MRSA

1. MRSA

2. What Is MRSA? • Staphylococcus aureus (Staph) • Common cause of infection in the community • Methicillin-Resistant Staph (MRSA) • Increasingly important cause of health care associatedinfections since 1970s • In 1990s, emerged as cause of infection in the community

3. How do you get MRSA? • Outbreaks of MRSA in the Community • Often first detected as abscesses or “spider bites” • Various Settings • Sports participants • Inmates • Military recruits • Daycare attendees • Hurricane evacuees in shelters

4. Types • Disease Syndrome (%) • Skin/soft tissue 1,266 (77%) • Wound (Traumatic) 157 (10%) • Urinary Tract Infection 64 (4%) • Sinusitis 61 (4%) • Bacteremia 43 (3%) • Pneumonia 31 (2%)

5. People Affected • The estimated number of people developing a serious MRSA infection (i.e., invasive) in 2005 was about 94,360 • Approximately 18,650 persons died during a hospital stay related to these serious MRSA infections • Overall rates of disease were consistently highest among older persons (age >65), blacks, and males

6. Most Invasive MRSA Infections are Healthcare-Associated Community-Associated 14% Healthcare-Associated 86%

7. Staphylococcus aureus (staph) • Bacteria commonly carried on the skin or in the nose of healthy people • Bacteria may be present without causing infection • 25% to 30% of the population is “colonized” • Staph bacteria are some of the most common causes of skin infections in the U.S. • Pimples and boils • Bloodstream infections • Pneumonia

8. Methicillin-resistantStaphylococcus aureus (MRSA) • Staph bacteria that are resistant to certain antibiotics • Methicillin • Penicillin • Amoxicillin • Occur most frequently among persons in hospitals and healthcare facilities who have weakened immune systems • May also cause illness in persons outside of hospitals and healthcare facilities • “community-associated” if acquired by a person who has not been recently (within the past year) hospitalized or has not had an invasive procedure

9. What does a MRSA infectionlook like? • MRSA can cause skin infections that may look like a pimple or boil • Can be red, swollen, painful or have pus or other drainage • Skin monitoring important for persons returning from hospitals • People with skin infections should see a healthcare provider • More serious infections may cause pneumonia, bloodstream infections or surgical wound infections

10. Risk Factors • Clusters of MRSA skin infections have been investigated among: • Athletes • Military recruits • Men who have sex with men • Prisoners • Factors associated with the spread of MRSA skin infections include: • Close skin-to-skin contact • Crowded living conditions • Cuts or abrasions of the skin • Contaminated items and surfaces • Poor hygiene

11. Prevention • Keep hands clean by washing thoroughly with soap and water or using an alcohol-based hand sanitizer • Keep cuts and scrapes clean and covered with a bandage until healed • Avoid contact with other people’s wounds or bandages • Avoid sharing personal items such as towels or razors • If skin is dry, use a moisturizer to prevent cracking.

12. Treatment • Most MRSA infections are treatable with antibiotics • Take all doses, even if the infection is getting better, unless your doctor tells you otherwise • Do not share antibiotics with other people • Some staph infections may be treated by draining the abscess or boil and may not require antibiotics • Drainage should only be done by a healthcare provider • If the infection does not get better after a few days, contact your healthcare provider again • If other people you know or live with get the same infection, tell them to go to their healthcare provider

13. Control • If MRSA is identified, follow these steps… • Cover the wound • Pus from infected wounds can contain staph and MRSA, so keeping the infection covered will help prevent the spread to others • Keep wounds that are draining or have pus covered with clean, dry bandages • Follow your healthcare provider’s instructions on proper care of the wound • Bandages or tape can be discarded with the regular trash

14. Control • Clean your hands • Persons with MRSA, and others in close contact, should wash hands frequently with soap and warm water or use an alcohol-based hand sanitizer • Especially important after changing the bandage or touching the infected wound • Do not share personal items • such as towels, washcloths, razors, clothing, or athletic equipment that may have had contact with the infected wound or bandage • Wash sheets, towels, and clothes that become soiled with water and laundry detergent • Drying clothes in a hot dryer, rather than air-drying, also helps kill bacteria in clothes

15. Should Students with MRSA Skin Infections Be Excluded From Attending School? • Unless directed by a physician, students with MRSA infections should not be excludedfromattending school • Exclusion from school and sports activities should be reserved for those with wound drainage ("pus") that cannot be covered and contained with a clean, dry bandage and for those who cannot maintain good personal hygiene

16. Environmental Control • The 5 “C”s of Community Associated MRSA • CLEANLINESS: • Hand hygiene, bathing, laundering of clothing/uniforms • COMPROMISED: • Skin integrity - Keep wound(s) clean and covered • CONTACT: • Avoid contact with other people’s wounds or bandages • CONTAMINATION: • Avoid sharing personal items (water bottles, towels, etc. Clean and disinfect environment • CROWDING: • Implement measures to avoid overcrowding, as appropriate