Methicillin Resistant Staphylococcus Aureus
What is Staphylococcus aureus?
Staphylococcus aureus (S. aureus) is a bacterium that can live on the skin and mucous membranes of healthy adults without causing illness. These individuals are colonized with the organism. As much as 20 percent of the population is persistently colonized with S. aureus. Occasionally, S. aureus might be the cause of infections such as impetigo, carbuncles, and abscesses or more serious disease. S. aureus is the single most common cause of hospital-associated infection.
What is MRSA?
When S. aureus develops resistance to certain antibiotics (e.g., the penicillin group) it is known as Methicillin Resistant Staphylococcus Aureus (MRSA). While MRSA may be harder to treat than S. aureus that is sensitive to this group of antibiotics, there is little evidence to suggest that it is more likely to cause infection or more severe infection. However, it is associated with higher case fatality rates because there are few treatment options available. MRSA may be either health care associated or community associated (CA-MRSA).
Control measures for MRSA
If in a hospital or long-term care home (LTCH), contact precautions will be used to prevent the spread of MRSA to others. In LTCH, these precautions may be modified to some extent to allow the residents to partake in activities occurring in the home. Normally, residents are not required to stay in their rooms if they have MRSA, unless they have draining wounds that cannot be contained with a dressing.
Contact precautions for colonized or infected people include:
- Hand hygiene - Health care providers and visitors must clean their hands before and after being in the resident's or patient's environment. Soap and water or an alcohol-based hand rub should be used. People with MRSA must clean their hands when they leave their room. Some people may require assistance with this task.
- Personal protective equipment (PPE) - Anyone entering a resident's or patient's room or providing direct care is required to wear gloves and gown. PPE must be removed after direct care or when exiting the room and hand hygiene performed. Pushing a wheelchair or assisting with feeding is not considered direct care and gloves are not needed.
- Equipment - Equipment such as thermometers and blood pressure cuffs should be dedicated for the use of the person with MRSA for the duration of their colonization or infection. If dedicated equipment is not available, all items must be properly cleaned and disinfected between uses.
- Environmental cleaning - MRSA can survive on surfaces and equipment for extended periods of time. Proper cleaning and disinfection practice is a two-step process: surfaces should be cleaned first with soap and water and then disinfected using a product that is meant for that purpose. The manufacturer's instructions must be followed to ensure that bacteria are effectively eliminated.
- Room placement - If possible, it is recommended that MRSA positive people be placed in a private room. If one is not available, they may be placed in a room with another MRSA positive individual. MRSA positive people can be placed in a room with someone who does not have MRSA, provided an assessment is done by an infection control practitioner to ensure that the risk of transmission is minimal.
Discontinuation of contact precautions
Routine decolonization of positive people with antibiotic treatment is not currently recommended. Screening may occur periodically to see if colonization with MRSA remains. Colonization may continue for years.
Transfer of residents
If a person with MRSA is transferred from one LTCH to another or to a hospital, the original facility must notify the receiving facility of the resident's or patient's MRSA status so that appropriate precautions can be taken.
Revised: 2014-02-24