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Community- Associated MRSA James R. Ginder, MS, WEMT,PI, CHES Health Education Specialist Hamilton County Health Department [PHONE REDACTED] www.co.hamilton.in.us Mary Jo Skinner, RN, MBA Public Health Nurse Hamilton County Health Department ---PAGE BREAK--- The participant will be able to… • recall what CA-MRSA is • list three ways to prevent CA-MRSA • explain the signs and CA-MRSA • identify three ways CA-MRSA can be transmitted • describe the proper way to wash hands ---PAGE BREAK--- Definitions… • Community Associated MRSA (CA-MRSA): ●MRSA infections that are acquired by persons who have not been recently (within the past year) hospitalized or had a medical procedure (such as dialysis, surgery, catheters). CDC • Carrier: ●A person who has MRSA living in the nose or on the skin but has no • Colonization: ●The bacteria are present but not causing a infection • Healthcare Associated MRSA (HA-MRSA): ●MRSA that occurs most frequently among patients who undergo invasive medical procedures or who have weakened immune systems and are being treated in hospitals and healthcare facilities such as nursing homes and dialysis centers. CDC • Infection: ●The bacteria is present and is causing illness ---PAGE BREAK--- Definitions Cont… • MRSA: ●MRSA is a kind of “staph” bacteria that has become resistant to many antibiotics, such as penicillins and cephalosporins • Reservoir: ●Anywhere bacteria can live and be colonized ---PAGE BREAK--- What is Staphylococcus aureus… • A bacteria commonly carried on the skin or in the nose of healthy people Source: University of Wisconsin-Madison Department of Bacteriology ---PAGE BREAK--- Facts About Staph… • Approximately 25% to 30% of the population are colonized in their noses, but the bacteria is not causing them any infections (CDC) • Staph is the most common cause of skin infections in the United States • Staph can cause minor and serious infections ---PAGE BREAK--- What is Methicillin-Resistant Staphylococcus aureus (MRSA)... • MRSA is a type of staph that is resistant to certain antibiotics but not limited to • Methicillin • Oxacillin • Penicillin • Ampicillin • Cephalosporins Source: University of Texas, Health Science ---PAGE BREAK--- How Can MRSA Be Spread … • Most commonly by skin to skin contact • Close contact with an infected person • Direct physical contact and not by air • Touching objects such as towels, sheets, sports equipment etc., contaminated with staph ---PAGE BREAK--- Chain of Infection… MRSA Reservoir Ways of Transmission Susceptible person ---PAGE BREAK--- Is All MRSA Contagious… • If a person touches an object such as a towel that was touched by a person with MRSA, then they may become infected with MRSA too ---PAGE BREAK--- How is MRSA Diagnosed… • It is identified by a lab from a sample of fluid taken from the wound or infection site • The bacteria then is tested to determine which antibiotics it is sensitive or resistant to ---PAGE BREAK--- What Does MRSA Look Like… • Large, red, painful bumps under the skin (called boils or abscesses) • A cut that is swollen, hot and filled with pus • Blisters filled with pus (called impetigo) • Sores that look and feel like spider bites (However, MRSA is not caused by a spider bite or any other insect bite) Source: www.healthline.com/.../2006/10/mrsa.html Source: Washington State Department of Health ---PAGE BREAK--- How Can MRSA Be Treated? • With appropriate antibiotics: ●A person must take ALL of the medication to kill the bacteria ●DO NOT share antibiotics with other people or save them for another time • By draining the abscess or boil: ●Draining of skin abscesses or boils should only be done by a healthcare provider ---PAGE BREAK--- CA-MRSA or HA-MRSA… Community - Associated (CA) MRSA Healthcare-Associated (HA) MRSA • Fairly new • Around for > 50 years • May affect healthy people, often misdiagnosed as “spider bite” • Usually affects sick people with access lines or wounds • Less antibiotic resistance, currently treatable with Clindamycin • Broad antibiotic resistance, may