Protecting yourself against MRSA

Preventing yourself against MRSA.

MRSA usually spreads from person to person through the human hand.

Hand washing the best way to stop the spread of MRSA.

Using contact percautions when caring for patients with MRSA.

http://www.cdc.gov/Features/MRSAinHealthcare/

MRSA swab...

How to perform a MRSA swab...

Nasal swab is the most commonly used method to identify MRSA.

http://www.cdc.gov/nchs/data/nhanes/nhanes_01_02/specimen_collection_year_3.pdf

MRSA & Orthopedic Surgery

I wanted to share this article because where I work we see a lot of patients return with MRSA infections.

http://www.apic.org/Resource_/EliminationGuideForm/34e03612-d1e6-4214-a76b-e532c6fc3898/File/APIC-Ortho-Guide.pdf

Healthcare workers & M.R.S.A

Studies show 1 in every 20 healthcare workers is MRSA carrier

http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/9117

MRSA Vaccine?!

Progress Made in Developing Community-Acquired MRSA Vaccine

A pediatric infectious-disease physician has raised the alarm about the epidemic and is taking an unconventional approach to combatting it.

http://www.scientificamerican.com/article.cfm?id=progress-made-in-developing-community

When in doubt....use CLOROX!!

http://www.clorox.com/clorox-cleaning-and-laundry-advisor/cleaning-advisor/kitchen/

MRSA linked to livestock? What are we eating?

I found this article interesting. Do you know what you are eating?


http://www.louise.house.gov/index.php?option=com_content&view=article&id=2672:new-study-links-antibiotic-resistant-mrsa-strain-between-humans-and-livestock&catid=101:2012-press-releases&Itemid=55

Informative MRSA video

This video gives an overview of MRSA. I found it to be very informative and could be used for patients requesting further information on MRSA.

http://www.youtube.com/watch?v=XbguONM0vqo&feature=related

Vancomycin

http://www.ajhp.org/content/66/1/82.full

Surveillance and Facts!

http://www.cdc.gov/mrsa/statistics/MRSA-Surveillance-Summary.html

Know the symptoms!!

http://www.cdc.gov/mrsa/symptoms/index.html

Treatment

http://www.cdc.gov/mrsa/treatment/index.html

Where is MRSA found and what is the treatment?

This article gives information about the common places MRSA is found and the treatment for MRSA.      http://www.patient.co.uk/health/MRSA.htm

Who gets MRSA?

·         People who are hospitalized are more likely to get MRSA, especially if they have been in the hospital for a length of time. Patients who are very ill or have wounds/open sores are more prone to get MRSA.  Urinary catheters and tubes going into veins sometimes are contaminated by MRSA and can lead to urine or blood infection.

·         MRSA can affect you in two ways; either you are a carrier of MRSA or have an infection caused by MRSA.

What is MRSA colonization?

·         MRSA colonization is when MRSA grows in or on your body with no signs or symptoms of an infection.

·         The most common place for colonization is armpits, nostrils, skin, throat, and urine.

·         MRSA colonization can later develop in your body and spread to other people.

What is the treatment for MRSA?

·         Treated with antibiotics. Although most antibiotics will not be effective. Many MRSA infections can only be treated with antibiotics that need to be given directly into the vein.

·         The course of treatment is often for several weeks.

Video on isolation

This video shows you how to apply and remove Personal Protective Equipment including the mask and goggles if needed. The education is focused on families of an isolation patient. It includes education on contact, airborne, and droplet. The only thing we would do differently, as health care workers, with a mask is take it off last and in my facility and throw it away outside of the room in a garbage can. N95's are no longer recommended at my facility as well due to it's poor seal on many health-care personnel. PAPR's (Powered Air Purifying Respirators) are now used.

http://www.youtube.com/watch?v=G7BybT0B46k

The video was created by martinisusb. Retrieved October 7, 2012. 

Cleaning and Disinfecting for MRSA

This article focuses on how to clean and what to clean after a person has be diganosed with MRSA.
 http://www.cdc.gov/mrsa/environment/index.html

What's the difference between cleaners, sanitizers, and disinfectants?

o   Cleaners or detergents are products that are used to remove soil, dirt, dust, organic matter, and germs (like bacteria, viruses, and fungi). Cleaners or detergents work by washing the surface to lift dirt and germs off surfaces so they can be rinsed away with water. The same thing happens when you wash your hands with soap and water or when you wash dishes. Rinsing is an important part of the cleaning process. Use these products for routine cleaning of surfaces.

 

o   Sanitizers are used to reduce germs from surfaces but not totally get rid of them. Sanitizers reduce the germs from surfaces to levels that considered safe.

 

o   Disinfectants are chemical products that destroy or inactivate germs and prevent them from growing. Disinfectants have no effect on dirt, soil, or dust. Disinfectants are regulated by the U.S. Environmental Protection Agency (EPA). You can use a disinfectant after cleaning for surfaces that have visible blood or drainage from infected skin.

