MRSA

Dorothy MacEachern, MS, MPHOctober 2007509.324.1569

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

History of MRSAPenicillin 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 Community1980 Injection drug users 1990s Children in child care1990s Native Americans1990s Prison and jail populations1999Urban 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 contactopenings in the skin such

as cuts or abrasionscontaminated items and

surfaces crowded living conditionspoor hygienesharing personal items

Transmission within households is common.

MRSA InfectionsMost often occur in skin and soft tissue.

How are MRSA skin infections treated?At home:

Wash with soap and waterApply an over-the counter antibiotic creamCover 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 drainageExample: Shaking hands

Indirect contact – touching contaminated objects and then touching skin or membranes Example: Touching a door handle, then touching

broken skin

Hand HygieneThe 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 SurfacesClean first – remove soil w/soap and water

Disinfect – wipe down surfaces with an EPA-approved 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 homeDo 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 settingsShower

After using public gym equipmentAfter using sauna/pool benchesAfter participating in sports practice or

competitionUse barriers

Gloves for cleaningTowels on equipment/benches

Clean and disinfect surfaces

Help reduce the spread of MRSA in schoolEncourage students & staff to wash their

hands regularlyClean 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, rememberWash 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=12http://www.doh.wa.gov/Topics/Antibiotics/

MRSAhttp://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.

html

Your local health department!