Methicillin-resistant Staphylococcus Aureus

- MRSA -

Sharon Walker, RN, BPSIngham County Health Department

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MRSA

• Bacteria staphylococcus aureus (staph)

• Resistant to certain antibiotics– Methicillin– Oxacillin– Penicillin– Amoxicillin

• Very common occurrence

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Nosocomial Community Acquired

• Nosocomial– Acquired in a healthcare setting

• Community Acquired– Non-hospitalized persons– No recent medical procedures– Otherwise healthy

Colonization

• Organisms are found but not causing infection

• In general – colonization is not treated

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Determinants of Resistance

• Organism

• Infection Control Practices

• Antimicrobial Use

Optimizing Antimicrobial Use

•Decreases Resistance

•Reduces Costs

•Decreases Antimicrobial Adverse Events

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

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?

Infection Control Practices

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

Contact Precautions

1. Hand washing2. Patient placement3. Hand washing4. Barrier protection5. Hand washing6. Environmental cleaning7. Hand washing

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

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

Collecting Lab SpecimensIn 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

Strategic Goals

1. Prevent Infections

2. Diagnosis and treat infections effectively

3. Use Antimicrobials wisely

4. Prevent transmission

Other Resistant Pathogens

1. Escherichia coli2. Coagulase-negative staphylococcus3. Enterococci4. Pseudomonas aeruginosa5. Enterbacter6. Klebsiella pneumoniae

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Resources

Centers for Disease Control and Prevention

www.cdc.gov

select “index a – z”

select first letter of condition