APIC Newsletter Discusses MRSA

Schools closing for scrubbing.  Sports cancelled. Worried school officials, worried parents.  Confusion, conflicting advice, uncertainty.
So what's the story with MRSA?  MRSA- methicillin resistant staph aureus has become a household word.  MRSA used to be a hospital germ, seen in patients who were frequently hospitalized or in long-term care, especially those with medical tubes.  Often, it wasn't particularly harmful; however, with time the germ has evolved, and some varieties of MRSA can now cause severe illness.
In the last five years MRSA infections have occurred in the community among people who have no history of recent hospitalizations.Community-associated or CA-MRSA infections often start as skin and soft tissue infections.  Many people think they have a "spider bite" or "bug bite."  The skin infections have been described as "boils" or even "little volcanoes."  While resistant to methicillin, CA-MRSA can be treated by a number of antibiotics that can be given by mouth.  Septra and clindamycin are two frequently used drugs.  With small skin infections, often just opening and draining the abscess will work just fine.
So why all the concern?  In rare cases, MRSA can cause life-threatening infections.  It can cause pneumonia, a serious lung infection, or get into the bloodstream and cause a bloodstream infection called sepsis.  In a few cases, the infection is so severe that the person dies from it.  This is a small number of people compared to the number with treatable skin and soft tissue infections or those who have the organism on their skin but have no symptoms of infection at all. There are other germs that can do the same thing, too.
What can you do to protect yourself and your family?
Handwashing is the most important way to protect yourself against MRSA, colds and flu, and even upset stomachs and diarrhea.  Most of the germs that cause illness get on our hands, then we put our hands in our mouths, rub our eyes or nose and put those germs into places that can make us ill.  Warm, running water, soap and friction for 20-30 seconds, scrubbing all hand surfaces, will remove most of those harmful bugs.  If soap and water aren't available, use an antiseptic hand cleaner that contains at least 60% alcohol.
A clean environment helps stop the spread of disease, too.  Kids and adults in schools, day cares and other close quarters touch a lot of shared surfaces.  Think about the pencil sharpener, door knobs, desks, tables, books and the many things we touch throughout the day.  Keeping surfaces clean and cleaning on a regular basis is a good way to prevent transmission of germs.  In sports and gym classes, it's very important that equipment that comes in contact with kids gets disinfected between and after uses.  Wrestling and tumbling mats, protective helmets and pads, any shared clothing, etc., must be sanitized after each use.  Schools and gyms should have a written policy on WHO is to do this, WHEN this is to be done, WHERE cleaning will take place, WHAT they will clean with, and HOW the item will be cleaned.
After sports or gym class, kids need to take a shower with soap.  Who doesn't forget that first after-gym shower!  Not only should everyone shower, towels shouldn't be shared.  Once the person has dried off, the towel goes into the hamper or the gym bag to go home for laundering.  All sports clothing and gym suits must be laundered after each use.  That "lucky shirt" will be just as lucky clean as full of germs.  Probably luckier, because the wearer is less likely to get an infection!
What happens if you get a MRSA infection?  First, be sure to see your healthcare provider.  MRSA infections are nothing to fool around with.  Your provider may open the wound and drain it and give you instructions for caring for the wound while it's healing.  Small wounds often do NOT need antibiotics, so you may or may not get a prescription.  If you DO get antibiotics, be sure to take them exactly as prescribed.  Remember, it's the last few pills that kill the hardiest bugs, so don't stop taking them until the pills are all gone.  If your infection gets worse, or you have a fever, seek medical attention.
To prevent spread to others, be sure to keep your wound covered with a bandage that doesn't leak.  Hands should be washed thoroughly before and after changing the dressing.  Used dressings should be placed in a plastic bag that is tied up and then placed in a wastebasket.  It is safe to go to school or work as long as the dressing will stay in place and not leak during the school or work day.  If the wound is leaking and the drainage can't be contained, stay home until it gets manageable.  If the drainage gets worse, seek medical attention.