require IV antibiotic regimen Source: Tacoma Health Department ---PAGE BREAK--- You May Have Community Associated MRSA (CA-MRSA) If You Have… • A diagnosis of MRSA in the outpatient setting or by a positive culture for MRSA within 48 hours after admission to a hospital • No previous history of MRSA infection or colonization • No medical history in the past year of: ●Hospitalization ●Admission to a nursing home or hospice ●Dialysis ●Surgery ●Recent or frequent antibiotic use within 6 months ●Direct contact with an infected person or a facility where MRSA cases have been identified ---PAGE BREAK--- What is Community Associated MRSA (CA-MRSA)… • A MRSA infection which occurs in healthy people who HAVE NOT been recently (within the past year) hospitalized or had a medical procedure performed on them • It usually presents as a skin infection, such as a pimple or boil, impetigo, or an infected wound ---PAGE BREAK--- Possible Complications if CA-MRSA Is Not Treated… • Cellulitis • Endocarditis • Toxic Shock • Pneumonia • Blood Poisoning Source; ADAM Health ---PAGE BREAK--- Underlying Diseases That May Increase The Risk of CA-MRSA … • Chronic renal disease • Insulin dependent diabetes • Peripheral vascular disease • Dermatitis or skin lesions ---PAGE BREAK--- High Risk Groups For CA-MRSA… • Athletes • Military • Children • Men Who Have Sex With Men (MSM) • Prisoners • Pacific Islanders & Native Americans • Immuno Compromised Individuals ---PAGE BREAK--- Risk Factors… • Direct contact with an infected person • Use of sport facilities in a community setting where CA-MRSA has been identified • Sharing personal items, razors and washcloths that might have been used by a person infected with MRSA ---PAGE BREAK--- How Can I Prevent CA-MRSA… • WASH HANDS FREQUENTLY! • If you get cut or scraped on the skin, clean it with soap and water, then cover it with a bandage • DO NOT touch sores. If you do, wash your hands afterwards • Cover all sores with a bandage • Clean bathrooms and countertops daily with a household cleaner • DO NOT participate in contact sports until sores have healed • DO NOT go to a gym, sauna, hot tub or pool until sores have healed • Bathe or shower frequently with soap • Wash sheets and towels at least weekly • Change clothing daily ---PAGE BREAK--- How Can I Prevent CA-MRSA Cont… • Use disposable tissue for nasal discharge • If you can not use soap and water use hand sanitizer to clean your hands • WASH HANDS FREQUENTLY! ---PAGE BREAK--- Changing Bandages… Source: Minnesota Department of Health ---PAGE BREAK--- Handwashing Is IMPORTANT To Prevent CA-MRSA Source: Durham Region Health Department ---PAGE BREAK--- Alcohol-based Hand Sanitizer • Apply product to the palm of one hand (size of a quarter) • Rub hands together • Rub the product over all surfaces of hands and fingers until hands are dry Source; CDC ---PAGE BREAK--- ---PAGE BREAK--- Cleaning The House… • Use any cleaner that can be bought at the store that has the word “disinfectant” on it • Read the label and follow the directions • You can make your own cleaner by mixing one tablespoon of bleach into one quart of water in a spray bottle • Make fresh solution each time you want to clean the house • Never mix bleach with any other product except water ---PAGE BREAK--- Laundry And CA-MRSA… • When collecting laundry or changing sheets, hold the dirty laundry away from your body and clothes • Wear disposable gloves to handle laundry that is soiled with body fluids • Wash the laundry with warm or hot water. Use bleach if possible • Dry in a warm or hot dryer, make sure the clothes are completely dry • Wash hands after handling dirty laundry • Wash hands before handling clean laundry Source: Washington State Department of Health ---PAGE BREAK--- Resources… • Center For Disease Control and Prevention www.cdc.gov • Indiana State Department Of Health www.in.gov/isdh • Mayo Clinic www.mayoclinic.com • Meckenburg County Health Department www.charmeck.org • Minnesota Department of Health www.health.state.mn.us ---PAGE BREAK--- Resources Cont… • Tacoma Health Department