MRSA: It’s Time to Get the Facts Straight

By Sharon Conroy, R.N.

This article is intended to inform the community about Methicillin – Resistant Staphylococcus aureus, also known as “MRSA.”

Fact number one: MRSA is not a new “Super Bug.”  Methicillin – Resistant Staphylococcus aureus has become a progressively more important human pathogen since its initial description in 1961 and the first documented outbreak of infection in 1968.

Fact number two: MRSA is not antibiotic-resistant. MRSA is resistant to many of the most common antibiotics, lending us to look at more powerful antibiotics for treatment.

Hard-to-kill (resistant) germs, such as MRSA develop when antibiotics are taken longer than necessary or when they are taken, but not needed. Any germs that survive treatment with an antibiotic can go on to reproduce and create more resistant germs. The more often antibiotics are used; the more chances resistant germs have to develop. This is why your healthcare provider may be reluctant to prescribe antibiotics unless he or she is certain that they are needed.

The most recent data from the National Nosocomial Infection Surveillance System of the Centers for Disease Control and Prevention showed in August 2003 that MRSA accounts for 57 percent of Staphylococcus aureus nosocomial (hospital-related) infections in intensive care units. Community Hospital does not fit into the national average. Since January 1, 2007 there has not been a single case of MRSA that could be documented back to originating at Community Hospital.

Fact number three: There are actually two kinds of MRSA, healthcare-acquired and community- acquired.  When not treated properly, MRSA infections can be fatal. At Community Hospital, physicians and staff take MRSA infections seriously. A patient with a known or suspected MRSA infection is placed in the appropriate isolation until a culture and sensitivity results can be obtained from the laboratory.  Staff and visitors are expected to follow isolation procedure until MRSA is ruled out, or isolation continues with confirmed diagnosis of MRSA. 

There are factors that make individuals more susceptible to a MRSA infection:

• Recent stay in a hospital or nursing home
• Recent operation, invasive procedures such as bladder catheters, feeding tubes, or having wounds
• Individuals with weakened immune systems such as kidney failure or diabetes.
• Being very young or very old
• Having a serious illness
• Injecting illegal drugs
• Playing contact sports
• Sharing towels, personal items, or athletic equipment, and living or having close contact with someone who is infected.

Preventing MRSA infection:  What patients in hospitals can do.

• Ask all hospital staff to wash their hands before touching you.  Don’t be afraid to speak up!
• Wash your hands frequently with soap and water or use an alcohol based hand gel (containing at least 60 percent alcohol)
• Ask that stethoscopes and other instruments be wiped with alcohol before they are used on you.
• If you have a urinary catheter (a soft tube in the bladder that drains urine) ask to have it removed as soon as possible.

Hand washing is the single most important way to prevent the spread of germs. Healthcare workers are expected to wash their hands with soap and water or alcohol based hand sanitizer before and after patient contact. Hand hygiene, by physicians and staff, is monitored on a continuum at Community Hospital.

In order to keep MRSA and other organisms at bay, Community Hospital has stepped up isolation procedures, placed alcohol hand sanitizer dispensers in all patients’ rooms, at all sinks, at the front and back desks, educated staff on the importance of hand hygiene, continually monitor hand hygiene, and educated patients to speak up. Bottles of hand sanitizer are also placed at the patients’ bedside if the patient is capable to use it.

Positive MRSA cultures are reviewed by a laboratory technician and the infection control nurse.  As the Infection Control Nurse at Community Hospital, I have been monitoring MRSA lab results for the past 11 months. Eighty percent of all positive MRSA cultures that have been run through our lab are community-acquired. The other 20 percent of positive cultures come from other places such as long-term care facilities. These numbers are cumulative from our service region. The real focus should be on protecting ourselves from community-acquired MRSA.

Preventing MRSA infection:  What can be done in the community?

• Wash hands thoroughly and often with soap and water
• If participating in contact sports, cover cuts, scrapes and other wounds with a bandage.  
• Keep cuts and abrasions clean and covered with a bandage until healed.
• Avoid contact with other people’s wounds or material contaminated by wounds.
• Do not share items such as razors, soap, ointments and balms, towels or wash cloths, clothing or uniforms.
• Shower with soap immediately after each practice or game. Wipe down all non-washable equipment (mats, head protectors, gymnastics equipment, etc.) with alcohol or antibiotic solution after each person uses it.
• See a physician promptly if you have a suspicious skin sore or boil.

Community Hospital is trying to increase awareness of infection issues in the community through news articles, acting as a resource by offering educational presentations upon request, and placing sanitizing wipes (for use on the shopping carts) at Schmick’s Market.

Fact Number Four: Some MRSA infections start as a small red bump on the skin which looks like a pimple or spider bite. These “sores” can quickly turn into pus filled pockets. The germ can spread deeper into the body causing severe infections of the bone, lungs, heart muscles, e.t.c.

If you have a lesion that appears quickly, especially for no known reason, suspect MRSA. You should contact your health care provider for proper diagnosis and treatment.

For more information about MRSA, contact Sharon Conroy, R.N. at Community Hospital, at 308-344-8220.