Transcript MRSA - ESD 101

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!