What is MRSA?
Submitted by Anthony
Perez, CHUC, of
Learning
Objectives
As
health unit coordinators, it is very important for us to learn about MRSA
(Methicillin-Resistant Staphylococcus aureus) so we can perform our job duties
competently in the healthcare setting. MRSA is a type of bacteria that is
resistant to many antibiotics. This type of infection was first discovered in
1961. Sometimes called Staph bacteria, it is like other kinds of bacteria that
live on and around us, usually without causing problems. MRSA only becomes a
problem when it causes an infection.
How
does someone come into contact with MRSA? It spreads from person to person by
casual contact like a handshake or by touching objects contaminated with
MRSA. A person spreading MRSA usually
has it on the surface of their skin though they may not even be infected. Infection
is contracted through cuts and sores or in the hospital setting on catheters or
oxygen tubes and other medical equipment that have been contaminated. It can
become airborne through coughing if a person has MRSA pneumonia. Many people
are carriers of Staph without ever being infected. Up to 25-30% of people have
these bacteria in their noses. Infections are most common among people with
weak immune systems and those staying in
hospitals, nursing homes and other health care facilities. Hospitals rates of
infection, especially those in the intensive care units, have been rising
throughout the world and MRSA is the cause of more than 60% of the infections.
The
symptoms of MRSA can vary. Small red bumps may appear on the skin that can
develop into deep and painful abscesses.
Patients with MRSA may also have fever, cough, fatigue, muscle aches and
shortness of breath. MRSA can cause serious infections to surgical wounds and
then spread the infection within the body. In turn, the infection could spread
into the blood system, lungs, urinary tract and even into the heart valves.
When infection penetrates into the body like this, MRSA becomes potentially
life threatening.
To
diagnose MRSA, doctors will usually order a variety of lab tests called
cultures. As unit coordinators we must be familiar with and be able to enter
these lab tests into the hospital computer system when doctors request them.
The type of cultures ordered will depend on the patient’s symptoms and are used
to detect and confirm the bacteria that is causing the infection. Most likely,
cultures will be ordered on the following specimens: blood, skin, sputum, urine
and nasal secretions. After specimens are collected, they are sent to a lab
where they are observed for bacteria growth for 24 to 48 hours. In many
hospitals, it is protocol to test patients for MRSA with a nasal culture if
they have been transferred from one health care facility to another. Patients
may also be required to have a nasal culture if they have had a previous
history of MRSA.
MRSA
is usually treated with an antibiotic to which the bacteria are not
resistant. In some cases, doctors may
only need to drain a wound or abscess to treat MRSA instead of treatment with
antibiotics. Because MRSA has become resistant to many antibiotics like
methicillin, amoxicillin, penicillin, oxacillin, and many other drugs,
researchers have to continue to develop new antibiotics that will work on MRSA.
Vancomycin and Bactrim are the antibiotics most often used. There are others
such as Cleocin, Minocycline, Cubicin, Zyvox and Synercid that are used as
well.
Prevention
of MRSA can vary, including antibiotics,
isolation precautions, thorough hand washing and just being educated to have a
good understanding of MRSA. Isolation may involve putting the patient in a
private room where contact with other people is limited. All who come into
contact with a patient on isolation must use the necessary precautions of
wearing an isolation gown, mask and gloves. As a unit coordinator, we must know
how to order the isolation carts and all isolation supplies that are necessary
in a health care environment. According to the Centers for Disease Control and
Prevention (CDC), some of the best ways to practice prevention is to just wash
your hands thoroughly. You can do this by using soap and water followed by an
alcohol-based hand sanitizer and always cover cuts and scrapes with a band-aid
or bandage.
As
unit coordinators, we are the eyes and ears of the nursing unit. We must be
ready to advise all to use precautions by washing their hands and adhering to
the isolation precautions. We need to make sure that all isolation signs are
placed appropriately for all to see before entering a patient isolation room.
It is very important that all be made aware of the precautions before entering
into an isolation room. This means everybody, from doctors, nurses, and health
care workers to patient visitors. Environmental services and dietary must be
notified. Many visitors do not know about or understand MRSA or isolation precautions.
Sometimes they do not notice that their family member or friend has an
isolation cart and isolation sign in front of their room and they will want to
walk right in to see them. Unit coordinators must be ready to explain to the
visitor that the patient is in isolation. We must be able to explain the
importance to adhering to these precautions, not only for the prevention of
infection to the visitors, but also to prevent the spread of infection to other
patients and staff in the hospital.
Therefore,
understanding MRSA is very important. With understanding and education, we can
all help to contribute to the prevention of MRSA.
Resources:
Methicillin-Resistant
Staphyloccoccus aureus (MRSA). By Ralph Poore, copyright 2007 Healthwise.
http://www.bing.com/health/article.aspx?id=articles%2fhealthwise%2f61018680CD889F782482E36C029575A9.html&br=lv&q=mrsa
MRSA
Infection. By Mayo Clinic Staff, copyright 2008 Mayo Clinic.
http://www.mayoclinic.com/health/mrsa/DS00735
Understanding
MRSA (Methicillin-Resistant Staphyloccoccus aureus). By Debbie Bridges, MD,
Copyright 2008 WebMD.
http://www.webmd.com/skin-problems-and-treatments/understanding-mrsa-methicillin-resistant-staphylococcus-aureus
MRSA.
By David Dugdale, III, MD and Jatin Vyas, PhD, MD, copyright 2009 Medline Plus.
http://www.nlm.nih.gov/medlineplus/ency/article/007261.htm
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1.
MRSA is sometimes called:
a. C-diff
b. Staph bacteria
c. Abscess
d. Pneumonia
2.
In what year was MRSA first discovered?
a. 1921
b. 1806
c. 2001
d. 1961
3.
What might an MRSA skin infection look like?
a. Red bumps
b. Blotchy skin
c. Dry flaky skin
d. Black and blue marks
4. MRSA has been the
cause of ______ percent of rising
infections in hospitals throughout the world.
a. 10%
b. 75%
c. 60%
d. 1%
5.
Which is not going to spread
infection when coming into contact with a person with MRSA.
a. Shaking hands
b. Touching contaminated objects
c. Being coughed on by someone with
MRSA pneumonia
d. Wearing isolation gown, mask and
gloves
6.
Up to 25-30% of people have Staph bacteria in their:
a. Nail cuticles
b. Eye lids
c. Noses
d. Wallets
7.
Which antibiotics are most often used when treating MRSA?
a. Cleocin and amoxicillin
b. Cubicin and Pepto
Bismol
c. Penicillin and Oxacillin
d. Vancomycin and Bactrim
8.
What is not likely to be cultured to
detect MRSA?
a. Blood
b. Nasal secretions
c. Sputum
d. Cerebral spinal fluid
9. If a patient was to
be transferred from one health care facility to another, which could be done as
part of a MRSA precaution?
a. CBC
b. Urine culture
c. Nasal culture
d. Chest X-Ray
10.
What is not a symptom of someone
infected with MRSA?
a. Muscle aches
b. Loss of hearing
c. Cough
d.
Painful abscess