1. MRSA (Methacillin- Resistant Staph Aureus) Deborah Moore, MS, APRN, BC VT PHS Regional Administrator

2. What is Methicillin-Resistant Staphylococcus Aureus (MRSA)? MRSA is a staph aureus infection that has become resistant to the class of antibiotics, such as Methicillin frequently used to treat staph infections.

3. Where Does the Name Come From? The term Staphylococcus is derived from the Greek expression staphyle (bunch of grapes). The term aureus was named due to the organisms golden appearance when viewed under the microscope.

4. MRSA infection has been making headlines all over the country. MRSA has been a major concern in hospital-based institutions for many years. Now “Community acquired MRSA” has become a health concern for everyone Facts About MRSA

5. MRSA has become a major concern in correctional institutions. 100,000 people are hospitalized each year with MRSA infections. Facts About MRSA

6. Staph aureus bacteria are commonly carried on the skin or in the noses of healthy people. MRSA frequently lives harmlessly on skin surfaces of the mouth, genitalia and rectum. Facts About MRSA

7. How “Tough” is MRSA? Staphylococci can survive many extreme environmental conditions. The bacteria can be cultured from dried clinical material after several months, are relatively heat resistant, and can tolerate high salt media.

8. So, “What Do we Do?” You can not get rid of MRSA; you can only control it.

9. Identifying MRSA MRSA infections often present as mild skin or soft tissue infections, such as an abscess or boil that occurs spontaneously and may evolve to include multiple lesions.

10. Challenges of Early Identification Inmates with MRSA skin infections commonly complain of “an infected pimple,” “an insect bite,” “a spider bite,” or “a sore.” MRSA infections cause minor inflammation without pain. Infected inmates may not seek medical attention.

11. How is MRSA transmitted? Virtually anything you touch can transmit MRSA. It is transmitted from person to person by: Contaminated hands Sharing towels, personal hygiene items and equipment Close contact sports Sharing of IV drug paraphernalia

12. How is MRSA transmitted? MRSA outbreaks have been linked to poor inmate hygiene, the sharing of contaminated personal items, and participating in unsanitary tattooing practices.

13. MRSA Isolation and Barrier Precautions

14. Intervention for MRSA Patients Wearing gloves can help reduce transmission Placing patients in isolation is strongly recommended. Cohorting Moving MRSA patients to a separate area maybe helpful. Patients with serious infections should be admitted to the infirmary or appropriate in-patient facility.

15. Intervention for MRSA Patients Personnel wear a clean non-sterile gown when entering the room if: They anticipate that their clothing will have substantial contact with the patient. Masks should be worn for aerosol- producing procedures.

16. PREVENTION Adequate hand hygiene is the simplest, most effective infection control measure for preventing and containing MRSA infections.

17. Environmental Control

18. Inmate housing areas and bathroom facilities should be regularly cleaned with an EPA-registered detergent disinfectant according to the manufacturer’s instructions. Recreational equipment, such as weight benches, should routinely be wiped clean after use with a clean dry towel. Inmates should use barriers to bare skin, such as a towel or clean shirt, while using exercise equipment.

19. Environmental Control Countertops and other treatable surfaces should be cleaned routinely after any contamination with blood or body fluids with an appropriate disinfectant. Laundry should be washed regularly with a detergent using a hot water cycle and then thoroughly dried.

20. Controlling MRSA: Recognition, Intervention, Treatment Principles and Management

21. Intervention Good Hygiene. Post “Wash your Hands” signs everywhere (PHS Hand Hygiene posters) Gloves reduce hand contamination by 70 percent to 80 percent. Catch and isolate MRSA early.

22. Intervention Standard universal precautions Designed to reduce the risk of transmission of bloodborne pathogens. Reduce the transmission of pathogens from moist body substances. Apply these to all patients receiving care, regardless of their diagnosis or presumed infection status.

23. Intervention Reduce Antibiotic use. Patients need to be educated that antibiotics do not work on the “common cold” or other viral infections. Provide appropriate treatment.

24. Prevention Education is one of the foundations in the prevention and control of MRSA. Prison Health Services has developed MRSA Patient Information Fact Sheets and MRSA Fact Sheets for Correctional officers for all PHS sites.

25. Prevention Education is a key ingredient in the strategy to control MRSA. Disease management involves a team effort on the part of the correctional staff, medical staff and the patient.