CA-MRSA: The Emerging Pathogen By Suzanne M. Bonner, RN, CMSRN, BSN Nursing made Incredibly Easy! March/April 2009 2.0 ANCC contact hours Online: www.nursingcenter.com © 2009 by Lippincott Williams & Wilkins. All world rights reserved.

CA-MRSA Facts On the rise in EDs across the country Frequent cause of skin and soft tissue infections (pimples, boils, and abscesses) Has a specific gene pattern or “fingerprint” (different from HA-MRSA) The median age of patients with CA-MRSA is 30 (compared with age 70 for HA-MRSA) Sensitive to: trimethoprim-sulfamethoxazole, gentamicin, tetracycline, and clindamycin

Picturing CA-MRSA Infection

Risk Factors Children (especially in day-care centers) Large groups of people living in close quarters (such as soldiers or prisoners) Those who play contact sports (such as wrestling, football, fencing, and rugby) I.V. drug users Homeless persons Men who are sexually active with other men

Risk Factors Ethnic groups: Pacific Islanders, Native Americans, Native Alaskans, and Native Canadians Theorized that lack of infection control may be responsible for CA-MRSA in these groups, according to the CDC

Treatment 75% of CA-MRSA infections are soft tissue infections Incision and drainage of the boil, abscess, or soft tissue area May or may not be followed by antibiotics, depending on the patient’s comorbidities, the size of the affected area, and the presence of fever or other symptoms A culture of the wound should be done to determine what antibiotic to use In several states MRSA is a reportable disease (check with your state’s health department)

Prevention and Patient Teaching CA-MRSA is very contagious Encourage use of frequent hand washing and hand sanitizer use Teach your patient and his family members how to prevent its spread in the household: Proper hand washing before and after wound cleaning Avoid skin-to-skin contact Don’t share personal items (such as razors, towels, and clothing) Wash clothes, bed linens, or towels that have come in contact with the wound with water and detergent and use a dryer

Sports Team Prevention Disinfect equipment Ensure appropriate laundering of uniforms, clothing, towels, and linens The surface of equipment in a gym or health club should be wiped down with a clean towel before and after use Keep wounds covered Refrain from participating in sports until wounds are completely healed