What is this Super Bug we always hear about?

Methicillin Resistant Staphylococcus Aureus (MRSA)

What you need to know about MRSA:
  
What is MRSA?





Staphylococcus aureus are bacteria that commonly live on the skin, or in the noses of healthy people.

MRSA is the term for Staphylococcus aureus bacteria that have become resistant to semi-synthetic penicillins such as cloxacillin and methicillin. It can also acquire resistance to other classes of antibiotics.

MRSA infections can be difficult to treat and drugs commonly used for treatment of other strains of Staphylococcus aureus are not always effective.

Traditionally, MRSA is seen in people who are taking antibiotics and those individuals who are receiving medical care.  More recently, MRSA has been found in people who have no contact with the health care system. This is referred to as community associated MRSA (CA MRSA).

In the community, MRSA most commonly causes skin and soft tissue infections (e.g., boils or abscesses on arms, legs or elsewhere).  These are treatable with antibiotics.  Rarely, MRSA can cause severe invasive infections such as pneumonia and bloodstream infections. These severe infections require urgent medical treatment.

How is MRSA spread?

MRSA bacteria are spread through direct person-to-person contact with a colonized or infected person.  It can be passed from hands that are not clean to any person, object or surface they touch.  When hands are washed thoroughly or rubbed with alcohol-based hand products, MRSA will likely be removed.

However, if the immediate environment is not clean, hands can very quickly become soiled again.  Frequent hand cleaning is necessary to either prevent spreading MRSA to others, or to prevent picking it up from others.

There are 5 C’s that describe risk factors for CA-MRSA infections:
            - crowded conditions
            - close contact
            - lack of cleanliness
            - sharing common personal items, e.g. towels, and
            - having compromised or broken skin.

What does colonization and infection mean?

Colonization:   Colonization refers to the presence and multiplication of a microorganism without tissue invasion or damage. MRSA can colonize the skin and nose of healthy people.

Infection:  Infection refers to the entry and multiplication of a microorganism in an individual causing tissue or cellular damage and signs and symptoms of infection.

What can I do to decrease the spread of MRSA?

1. Clean hands regularly with soap and water or alcohol based hand gel. If hands are visibly soiled, soap and water works best.  Antibacterial soaps are NOT recommended.

2.  Always clean hands immediately after touching skin or any item that has come in direct contact with a draining wound.

3.  Keep wounds that are draining covered with clean, dry bandages.

4.  If you are not able to keep your wound covered with a clean, dry bandage at all times, do not participate in activities where you have skin-to-skin contact with other persons (such as athletic activities) until your wound is healed.

5. Maintain good general hygiene with regular showering.

6. Do not share personal items that may become contaminated with wound drainage, such as towels, clothing, bedding, bar soap, razors, and athletic equipment that touches the skin.

7. Wash clothing using regular laundry soap in the regular wash cycle of a household washing machine.

8. Clean shared items e.g., sports equipment or environmental surfaces with over- the-counter detergent/disinfectant that are suitable for the type of surface being cleaned. 

9. If you have signs of an infection, seek appropriate medical care promptly.

 HAND WASHING IS THE BEST WAY TO PREVENT THE SPREAD OF MRSA! 
Follow these simple instructions when washing your hands with plain soap and water:

1. Wet with warm water.
                                          
2. Apply soap and scrub for 15 seconds – all surfaces including front and back of hands, between fingers, around nails (especially cuticles), thumbs and wrists.

3. Rinse well.

4. Dry with a paper towel.

5. Use towel to turn off taps.

 Follow these simple instructions when using a waterless hand sanitizer:
1.  Apply a measured pump (or nickel size) of the product to your open palm.

2.  Rub into hands covering all surfaces including front and back or hands, between fingers, around nails (especially cuticles), thumbs and wrists.

3.  Rub until dry (approximately 15 seconds).

For more information, visit www.dobugsneeddrugs.org

Thank you for helping to prevent the spread of MRSA!
For Administrators of Schools

Emphasis must be placed on the consistent application of hygienic measures within schools to reduce the risk of spreading MRSA.

Recommendations:

• Educate providers, teachers, children and families on general hygiene practices (e.g., hand hygiene, respiratory etiquette and staying home if ill).
• Ensure availability of products to allow hand hygiene to be performed. This includes access to liquid soap in pump dispensers, running water and paper towel to dry hands.  Alcohol based waterless hand sanitizers can be used as an alternative as long as hands are not visibly soiled.
• Structure activities to include opportunities for hand hygiene to be practiced (before eating, after outdoor play and after using the washroom).
• In situations in which open lesions cannot be kept covered, consider recommending that a child stays at home from the school setting until the wound has healed or drainage can be contained.
• Ensure that frequently touched surfaces (e.g., counters, desks and toys) are cleaned at least once a day with a disinfectant solution.
• Items soiled with body fluids should be cleaned and disinfected as soon as possible and before use by another child.

Thank you for helping to prevent the spread of MRSA!

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[1] Barton M, Hawkes M, Moore D, Conly J, Nicolle L, Allen U, Boyd N, Embree J, Van Horne L, Le Saux N, Richardson S, Moore A, Tran D, Waters V, Vearncombe M, Katz K, Weese JS, Embil J, Ofner-Agostina M, Ford-Jones EL and The Writing Group of the Expert Panel of Canadian Infectious Disease, Infection Prevention and Control and Public Health Specialists. (2006). Guidelines for the Prevention and Management of Community Associated Methicillin Resistant Staphylococcus Aureus: A Perspective for Canadian Health Care Practitioners. Retrieved January 24, 2007 http://www.pulsus.com/infdis/17_SC/Pdf/mrsa_ed.pdf