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MRSA in homecare: What is MRSA and how can it be prevented?

Homecare Insider, April 8, 2013

The Centers for Disease Control and Prevention (CDC) defines Methicillin-resistant Staphylococcus aureus (MRSA) as "a type of staph bacteria that is resistant to certain antibiotics called beta-lactams. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin, and amoxicillin.

In the community, most MRSA infections are skin infections. More severe or potentially life-threatening MRSA infections occur most frequently among patients in healthcare settings." It's estimated that over 94,000 people suffered from MRSA infections in 2005, and over 18,000 of those people died. About 85% of all invasive MRSA infections are associated with healthcare, and of those, about two-thirds occur outside of the hospital, while about one-third occur during hospitalization.

In the past, MRSA was predominantly in healthcare facilities, but now it exists more frequently in the community, and homecare providers are treating and educating on MRSA much more frequently than in the past. MRSA in the community is widespread; therefore, anyone is at risk. Most people who get MRSA in the community get infections of the skin. Factors that have been associated with the spread of MRSA skin infections include close skin-to-skin contact, openings in the skin such as cuts or abrasions, contaminated items and surfaces, crowded living conditions, and poor hygiene. MRSA infections are usually spread by contact with infected skin or contact with personal items, such as towels, bandages, or razors that have touched infected skin.

MRSA skin infections may appear as pustules or boils that often are red, swollen, painful, or have pus or other drainage. They often first look like spider bites or bumps. These skin infections commonly occur at sites of visible skin trauma, such as cuts and abrasions, and areas of the body covered by hair (e.g., back of neck, groin, buttock, armpit, beard area of men). Treatment will vary by type and location of infection. The best defense is prevention.

The CDC recommends good hygiene as a key step in personal prevention for ­clinicians. Keep your hands clean by washing them thoroughly with soap and water or using an alcohol-based hand rub; keep cuts and scrapes clean and ­covered with a bandage until healed; avoid contact with other people's wounds or bandages; and avoid sharing personal items such as towels or razors.

Homecare agencies should consider developing a patient/caregiver education tool regarding MRSA, including the personal prevention strategies posted on the CDC website at www.cdc.gov/mrsa/index.html. Homecare providers must not only educate patients, but also provide thorough education to their staff regarding MRSA and the precautions to be taken. This includes not only clinical staff, but home health aides as well. 

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