Recently the media has been having a great time causing sensationalism around the “Super Bug” and its effects on society.  MRSA is no stranger to the health care provider.

MRSA was so named because of the resistances of Staphylococcus aureus to methicillin, oxacillin, penicillin, and the commonly used amoxicillin.  These types of infections happen most commonly in those with weakened immune systems, typically in hospitals and healthcare facilities.  Now, the infection is appearing in the form of abscesses, boils, and other pus-filled lesions, in otherwise healthy people without contact within the healthcare system.  This is being termed community-associated MRSA or CA-MRSA.

In 2005, the estimated number of people developing serious MRSA infections was about 94,360.  In that same year 18,650 people died from MRSA infections.

Society in general is now becoming scared of a “Super Bug” that has been frightening nurses for years.  MRSA alone is not our only problem; other resistant strains include VRE - vancomycin-resistant enterococci, ESBLs - extended-spectrum beta-lactamases (which are resistant to cephalosporins and monobactams) and PRSP - penicillin-resistant Streptococcus pneumoniae.

What are the best defenses we can offer to protect ourselves, our patients, and our friends and neighbors from this invasion?  How do we educate a nation in fear?

Though the most significant reservoirs for MRSA and other related infections are still immune compromised, hospitalized patients, the most significant reservoir for transfer is in our hands.  Literally.  Hospital personnel can harbor MRSA organisms for months, transferring it to others in that time.  The ever famous Standard Precautions are still the best defense against this spread.

Hands should be washed after any contact with blood or body fluids of any type, whether or not gloves were worn.  Wash your hands after removing gloves, between patient contact, and in between contact on the same patient to avoid cross-contamination of infectious organisms from different body sites.

Wear gloves any time it can be reasonably anticipated that you will come in contact with any body fluid or area with open skin.  Don’t wear the same gloves for more than one procedure.  Don’t attempt to reuse these gloves for any purpose.

Use personal protective wear such as goggles, face shields, and gowns in anticipation of splashes or sprays.

Prevent medical devices that have come in contact with body fluids from being allowed to spread onto clothing, surfaces or other parts of the patient or environment.  Ensure that reusable equipment and surfaces are cleaned and disinfected any time contamination is even suspected.

When there is a known or suspected case of MRSA, these patients have priority for private rooms as well. Areas of open infection should be carefully covered if the patient is to be transferred or move throughout the facility.

What about in the community?  Again, the main key is hand washing.  Be vigilant and be sure those around us are aware of the importance as well.  In general, healthy people are still at low risk for acquiring an infection.  Casual contact such as kissing, hugging and touching a person, even one who is a known carrier is acceptable, except in the presence of an open lesion that is not properly covered.  Take special care around public areas that are handled frequently such as shopping cart handles and door knobs.

In the presence of an infection in the home also include routinely changing out linens and using disposable towels for washing hands.

Above all else assure those around you while there is a great cause for worry, there is not need for panic.  The basic answers to stopping the spread of MRSA are still within our hands.  The answer is our hands, plus a little soap and water.  Repeat often.

References:

• Department of Health and Human Services Centers for Disease Control and Prevention.  Healthcare-Associated Methicillin Resistant Staphylococcus aureus (HA-MRSA).  Available at: http://www.cdc.gov/ncidod/dhqp/ar_mrsa.html  Accessed November 2007.

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