
3.
4.
5.
6.
Escherichia coli
Coagulase-negative staphylococcus
Enterococci
Pseudomonas aeruginosa
Enterbacter
Klebsiella pneumoniae
Resources
Centers for Disease Control and
Prevention
www.cdc.gov
select “index a – z”
select first letter of condition
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