14.03.2008

MRSA (methicillin-resistant Staphylococcus Aureus) and precautions for healthcare workers

First there was Staphylococcus aureus, a bacterium that continues to cause
illness. Overprescribing of antibiotics helped change it into a "superbug" that
eventually defeated methicillin, the drug that had been most effective in
fighting it. This new strain was called methicillin-resistant Staphylococcus
aureus (MRSA) and became common in hospitals. Only a few antibiotics are
effective against some hospital strains of MRSA infection.

Meanwhile, in the 1990s, staph took on yet another form, community-associated
MRSA (CA-MRSA) - infections in healthy people who had not been hospitalized nor
had a medical procedure such as dialysis or surgery within the past year.
Several drugs continue to work against this strain, but this strain of staph
could also become drug-resistant in time.

What are the symptoms?

It's possible to carry the staph bacteria for years without becoming sick.
Sometimes it causes a minor skin problem by infecting a cut or wound. The first
sign of a staph infection is usually an outbreak of small red bumps on the
skin, which can soon become deep, painful abscesses that need to be surgically
drained. Other signs of infection are headache, fever and lack of energy.

The bacteria may remain confined to the skin, but in more serious cases, they
can go deep into the body, causing potentially life-threatening infections in
bones, joints, surgical wounds, the bloodstream, heart valves and lungs. MRSA
has also been known to cause urinary tract infections, pneumonia, toxic shock
syndrome, and even death.

As a precaution, as soon as a pimple, insect bite, cut or scrape on the skin
becomes infected, see your doctor. Rather than asking for antibiotics, ask to
be tested for MRSA. Drugs that have no effect against MRSA could lead to
serious illness and more resistant bacteria.

How is it spread?

MRSA is usually spread through physical contact - not through the air. The risk
factors for hospital and community strains of MRSA are different because they
generally occur in different settings, however both strains are spread in the
same way, mainly through person-to-person contact or contact with a
contaminated item.

Who is at risk?

People who are currently or have recently been hospitalized, or live in
long-term care facilities are at risk of hospital-acquired MRSA. Older adults
and people with weakened immune systems, burns, surgical wounds or serious
underlying health problems are vulnerable as are those on dialysis, who are
catheterized, or have feeding tubes or other invasive devices. MRSA is
transmitted most commonly by hands (especially health care workers' hands),
which may become contaminated by contact with infected patients, or surfaces
and medical devices that are contaminated with body fluids containing MRSA.

Community-associated MRSA can be especially dangerous to children, whose immune
systems are not yet fully developed or who don't yet have antibodies to common
germs. Elderly people and those weakened by pre-existing health issues are also
susceptible, as are people whose immune systems are compromised.

Amateur and pro athletes have been known to contract CA-MRSA from cuts,
abrasions, skin-to-skin contact, shared towels or athletic equipment, or shared
razors. Outbreaks have been also seen among prisoners, military recruits,
daycare attendees, and injection drug users. People who have lived in crowded,
unsanitary conditions, or have had close contact with health care workers,
should be alert for symptoms of CA-MRSA.

Help prevent MRSA skin infections

To prevent infection from MRSA and other strains of staph, it is important to
follow good hygiene (hand washing) practices. If you are a healthcare worker
the best way to prevent the spread of germs is to take standard infection
control precautions that include washing hands frequently, properly
disinfecting hospital surfaces and taking other precautions such as wearing a
mask when working with people with weakened immune systems. Visitors and
healthcare workers caring for infected or colonized (bacteria are present but
not causing an infection) patients placed in isolation may be required to wear
personal protective equipment and garments and to prevent the spread of the
bacteria.

To prevent infection from CA-MRSA - in addition to practicing good hygiene -
don't share personal items that may be contaminated (towels, razors, clothing,
etc.). Closely monitor skin irritations, keep cuts and scrapes clean and
covered with bandages until healed, and seek medical attention at the first
sign of skin infection. When using a prescribed antibiotic for an illness,
finish the entire prescription, even if you're feeling better. This way you
will increase the chance of killing every last germ instead of leaving the few
surviving ones to gain new resistance to medication.

Further Information


AplusA-online.de - Source: Canadian Centre for Occupational Health and Safety