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The Facts About MRSA: Questions & Answers

MRSA—a little known germ with a big name—has captured the attention of news media throughout the nation.   The recent news about the number of individuals infected with or at risk of developing a staph infection—or the more serious Methicillin-Resistant Staphylococcus aureus (MRSA) infection—in local communities has created concern among schools, parents, community organizations, and other places where people congregate. Because the majority of invasive MRSA infections occur in hospitals and other health care settings, health care providers have decades of experience in combating these and other germs. However, combating MRSA requires a concerted effort by more than hospital and health care providers—it requires vigilance and attention by us all.

What are Staph Infections and MRSA?
Staphylococcus aureus (staph) is a germ that often lives in the noses and on the skin of healthy people and spreads from person to person on contaminated hands, skin, and objects. Most infections caused by staph are skin infections, but staph can also cause more serious infections such as blood and joint infections, and pneumonia.

Some staph called MRSA has been featured in the news and on television programs a great deal recently. MRSA stands for Methicillin-resistant Staphylococcus aureus. This type of bacteria causes infections that are resistant to treatment with usual antibiotics.

MRSA occurs most frequently among patients who undergo invasive medical procedures or who have weakened immune systems and are being treated in hospitals and health care facilities such as nursing homes, ambulatory surgery centers, and dialysis centers. MRSA in health care settings may cause serious and potentially life threatening infections.

MRSA can also involve people in the community at large, generally as skin infections that may look like insect bites, pimples or boils and can be swollen, painful and have draining pus. These skin infections often occur in otherwise healthy people.

What are Multi-Drug Resistant Organisms?
They are bacteria and other microorganisms that have developed resistance to antimicrobial drugs. Common examples of these organisms include:

  • MRSA - methicillin/oxacillin-resistant Staphylococcus aureus
  • VRE - vancomycin-resistant enterococci
  • ESBLs - extended-spectrum beta-lactamases (which are resistant to cephalosporins and monobactams)
  • PRSP - penicillin-resistant Streptococcus pneumoniae

MRSA and VRE are the most commonly encountered multidrug-resistant organisms in patients residing in non-hospital health care facilities, such as nursing homes and other long-term care facilities. PRSP are more common in patients seeking care in outpatient settings such as physicians' offices and clinics, especially in pediatric settings.

How is MRSA Spread in Health Care Settings?
Patients who already have MRSA infection or who carry the bacteria on their bodies but do not have symptoms (colonized) are the most common sources of transmission.  The main mode of transmission to other patients is through human hands.  Hands may become contaminated with MRSA bacteria by contact with infected or colonized patients. If appropriate hand hygiene such as washing with soap and water or using an alcohol-based hand sanitizer is not performed, the bacteria can be spread when the health care worker or visitor touches other patients.

What Factors are Associated with Increased Risk for Community-Associated Staph or MRSA Infections?
Factors that have been associated with the spread of MRSA skin infections include: close skin-to-skin contact, openings in the skin such as cuts or abrasions, contaminated items and surfaces, crowded living conditions, and poor hygiene.

What are Hospitals and Other Health Care Providers Doing to Prevent or Control MRSA?
The good news is that MRSA is preventable. The first step to prevent MRSA is to prevent health care infections in general. Infection control guidelines produced by CDC and the Healthcare  Infection Control and Prevention Advisory Committee (HICPAC) are central to the prevention and control of health care infections and ultimately, MRSA in health care settings. To learn more about infection control guidelines to prevent infections and MRSA go to http://www.cdc.gov/ncidod/dhqp.

In Maryland, Hospitals are engaged in a number of initiatives that are effectively combating MRSA and other infections. 

Through the Maryland Patient Safety Center, ten hospitals are currently engaged in an innovative approach to preventing MRSA—and more hospitals plan to join this “positive deviance” initiative.  In addition, hospitals throughout Maryland are fighting MRSA and other infections by:

  • Strictly adhering to and promoting hand hygiene programs;
  • Screening patients in high risk areas, such as the ICU and SCU, for infection; and,
  • Disinfecting patient care areas and equipment. 

What Can We Do to Prevent Staph Skin Infections?

  • Keep your hands clean by washing well with soap and water or using an alcohol hand gel.
  • 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.
  • Report suspicious skin inflammation to your health care provider.

Are Staph and MRSA Infections Treatable?
Yes. Most staph and MRSA infections are treatable with antibiotics. If you are given an antibiotic, take all of the doses, even if the infection is getting better, unless your doctor tells you to stop taking it. Do not share antibiotics with other people or save unfinished antibiotics to use at another time.

However, many staph skin infections may be treated by draining the abscess or boil and may not require antibiotics. Drainage of skin boils or abscesses should only be done by a health care provider.

If after visiting your doctor the infection is not getting better after a few days, contact him/her again. If other people you know or live with get the same infection tell them to go to their doctor.

What Should I Do if I Have a Staph Skin Infection?

  • Cover your wound. Keep wounds that are draining or have pus covered with clean, dry bandages. Follow your health care provider’s instructions on proper care of the wound. Pus from infected wounds can contain staph. So keeping the infection covered will help prevent the spread to others. Bandages or tape can be thrown away with the regular trash.
  • Wash your hands. You, your family, and others in close contact should wash their hands often with soap and warm water. You can use an alcohol hand gel when soap and water are not available. This is especially important to do after changing the bandage or touching the infected wound.
  • Do not share personal items such as towels, washcloths, razors, clothing, or uniforms that may have had contact with the infected wound or bandage. Wash soiled sheets, towels, and clothes with water and laundry detergent. Dry clothes in a hot dryer, rather than air-drying. This also helps kill bacteria in clothes.

What Precautions Should Family Caregivers Take for Infected Persons in their Homes?
Outside of health care settings, healthy people are at low risk of getting infected. In the home, the following precautions should be followed:

  • Caregivers should wash their hands with soap and water immediately after physical contact with the infected or colonized person.
  • Towels used for drying hands after contact should be used only once.
  • Disposable gloves should be worn if contact with body fluids is expected and hands should be washed after removing the gloves.
  • Linens should be changed and washed if they are soiled and on a routine basis.
  • The patient's environment should be cleaned routinely and when soiled with body fluids.
  • Notify doctors and other health care personnel who provide care for the patient that the patient is colonized/infected with a multidrug-resistant organism.

Can I Get a Staph or MRSA Infection at my Health Club?
In the outbreaks of MRSA, the environment has not played a significant role in the transmission of MRSA. MRSA is transmitted most frequently by direct skin-to-skin contact. You can protect yourself from infections by practicing good hygiene (e.g., keeping your hands clean by washing with soap and water or using an alcohol-based hand rub and showering after working out); covering any open skin area such as abrasions or cuts with a clean dry bandage; avoiding sharing personal items such as towels or razors; using a barrier (e.g., clothing or a towel) between your skin and shared equipment; and wiping surfaces of equipment before and after use. 

Information adapted from the Centers for Disease Control and Prevention (CDC)
by the Maryland Patient Safety Center.