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

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

3 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

6 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 washing 2. Patient placement 3. Hand washing 4. Barrier protection 5. Hand washing 6. Environmental cleaning 7. 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 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

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

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

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