Community-Associated MRSA, California

CA-MRSA stands for community-associated methicillin-resistant Staphylococcus aureus. MRSA is a type of bacteria that is resistant to some common antibiotics. It can cause infections in the skin and many other places in the body. Staphylococcus aureus, often called "staph," is a bacteria that normally lives on the skin or in the nose. Staph on the surface of the skin or in the nose does not cause problems. However, if the staph enters the body through a cut, wound, or break in the skin, an infection can happen.

Up until recently, infections with the MRSA type of staph mainly occurred in hospitals and other healthcare settings. There are now increasing problems with MRSA infections in the community as well. Infections with MRSA may be very serious or even life-threatening.

CA-MRSA is becoming more common. It is known to spread in crowded settings, in jails and prisons, and in situations where there is close skin-to-skin contact, such as during sporting events or in locker rooms. MRSA can be spread through shared items, such as children's toys, razors, towels, or sports equipment.

CAUSES

All staph, including MRSA, are normally harmless unless they enter the body through a scratch, cut, or wound, such as with surgery. All staph, including MRSA, can be spread from person-to-person by touching contaminated objects or through direct contact.

  • MRSA now causes illness in people who have not been in hospitals or other healthcare facilities. Cases of MRSA diseases in the community have been associated with:

  • Recent antibiotic use.

  • Sharing contaminated towels or clothes.

  • Having active skin diseases.

  • Participating in contact sports.

  • Living in crowded settings.

  • Intravenous (IV) drug use.

  • Community-associated MRSA infections are usually skin infections, but may cause other severe illnesses.

  • Staph bacteria are one of the most common causes of skin infection. However, they are also a common cause of pneumonia, bone or joint infections, and bloodstream infections.

SCREENING AT CALIFORNIA-BASED MEDICAL FACILITIES

(For compliance with the 2008 Medical Facility Infection Control and Prevention Act)

As a part of our hospital's commitment to reduce antibiotic-resistant bacteria and keep patients safe, patients who meet specific criteria will have a culture collected from their nose in order to determine if they are carriers of the MRSA bacteria. If your culture comes back positive, nurses, doctors, and other healthcare staff will wear gowns and gloves when they come into your room. These protective measures are necessary to assure the highest level of safety for our patients.

DIAGNOSIS

Diagnosis of MRSA is done by cultures of fluid samples that may come from:

  • Swabs taken from cuts or wounds in infected areas.

  • Nasal swabs.

  • Saliva or deep cough specimens from the lungs (sputum).

  • Urine.

  • Blood.

Many people are "colonized" with MRSA but have no signs of infection. This means that people carry the MRSA germ on their skin or in their nose and may never develop MRSA infection.

TREATMENT

Treatment varies and is based on how serious, how deep, or how extensive the infection is. For example:

  • Some skin infections, such as a small boil or abscess, may be treated by draining yellowish-white fluid (pus) from the site of the infection.

  • Deeper or more widespread soft tissue infections are usually treated with surgery to drain pus and with antibiotic medicine given by vein or by mouth. This may be recommended even if you are pregnant.

  • Serious infections may require a hospital stay.

If antibiotics are given, they may be needed for several weeks.

PREVENTION

Because many people are colonized with staph, including MRSA, preventing the spread of the bacteria from person-to-person is most important. The best way to prevent the spread of bacteria and other germs is through proper hand washing or by using alcohol-based hand disinfectants. The following are other ways to help prevent MRSA infection within community settings.

  • Wash your hands frequently with soap and water for at least 15 seconds. Otherwise, use alcohol-based hand disinfectants when soap and water is not available.

  • Make sure people who live with you wash their hands often, too.

  • Do not share personal items. For example, avoid sharing razors and other personal hygiene items, towels, clothing, and athletic equipment.

  • Wash and dry your clothes and bedding at the warmest temperatures recommended on the labels.

  • Keep wounds covered. Pus from infected sores may contain MRSA and other bacteria. Keep cuts and abrasions clean and covered with germ-free (sterile), dry bandages until they are healed.

  • If you have a wound that appears infected, ask your caregiver if a culture for MRSA and other bacteria should be done.

  • If you are breastfeeding, talk to your caregiver about MRSA. You may be asked to temporarily stop breastfeeding.

HOME CARE INSTRUCTIONS

  • Take your antibiotics as directed. Finish them even if you start to feel better.

  • Avoid close contact with those around you as much as possible. Do not use towels, razors, toothbrushes, bedding, or other items that will be used by others.

  • To fight the infection, follow your caregiver's instructions for wound care. Wash your hands before and after changing your bandages.

  • If you have an intravascular device, such as a catheter, make sure you know how to care for it.

  • Be sure to tell any healthcare providers that you have MRSA so they are aware of your infection.

SEEK IMMEDIATE MEDICAL CARE IF:

  • The infection appears to be getting worse. Signs include:

  • Increased warmth, redness, or tenderness around the wound site.

  • A red line that extends from the infection site.

  • A dark color in the area around the infection.

  • Wound drainage that is tan, yellow, or green.

  • A bad smell coming from the wound.

  • You feel sick to your stomach (nauseous) and throw up (vomit) or cannot keep medicine down.

  • You have a fever.

  • Your baby is older than 3 months with a rectal temperature of 102° F (38.9° C) or higher.

  • Your baby is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.

  • You have difficulty breathing.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.