MRSA Physician Offices
Project Overview
Resistant Staphylococcus has become a concern not only for health care professionals and medical facilities, but for the general public as well. Reports in the lay press have focused substantial attention on this growing problem. AFMC, in concert with the Arkansas Department of Human Services, has developed materials to assist in dealing with new issues related to resistant Staphylococcus.
Central points for Arkansas physicians and their staff include appropriate awareness of the prevalence of this organism, early identification of suspicious lesions, appropriate use of select antibiotics, regular hand-washing after patient contact and targeted advice to community facilities for coping with local outbreaks.
Twenty percent to 40 percent of the population carry Staphylococcus on their hands, in their nose or on other regions of the body, and about 10 percent of this population carry MRSA. Patients with MRSA-positive nasal cultures are two to 15 times more likely to develop a subsequent staphylococcal infection. Carrier status can spontaneously resolve in half of these individuals over a period of many months. It is not recommended at present to screen all patients and health care workers for carrier status. Such screening might be appropriate in response to local outbreaks in particular units or preoperatively before high-risk procedures. Patients and members of their families who suffer recurrent staphylococcal infections should be screened for carrier status and treated with intranasal muciprocin to reduce the risk of recurrence.
It is not necessary to eliminate carrier status of patients with Staphylococcus prior to transfer to a new clinical facility. Rather, these patients should be identified and subject to appropriate isolation procedures, such as regular hand-washing by the patient and their care attendants, as well as respiratory isolation for those patients with active upper airway secretions.
Not all soft tissue infections with MRSA require hospitalization and intravenous antibiotics. Oral tetracyclines and sulfonamides can control early infections. Importantly, these lesions can develop into a large abscess in a short period of time. Such patients, especially if they are diabetic, deserve hospitalization, drainage consideration and aggressive anti-microbial therapy.
Prevention of the spread of resistant Staphylococcus should focus on avoiding shared personal equipment (towels and razors, etc.), careful cleaning of surfaces subject to skin contact and attention to hand hygiene. Cleansing of walls and other objects that do not come in contact with bare skin probably results in minimal protection for future infections.
AFMC will provide materials on its website and work with health professionals in different clinical settings to respond to this evolving challenge. We will also work with different health care settings to agree on common protocols for the transfer and care of patients with resistant Staphylococcus. Our quality improvement teams are available for comments and questions concerning this communication and project.
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Other Resources:
How is MRSA spread? How can MRSA infections be prevented? Click here to view and download the MRSA brochure offered by DHHS and APIC.
Learn more about MRSA and strategies to prevent infection in light of increasing antibiotic resistance. By following the recommendations in this guide, your patients will learn to manage their MRSA and avoid spreading it to their family and friends.
Download/Printable posters are available for your practice from the CDC: