Transcript Educational Power Point on MRSA

Mark Eades
Director of Sales
SPORTS-O-ZONE
SANITIZING SYSTEM
Staph Germs Harder than Ever to Treat, Studies Say
By Marilynn Marchione, Associated Press Writer , Wed, Nov. 05 2008 01:14 PM EST
WASHINGTON – Drug-resistant staph bacteria picked up in ordinary
community settings are increasingly acquiring "superbug" powers and
causing far more serious illnesses than they have in the past, doctors
reported Monday. These widespread germs used to be easier to treat than
the dangerous forms of staph found in hospitals and nursing homes.
"Until recently we rarely thought of it as a problem among healthy people in
the community," said Dr. Rachel Gorwitz of the federal Centers for Disease
Control and Prevention.
Now, the germs causing outbreaks in schools, on sports teams and in
other social situations are posing a growing threat. A CDC study found that at
least 10 percent of cases involving the most common community strain were
able to evade the antibiotics typically used to treat them.
The conference is a joint meeting of the American Society for Microbiology and the Infectious Diseases Society
of America.
SPORTS-O-ZONE
SANITIZING SYSTEM
What is staph?
• Staphylococcus, or staph, is a group of
infectious bacteria which can cause a variety of
conditions ranging from skin rashes to
abscesses.
• Staph is actually an extremely common bacteria,
living on the surface of all human skin, but it will
take advantage of vulnerability in the skin to
enter the body, causing infection and discomfort.
• According to the Center for Disease Control
(CDC) 25% to 30% of humans have the staph
bacterium on their skin or in their nose .
SPORTS-O-ZONE
SANITIZING SYSTEM
What is drug resistant staph?
• Methicillin-resistant Staphylococcus aureus
(MRSA) is a type of bacteria that is resistant to
certain antibiotics. These antibiotics include
methicillin and other more common antibiotics such
as oxacillin, penicillin and amoxicillin. Staph
infections, including MRSA, occur most frequently
among persons in hospitals and healthcare
facilities who have weakened immune systems.
(CDC)
SPORTS-O-ZONE
SANITIZING SYSTEM
Who has MRSA?
• Approximately 1% of the U.S. population (roughly
2.3 million persons).
• Serious MRSA infections occur in approximately
94,000 persons each year and associated with
approximately 19,000 deaths.
• Of these infections, about 86% are healthcareassociated and 14% are community-associated.
Journal of the American Medical Association
SPORTS-O-ZONE
SANITIZING SYSTEM
What is the difference between Healthcare and
Community MRSA?
• Healthcare-Associated MRSA (HA-MRSA)
occurs most frequently among persons in
hospitals and healthcare facilities who have
weakened immune systems.
• Community-Associated MRSA (CA-MRSA)
infections are not acquired by people through
hospitalization or medical procedures. Typically
these infections manifest themselves as pimples
or boils, and occur in otherwise healthy people.
SPORTS-O-ZONE
SANITIZING SYSTEM
What are the risk groups for MRSA?
• Athletes (1st group--wrestling, football, and rugby. 2nd group--soccer,
basketball, field hockey, volleyball, rowing, martial arts, fencing, and
baseball.)
•
•
•
•
•
•
•
Military recruits
Children
Pacific Islanders
Alaskan Natives
Native Americans
Men who have sex with men
Prisoners
Center for Disease Control
SPORTS-O-ZONE
SANITIZING SYSTEM
What factors are common to these risk
groups?
• Close skin-to-skin contact
• Openings in the skin such as cuts or
abrasions
• Contaminated items and surfaces
• Crowded living conditions
• Poor hygiene
Center for Disease Control
SPORTS-O-ZONE
SANITIZING SYSTEM
How fast can MRSA attack?
• Ricky Lannetti’s story demonstrates – a
healthy college athlete went from first
symptom to death in 5 days.
• In 2007, healthy Virginia student from
symptom to death in 7 days.
• 2 cases in California prisons went from
first symptom to death in 3 days.
• CA-MRSA can rapidly progress to blood
stream, joints, and organs.
SPORTS-O-ZONE
SANITIZING SYSTEM
SPORTS-O-ZONE
SANITIZING SYSTEM
SPORTS-O-ZONE
SANITIZING SYSTEM
SPORTS-O-ZONE
SANITIZING SYSTEM
15 year old with a MRSA infection on right thigh, Fall 2008
SPORTS-O-ZONE
SANITIZING SYSTEM
Removal of 15 yr old MRSA puss pocket, Fall 2008
SPORTS-O-ZONE
SANITIZING SYSTEM
15 yr old MRSA site drainage, Fall 2008
SPORTS-O-ZONE
SANITIZING SYSTEM
Cost of 15 year old MRSA Removal
• Emergency Room
• Doctor follow up
• Total
$ 2,605.54
$
97.80
$ 2,703.34
Missing from total - “antibiotics.”
