VI Standpoint.com: What is MRSA?

What is MRSA?
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Publisher  on 17/02/2011 14:19:27

Meticillin-Resistant Staphylococcus Aureus (MRSA)
Introduction
MRSA, or methicillin-resistant staphylococcus aureus, is a hard-to-treat
bacterium that use to cause problems only in hospitals but is now found in gyms,
prisons and nurseries, and is occasionally picked up by healthy people through
cuts and scrapes.

At Peebles Hospital, most of the positive MRSA cases are acquired in the
community. The organism is resistant to Methicillin and some other antibiotics
normally used to treat Staphylococcus aureus infections.
Most staph infections, including MRSA, will grow as a bump or infected area on
the skin. Persons should look for skin that is: red, swollen, painful, warm to
touch, full of pus or other discharge and accompanied by a fever.
Transmission or Spread
Staphylococcus aureus is a common colonizer (that is, carried in or on a
person’s body without causing infection) of human skin and mucosa, but can
cause disease, particularly if there is an opportunity for the bacteria to enter
the body. However, most patients who are colonized with MRSA do not go on to
develop an infection.  While colonized or infected patients are the most
important reservoirs of MRSA, hospital personnel can also serve as reservoirs of
MRSA and may harbor the organism for many months. In most instances, hospital
personnel are just the link for transmission or spread between colonized or
infected patients.  The main method of spread of MRSA is via the hands which
may become contaminated by one of these methods:
By contact with a colonized or infected patient, From colonized or infected body
sites of the personnel themselves, or From devices, items, or environmental
surfaces contaminated with body fluids containing MRSA. It can also be spread by
persons sharing personal items such as towels or razors that have touched
infected skin.
Airborne spread usually plays little role in the spread with the exception of
patients with S. aureus pneumonia, or patients with tracheotomies.  Nasal
carriage of S. aureus is very common and may be due to hand-to-nose
transmission.  A nasal carrier often contaminates his/her own hands by
hand-to-nose contact, and then transmits the organism during routine activities.
Prevention
The key to the prevention of the spread of MRSA is proper hand hygiene.  Hands
of caregivers must be washed after any skin-to-skin contact with a patient,
after all work-related activities, between care of different anatomical body
sites on the same patients, before eating and drinking, before and after using
the bathroom, and before leaving work.
Gloves should be worn for any contact with a wound, sore, invasive site, or
mucous membrane of a patient.  Gowns may be worn if extensive soiling is likely
or if the caregiver’s clothing will come into contact with the environmental
surfaces surrounding the patient.  Masks are only necessary if there will be
exposure to aerosols generated by coughing patients, or when suctioning
patients.
To prevent the spread of infection and colonization, patients with MRSA are
nursed in single rooms.  When single rooms are not available, patients with the
same MRSA are nursed in the same patient care area.  This is known as
cohorting.  These patients are not nursed with high risk patients, such as
patients with compromised immune status or with post-operative patients.  High
priority for a private room is given to patients who have uncontained secretions
or excretions.
When patients are discharged home, the family should be educated.  They need to
understand that they rarely need to practice extraordinary infection control
measures in the home beyond good hand washing and careful handling of soiled
dressings. If there is a highly susceptible family member (e.g. patient with
immunosuppression, or cancer) more extensive precautions might be needed and
should be discussed with a healthcare provider before the patient’s discharge.
Conclusion
Bacteria like MRSA have developed mechanisms to promote their survival and to
resist attempts by humans to eliminate them.  Armed with the knowledge of how
infections are transferred, what barriers are used to deter their spread, and
how infections can be effectively resolved, it is possible for health care
workers to be properly prepared to take on such a persistent adversary as MRSA.
By implementing infection control and prevention practices, workers will
contribute to the prevention of MRSA-related morbidity and mortality, as well as
decrease the cost of health care.  Successful management of this organism will
protect patients, staff and visitors from the risk of transmission of MRSA and
other infectious microorganisms.
References
Guide to the Elimiation of Methicillin-Resistant Staphyloccus aureus (MRSA) in
Long-Term Care Facility: an APIC Elimination Guide, 2009. Information About MRSA
for Health Care Personnel: http://www.cdc.gov/ncidod/ar_mrsa_
Submitted by Helen Frett, RN, RM, BSN (Infection Control Manager)