Which disinfectants should I use against MRSA?

o   Disinfectants effective against Staphylococcus aureus or staph are most likely also effective against MRSA. These products are readily available from grocery stores and other retail stores. Check the disinfectant product’s label on the back of the container. Most, if not all, disinfectant manufacturers will provide a list of germs on their label that their product can destroy. Use disinfectants that are registered by the EPA (check for an EPA registration number on the product’s label to confirm that it is registered).

Laundry-

o   No special precautions need to be done with laundry. Routine laundry procedures, detergents, and laundry additives will all help make clothes, towels, and linens safe to touch and wear.

What items should be cleaned to prevent the spread of MRSA?

Focus on surfaces that touch people’s bare skin each day and any surfaces that could come into contact with uncovered infections. For example, surfaces such as benches in a weight room or locker room.

Large surfaces such as floors and walls have not been directly associated in the spread of staph and MRSA.

There is no evidence that spraying or fogging rooms or surfaces with disinfectants will prevent MRSA infections more effectively than the targeted approach of cleaning frequently touched surfaces and any surfaces that have been exposed to infections.

Strain on the Rise

Originally, we chose the topic of M.R.S.A. because we as nurses realized how common it seems to be these days and how many new cases we see in hospitals. When I ran across this article I knew it was right for our blog!

A potentially dangerous and rapidly spreading strain of the "superbug" MRSA poses a much greater public health threat than previously thought, new research shows.

Community-associated MRSA (CA-MRSA) is spreading in hospitals and other health care facilities, according to a study in the December issue of Emerging Infectious Diseases.

The CA-MRSA strain of superbug can be picked up in fitness centers, schools, and other public places, and is increasing the already significant burden of MRSA (methicillin-resistant Staphylococcus aureus) in hospitals, the researchers report.
CA-MRSA and hospital-associated MRSA (HA-MRSA) are bacteria resistant to most common antibiotics.
HA-MRSA infections occur mostly in hospitals and other health care settings, including dialysis centers and nursing homes, and often strike mostly older adults, people having invasive medical procedures, and people with weakened immune systems.
CA-MRSA is a leading cause of serious skin and soft tissue infections, entering the body through scrapes and cuts, the researchers say.
The study, which analyzed data from more than 300 microbiology labs across the U.S., found a sevenfold increase in the proportion of CA-MRSA in outpatients between 1999 and 2006.
This community-associated strain is making its way into hospitals, the researchers say, increasing threats to patient safety because patients and their doctors move back and forth between inpatient and outpatient units of hospitals.
"This emerging epidemic of community-associated MRSA strains appears to add to the already high MRSA burden in hospitals," Ramanan Laxminarayan, PhD, MPH, a senior fellow at Extending the Cure, a project at the Resources for the Future think tank in Washington, D.C., says in a news release.
This major increase in CA-MRSA, the researchers say, has become a major concern.
Over the length of the study, the scientists report finding that the proportion of MRSA had increased more than 90% among outpatients with staph, and now accounts for more than 50% of all Staphyloccus aureus infections.
This was due, the findings suggest, almost entirely to an increase in CA-MRSA strains.
Similar increases in inpatients suggest these strains are spreading rapidly into hospitals.
"MRSA has generally been a significant problem only in hospitals," says Eili Klein, MA, the lead author of the report and also a researcher at Resources for the Future. "But the findings from this study suggest there is a significant reservoir in the community as well."
This suggests that the increased cases of CA-MRSA are causing that bug to spread from the community into hospitals, Klein says.
Hospitals need to take steps to stop this by stepping up infection control procedures, the researchers say, adding that the best way to contain MRSA and other superbugs is through surveillance and regular efforts aimed at infection control.
"Community-associated methicillin-resistant Staphylococcus aureus has become a major problem in U.S. hospitals already dealing with high levels of hospital-associated MRSA," the researchers write. They conclude that "more rapid diagnostic methods are urgently needed to better aid physicians" in fighting MRSA.

Retrieved at: http://www.webmd.com/skin-problems-and-treatments/news/20091124/mrsa-strain-on-the-rise-in-hospitals

Treating M.R.S.A.

How is MRSA treated?MRSA should always be treated by a health care provider. It is important to follow the instructions for treatment that your provider gives you. If you do not have an active infection, your health care provider may do tests to find out if you still carry MRSA bacteria on your skin. If you are a MRSA carrier, your provider may decide to:• Do nothing, because the bacteria may go away without treatment
• Reduce the amount of bacteria on your skin
If you have an active MRSA infection, your provider may choose one or more of the following treatments:1. Drain the infection
2. Give antibiotics
3. Reduce the amount of bacteria on your skin
1. Drain the infectionDon’t do this yourself. It is very dangerous to squeeze or poke a skin infection because it can push the bacteria deeper into the skin and make the infection much worse. Draining the infection should only be done by a trained health care provider.The provider will open the sore and drain it. After the infection is drained, you must keep it covered until it heals. Sometimes your provider may ask you to come back for a checkup or to change the dressing. This is to make sure it is healing okay. Some skin infections will heal after your health care provider has drained the pus out. You may not need an antibiotic.
2. Give antibioticsMRSA is resistant to many antibiotics so it can be difficult to treat. However, there are antibiotics that can treat MRSA and make the infection go away. Your provider may culture your infection and have the lab test the bacteria to find out which antibiotic is best for you. If your provider gives you antibiotics, take them exactly as prescribed. Do not stop early, even if you feel better. The last few pills kill the toughest germs. Never take antibiotics without a prescription from your health care provider.3. Reduce the amount of bacteria on your skin or in your noseThis may prevent the spread of MRSA if you have an active infection or if you are a carrier.
To decrease the amount of bacteria on your skin your provider may, for a short period of time:
• Have you shower daily with antibacterial soap
• Prescribe antibiotic pills
• Prescribe antibiotic ointment to put in your nose for several days