SPORTS-O-ZONE
SANITIZING SYSTEM
SPORTS-O-ZONE
SANITIZING SYSTEM
SPORTS-O-ZONE
SANITIZING SYSTEM
SPORTS-O-ZONE
SANITIZING SYSTEM
Fig. 1 Chronic MRSA periprosthetic total
knee sepsis. Courtesy of Richard P.
Evans, MD
Athletic trainer-- from scratch on
elbow to above in 30 hrs. Close call
on potential amputation.
SPORTS-O-ZONE
SANITIZING SYSTEM
Abscess: Incision and Drainage
SPORTS-O-ZONE
SANITIZING SYSTEM
SPORTS-O-ZONE
SANITIZING SYSTEM
MRSA is often misdiagnosed as:
• Spider bite
• Cellulites
• Impetigo (blistering skin infection)
• Harmless pimple
Most common treatment (the irony):
• Antibiotics
SPORTS-O-ZONE
SANITIZING SYSTEM
Reason Resistant bugs exist:
• Antibiotic Overuse
• When the Rams had their outbreak, the
CDC found their level of antibiotic use at
10 times normal
• Empiric (doing what we’ve always done) and
prophylactic (preventive) use of antibiotics
cited as a leading cause of MDROs
(Multi Drug Resistant Organisms)
SPORTS-O-ZONE
SANITIZING SYSTEM
What does MRSA need to live?
• Bacteria have the same needs as many
other organisms. They must obtain food
(dried skin is one), break the food down,
and protect themselves from their
environment.
• Ideally warmth, moisture, air (not always),
and food (skin and nose).
SPORTS-O-ZONE
SANITIZING SYSTEM
What is the life span of MRSA?
• 7 months on dust
• 56 days on a mop head
• 203 days on a blanket
• 9 weeks on cotton
SPORTS-O-ZONE
SANITIZING SYSTEM
MRSA is much more likely to get worse
than better:
• Antibiotic options are shrinking
• Exposure increasing
• Low-risk environments becoming scarce
SPORTS-O-ZONE
SANITIZING SYSTEM
Conflicting data from medical
community?
SPORTS-O-ZONE
SANITIZING SYSTEM
60 minutes, November 11, 2007
"Everyone agrees that this an epidemic.
And not only is it an epidemic. But, it's
an epidemic of our times. It's here in
huge numbers," says Dr. Robert Daum,
an infectious disease pediatrician at the
University of Chicago Medical Center.
SPORTS-O-ZONE
SANITIZING SYSTEM
AP Washington, November 7, 2007
(AP) Drug-resistant staph infections that have made headlines in recent
weeks come from what one of the nation's top doctors calls “the
cockroach of bacteria” -- a bad germ that can lurk in lots of places, but
not one that should trigger panic.
“This isn't something just floating around in the air,” Dr. Julie
Gerberding, head of the Centers for Disease Control and
Prevention, told members of Congress on Wednesday.
It takes close contact -- things like sharing towels and razors, or rolling
on the wrestling mat or football field with open scrapes, or not bandaging
cuts -- to become infected with the staph germ outside of a hospital, she
said.
Called MRSA, the staph germ is preventable largely by common
sense hygiene, Gerberding stressed.
“Soap and water is the cheapest intervention we have, and it's one
of the most effective,” she told a hearing of the House Committee on
Oversight and Government Reform.
SPORTS-O-ZONE
SANITIZING SYSTEM
Compliance rates of healthcare
workers in hand hygiene are known to
be around 50% [1]. Due to the
overwhelming evidence of low
compliance with hand hygiene, the
risk from contaminated surfaces
cannot be overlooked [2].
[1] Kampf G, Kramer A: Epidemiologic background of hand hygiene and evaluation of the most
important agents for scrubs and rubs. Clinical Microbiology Reviews 2004, 17:863-893.
[2] BioMed Central, Infectious Diseases, 2006
SPORTS-O-ZONE
SANITIZING SYSTEM
The BioMed Central (BMC) Journal, Infectious Diseases, 2006
references “the persistence (ability to survive) of clinically relevant
bacteria on inanimate surfaces (table, floor, bed rail, operating table,
etc.)” can vary in duration. The following were documented to
survive on inanimate surfaces:
• Bordetella pertussis (whooping couch) up to five days
• Chlamydia pneumoniae (community acquired pneumonia) up to 30
hours
• Corynebacterium diphteriae (diphtheria) up to 6 months
• Escherichia coli (E. coli) up to 16 months
• Pseudomonas aeruginosa (pneumonia) up to 16 months and 5
weeks on a dry floor
• Enterococcus spp., including VRE (vanocomycin-resistant) and VSE
up to 4 months
• Staphylococcus aureus, including MRSA (methicillin-resistant) up to
7 months.
