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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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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 2
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 6
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. Hand washing • 2. Patient placement • 3. Hand washing • 4. Barrier protection • Hand washing • Environmental cleaning • Hand washing
Housekeeping • 1. Routine terminal cleaning • detergent/disinfectant • Discard water when done and wash the • bucket • Trash is not regulated medical waste • Environment is not routinely cultured
Laundry - Dietary • Gown and glove for dirty linen as usual • Launder items as usual • No need for red bags • 4. Regular food trays can be used
Collecting Lab Specimens In General • 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 • Prevent Infections • Diagnosis and treat infections effectively • Use Antimicrobials wisely • 4. Prevent transmission
Other Resistant Pathogens 1. Escherichia coli 2. Coagulase-negative staphylococcus 3. Enterococci 4. Pseudomonas aeruginosa 5. Enterbacter 6. Klebsiella pneumoniae
Resources Centers for Disease Control and Prevention www.cdc.gov select “index a – z” select first letter of condition 18