Directions for putting ointment in your nose
1. Put 1/4 inch dab of ointment on a cotton swab (Q-tip)
2. Insert the swab as far into your nose as you can tolerate
3. Gently rub the swab on the inside of your nostril
4. Using a new swab repeat with the other nostril
5. Dispose of the swabs
6. Wash your hands

http://www.tpchd.org/files/library/2357adf2a147d1aa.pdf

Athletic Facilities Research and Care

The Study

Open abrasions, therapeutic whirlpools, treatment tables, locker rooms (LR), and athletic equipment are identified as potential areas of transmission in athletic training rooms (ATR) and LR facilities. To determine the prevalence of MRSA and to identify control measures in ATR and LR, the authors collected samples from nine surfaces at seven high schools over a four-month period. Initial analyses considered both suspected colonies and confirmed MRSA colonies with analyses of variance revealing significant differences of suspected colonies based on regular cleaning product and facility surface. Of the 67 positive MRSA cultures collected during this study, 60 (89.6%) were found in LR facilities. Contrary to what was hypothesized, the girls’ LR surfaces presented the highest rate of positive MRSA cultures, followed by the boys’ LR and ATR surfaces. The rate of positive MRSA cultures was also assessed by the type of flooring found in the LR facilities. Of the regular cleaning products used in the ATR at the different schools, bleachwater solutions had the highest rate of positive MRSA cultures 8.3%, followed by Whizzer 6.2%. The use of Matt Kleen, Sanizide, and Sanizide with a filter box showed no MRSA strains. The use of two different cleaning products were Lysol and Cavicide. Lysol resulted in a higher rate of positive MRSA cultures 5.6% than did Cavicide 2.1%. The highest rate of MRSA was found in both girls’ and boys’ LR's where carpet was present, followed by concrete and tile. Results indicate a need for more effective cleaning products and schedules in LRs.

 

Hostetter, K. S., Lux, M., Shelley, K., Drummond, J. L., & Laguna, P. (2011). MRSA as a health concern in athletic facilities. Journal Of Environmental Health, 74(1), 18-25.

This would be how to clean and disinfect Athletic Facilites Properly.

Cleaning & Disinfecting Athletic Facilities for MRSA

 Athletic facilities such as locker rooms should always be kept clean whether or not MRSA infections have occurred among the athlete.

•  Review cleaning procedures and schedules with the janitorial/environmental service staff.  Cleaning procedures should focus on commonly touched surfaces and surfaces that come into direct contact with people's bare skin each day.
•  Cleaning with detergent-based cleaners or Environmental Protection Agency (EPA)-registered detergents/disinfectants will remove MRSA from surfaces.
•   Cleaners and disinfectants, including household chlorine bleach, can be irritating and exposure to these chemicals has been associated with health problems such as asthma and skin and eye irritation.
•   Take appropriate precautions described on the product's label instructions to reduce exposure. Wearing personal protective equipment such as gloves and eye protection may be indicated.

Follow the instruction labels on all cleaners and disinfectants, including household chlorine bleach, to make sure they are used safely and correctly. 

• Some key questions that should be answered by reading the label include: How should the cleaner or disinfectant be applied?, Do you need to clean the surface first before using the disinfectant (e.g., precleaned surfaces)? Is it safe for the surface?
• Some cleaners and disinfectants, including household chlorine bleach, might damage some surfaces (e.g., metals, some plastics). How long do you need to leave it on the surface to be effective (i.e., contact time)?, Do you need to rinse the surface with water after using the cleaner or disinfectant?

If you are using household chlorine bleach, check the label to see if the product has specific instructions for disinfection. If no disinfection instructions exist, then use 1/4 cup of regular household bleach in 1 gallon of water for disinfection of pre-cleaned surfaces.

Environmental cleaners and disinfectants should not be put onto skin or wounds and should never be used to treat infections.

The EPA provides a list of registered products that work against MRSA on List H.

Repair or dispose of equipment and furniture with damaged surfaces that do not allow surfaces to be adequately cleaned.

Covering infections will greatly reduce the risks of surfaces becoming contaminated with MRSA.

CDC. (2012). Cleaning & Disinfecting Athletic Facilities for MRSA. Retrieved from http://www.cdc.gov/mrsa/environment/athleticFacilities.html