SPORTS-O-ZONE
SANITIZING SYSTEM
“A single hand contact with a contaminated
surface results in a variable degree of pathogen
transfer. Transmission to hands was most
successful with Escherichia coli, Salmonella
spp., Staphylococcus aureus (all 100%),
Candida albicans (90%)….Contaminated hands
can transfer viruses to 5 more surfaces or 14
other subjects. Contaminated hands can also
be the source of re-contaminating the
surface….”
BioMed Central (BMC) Journal, Infectious Diseases, 2006
SPORTS-O-ZONE
SANITIZING SYSTEM
Fox News, March 17, 2009
NEW YORK — Roughly one in three stethoscopes carried by emergency
medical service (EMS) providers harbor the superbug MRSA
(methicillin-resistant Staphylococcus aureus), a small study carried
out at one hospital shows.
The investigation checked 50 stethoscopes provided by EMS professionals in
an emergency department.
Dr. Mark A. Merlin, from Robert Wood Johnson Medical School, New
Brunswick, New Jersey, and colleagues found 16 stethoscopes were
colonized with MRSA.
Sixteen of the EMS personnel could not remember the last time their
stethoscope was cleaned, according to the report in the journal Prehospital
Emergency Care. Typically, the time from last stethoscope cleaning to the
test date was 1 to 7 days.
As might be expected, with more recent cleaning, the odds of MRSA
colonization fell significantly.
"In most busy EMS systems, the concept of cleaning an entire ambulance after
every patient is not practical," Merlin's team notes. "Cleaning a stethoscope,
however, is not labor-intensive, does not require much time, and does not
require any special equipment beyond currently stocked items."
SPORTS-O-ZONE
SANITIZING SYSTEM
What can be done against MRSA?
CDC recommendations>>
SPORTS-O-ZONE
SANITIZING SYSTEM
Practice good personal hygiene
• Keep your hands clean by washing frequently with soap and water or
using an alcohol-based hand rub.
– At a minimum, hands should be cleaned before and after playing
sports and activities such as using shared weight-training
equipment, when caring for wounds including changing bandages,
and after using the toilet.
– Both plain and antimicrobial soap are effective for hand washing, but
liquid soap is preferred over bar soap in these settings to limit
sharing.
– If hands are not visibly dirty and sinks are not available for hand
washing, for example, while on the field of play or in the weightroom, alcohol-based hand rubs and sanitizers can be used. Alcoholbased hand rubs with at least 60% alcohol content are preferred.
• Shower immediately after exercise. Do not share bar soap and towels.
• Wash your uniform and clothing after each use. Follow the clothing
label's instructions for washing and drying. Drying clothes completely in
a dryer is preferred.
SPORTS-O-ZONE
SANITIZING SYSTEM
Take care of your skin
• Wear protective clothing or gear designed to prevent skin
abrasions or cuts.
• Cover skin abrasions and cuts with clean dry bandages or
other dressings recommended by your team’s healthcare
provider (e.g., athletic trainer, team doctor) until healed.
– Follow your healthcare provider’s instructions for when and how
often to change your bandages and dressings.
Do not share items that come into contact with your skin
• Avoid sharing personal items such as towels and razors that
contact your bare skin.
• Do not share ointments that are applied by placing your
hands into an open-container.
• Use a barrier (such as clothing or a towel) between your
skin and shared equipment like weight-training, sauna and
steam-room benches.
SPORTS-O-ZONE
SANITIZING SYSTEM
Controlling the risk of MRSA (4 areas of concern):
1.
2.
3.
4.
Surfaces
Equipment
Laundry
Skin
SPORTS-O-ZONE
SANITIZING SYSTEM
Surfaces:
• Floors, furniture, walls, doorknobs, mats,
tables, etc.
• A good cleaner/disinfectant (i.e. KilZone)
is recommended for these areas. Follow
label directions.
SPORTS-O-ZONE
SANITIZING SYSTEM
Equipment:
• Helmets, shoulder pads, leg braces, shin
guards, shoes, headgear, etc.
• A solid equipment cleaning or sanitizing
protocol (i.e. Riddell’s Staph Fighter
and/or your own Sports-O-Zone
Sanitizing System) is recommended in
this area.
SPORTS-O-ZONE
SANITIZING SYSTEM
Laundry:
• Wash and Dry on HOT as recommended
by clothing manufacturer.
• All fabrics must be completely DRY when
they are taken out of the dryer – per CDC.
• A solid detergent system along with a
sanitizer/bacteriostatic/deodorizer (i.e.
KilZone) is recommended in this area.
Follow label directions.
SPORTS-O-ZONE
SANITIZING SYSTEM
Skin:
• The skin is the bodies layer of protection.
If an opening occurs, MRSA can move in.
• Using a good antibacterial soap (i.e.
Hibiclens) is recommended in this area.
Follow label directions.
www.sportsozone.com