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Community-Associated Methicillin Resistant Staphylococcus aureus (CA-MRSA) . What is it ? How is it transmitted? How can we prevent it?. What is CA-MRSA? . Type of staph bacteria that is resistant to certain antibiotics, including methicillin, oxacillin, penicillin and amoxicillin.

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Community-Associated Methicillin Resistant Staphylococcus aureus (CA-MRSA)

What is it?

How is it transmitted?

How can we prevent it?


What is ca mrsa l.jpg
What is CA-MRSA?

  • Type of staph bacteria that is resistant to certain antibiotics, including methicillin, oxacillin, penicillin and amoxicillin.

  • Infection acquired by persons who have not been hospitalized or had a medical procedure.

  • Infection presents as skin pimples or boils that may be mistakenly identified as a spider bite.

  • Differs from HA-MRSA which occurs in the hospital setting

  • Is not new – first identified in 1968


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Are certain people at increased risk for MRSA infections?

  • Outbreaks of CA-MRSA have occurred among:

    • Athletic teams – football, wrestling, rugby, fencing

    • Correctional facilities

    • Military barracks

    • Daycares and schools

    • Dormitories


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MRSA Outbreaks among Sports Teams, U.S., 1994-2004

1 Lindenmayer JM, et al. Arch Intern Med 1998;158:895-9.

2 Kainer MA. MRSA among college football team. (CDC unpublished)

3 Begier EM, et al. Clin Infect Dis. 2004;39:1446-53.

4 Kazakova SV, et al. New Engl J Med. 2005;352:468-75.

5 Nguyen DM, et al.Emerg Infect Dis. 2005;11:526-532.


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How is MRSA transmitted?

  • Person to person via hands & skin-to-skin contact

  • Sharing contaminated items such as soap, towels, clothing, athletic equipment, razors and other personal care items

  • Contaminated surfaces

  • Breaks in skin, abrasions increase risk of transmission


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Factors that make it easy for MRSA to be transmitted (5 C’s)

  • Crowding

  • Frequent, skin-to-skin Contact

  • Compromised skin (abrasions, cuts)

  • Contaminated surfaces

  • Lack of Cleanliness


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Frequent Contact C’s)

Defense

Offense

Cleanliness

Compromised Skin

CA-MRSA Common Factors

Crowding

Contaminated Surfaces

and Shared Items

Compromised Skin



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How is MRSA treated? C’s)

  • Request culture from health professional to confirm diagnosis

  • Incision and drainage of wound

  • Antibiotics – Take all doses!

  • Don’t share antibiotics or save for future use

  • Topical anti-microbial

  • Cover wound at all times

  • Exclude from close contact if

    drainage can’t be contained


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What we need to do to prevent transmission C’s)

  • Practice good hygiene:

    • Keep hands clean by washing thoroughly with soap and water

    • Use alcohol-based hand sanitizer if no access to soap and water

    • Shower daily and after athletic practice or competition

    • Keep cuts and scrapes clean and covered with a bandage until healed.

    • Discard used bandages and tape in garbage

    • Avoid contact with other people’s wounds or bandages.


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More recommendations to avoid transmission C’s)

  • Avoid sharing personal items such as towels, razors, clothing, washcloths, lotions, cosmetics

  • Launder all clothing and washable equipment in hot water with detergent and dry in a hot dryer.

  • Check skin routinely for signs of infection and monitor wound management

  • Maintain a clean environment by establishing cleaning procedures for frequently touched surfaces and surfaces that come in direct contact with people’s skin


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Precautions for Athletes C’s)

  • Shower with soap and water as soon

    as possible after contact sports

  • Do not share towels, razors, clothing, ointment

  • Use a barrier (towel) between skin and equipment surfaces

  • Wash towels, uniforms, scrimmage shirts, in hot water and dry in hot dryer

  • Transport laundry home in a plastic bag

  • Inform coach/trainer of skin infections and get approval for return to participation.


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Additional tips for athletic facilities C’s)

  • Weight Room

    • Wipe down equipment after use

    • No cut off tees in weight room

    • Place antibacterial gel or hand wipes in weight room so that athletes clean hands before picking up or using equipment

    • Names on towels

    • Clean athletic area and sports equipment at least weekly using commercial disinfectant or a FRESH (MIXED DAILY) solution of bleach 1:100 (1 tbsp bleach in one quart of water


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In the classroom C’s)

  • Children with open draining infections should be referred for medical evaluation

  • Enforce hand hygiene with soap and water or alcohol-based hand sanitizers before eating and after using the restroom

  • Use standard precautions (hand hygiene + gloves) when caring for non-intact skin or potential infections


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Cleaning the environment C’s)

  • Clean surfaces first; then disinfect

  • Read label and follow directions

  • Bleach + water 1:100

  • Lysol/original Pine Sol/EPA registered disinfectant (list @:http://epa.gov/oppad001/chemreindex.htm)

  • Quaternary ammonia

  • Leave surfaces wet for 10 minutes

    (if possible) or dry with paper towels


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Resources C’s)

  • Center for Disease Control

    • http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html

    • http://www.cdc.gov/Features/MRSAinSchools

  • National Athletic Trainers’ Association

    • https://www.nata.org/members1/canworc/powerpoint/CA-MRSA%20Dublin_files/frame.htm#slide0114.html


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More resources C’s)

  • Mich.Dept of Community Health

    http://www.michigan.gov/domuments/MRSA

    educational brochures and posters

  • Massachusetts State Health Dept.

    http://www.mass.gov/dph/cdc/antibiotic/mrsa

    MRSA materials translated into different languages


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CDC posters C’s)


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Recognize…React…Refer C’s)

Common sense, basic hygiene and disinfection practices CAN control the spread of communicable disease.

So smile and go wash your hands!


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