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 associated infections 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-resistant Staphylococcus 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 infection look 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 excluded from attending 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