Healthcare-Associated MRSA

HA-MRSA stands for healthcare-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.

HA-MRSA can be acquired by people in any healthcare setting. MRSA can be a big problem for hospitalized people, people in nursing homes, people in rehabilitation facilities, people with weakened immune systems, dialysis patients, and those who have had surgery.

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.

  • HA-MRSA happens commonly among people in hospitals and people receiving care in other healthcare facilities.

  • If someone gets a MRSA infection, it is likely to be HA-MRSA if:

  • He or she has had frequent or recent contact with hospitals or healthcare facilities (such as nursing homes or dialysis centers) within the previous year.

  • He or she recently had an invasive medical procedure (including having a tube placed in the body, such as a urinary catheter or a central line IV catheter). The chance of getting MRSA can be higher for someone who gets kidney dialysis, has a long-term vascular access device, or has a long-term urinary catheter.

  • HA-MRSA infections acquired in hospitals and healthcare settings can be severe. Certain things can put some patients at higher risk for acquiring HA-MRSA. These include:

  • Prolonged hospital stay.

  • Receiving broad-spectrum antibiotics or long or repeat courses of antibioitics.

  • Being hospitalized in an intensive care or burn unit.

  • Spending time close to other patients with HA-MRSA.

  • Having recent surgery.

  • Having tubes or catheters in the body as part of care.

  • Carrying MRSA in the nose without developing illness.

  • A common method of contracting HA-MRSA is through direct contact with a person who is colonized with MRSA.

  • Another common method of contracting HA-MRSA is through skin contact with a surface that is contaminated with MRSA.

You may be screened for MRSA on your skin or in your nose at the time of admission or treatment. This depends on where you live and why you are receiving care.

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 the hospital and healthcare settings.

  • Strict hand washing or hand disinfection procedures need to be followed before and after touching every patient.

  • Patients infected with MRSA are placed in isolation to prevent the spread of the bacteria.

  • Healthcare workers need to wear disposable gowns and gloves when touching or caring for patients infected with MRSA. Visitors may also be asked to wear a gown and gloves.

  • Hospital surfaces need to be disinfected frequently.

  • 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, other personal hygiene products, 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.

  • 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.

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

  • 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.