1. Methicillin-resistant Staphylococcus Aureus - MRSA - Sharon Walker, RN, BPS Ingham County Health Department

2. 2 MRSA Bacteria staphylococcus aureus (staph) Resistant to certain antibiotics –Methicillin –Oxacillin –Penicillin –Amoxicillin Very common occurrence

3. 3 Nosocomial Community Acquired Nosocomial –Acquired in a healthcare setting Community Acquired –Non-hospitalized persons –No recent medical procedures –Otherwise healthy

4. Colonization Organisms are found but not causing infection In general – colonization is not treated

6. 6 Determinants of Resistance Organism Infection Control Practices Antimicrobial Use

7. Optimizing Antimicrobial Use Decreases Resistance Reduces Costs Decreases Antimicrobial Adverse Events

8. Current Antimicrobial Use 20-50% of pharmaceutical costs $1.2 billion spent in hospitals Broad spectrum antibiotic use is increasing 100 million courses of Antibiotics prescribed annually – up to 80% are viruses

10. Treatment of MRSA Infection Sometimes no treatment is the best treatment Removal of a devise (tube) Appropriate antibiotic selection Will treating the infection help the patients quality of life?

11. Infection Control Practices Standard Universal Precautions is sufficient unless it is an outbreak situation or there is evidence of transmission via HCW.

12. Contact Precautions 1. Hand washing 2. Patient placement 3. Hand washing 4. Barrier protection 5. Hand washing 6. Environmental cleaning 7. Hand washing

13. Housekeeping 1. Routine terminal cleaning detergent/disinfectant 2. Discard water when done and wash the bucket 3. Trash is not regulated medical waste 4. Environment is not routinely cultured

14. Laundry - Dietary 1. Gown and glove for dirty linen as usual 2. Launder items as usual 3. No need for red bags 4. Regular food trays can be used

15. Collecting Lab Specimens In General 1. Collect specimens before starting antibiotic 2. Don't culture during antibiotic therapy 3. If follow up cultures are needed - wait 72 hours after treatment completion

16. Strategic Goals 1. Prevent Infections 2. Diagnosis and treat infections effectively 3. Use Antimicrobials wisely 4. Prevent transmission

17. Other Resistant Pathogens 1. Escherichia coli 2. Coagulase-negative staphylococcus 3. Enterococci 4. Pseudomonas aeruginosa 5. Enterbacter 6. Klebsiella pneumoniae

18. 18 Resources Centers for Disease Control and Prevention www.cdc.gov select “index a – z” select first letter of condition