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MRSA


MRSA is a member of the extremely common staph family of infections.

According to Centers for Disease Control and Prevention (CDC) and Agency for Healthcare Research and Quality data (AHRQ), the proportion of antimicrobial-resistant infections in healthcare settings has been growing.

  • From 1974 to 2004, MRSA infections increased from 2% of the total number of staph infections to 63%1
  • Patients diagnosed with MRSA infections rose from 1,900 in 1993 to 368,600 in 20052
  • In 2005, MRSA caused more than 94,000 life-threatening infections and nearly 19,000 deaths in the U.S. alone
  • Of these, 85% were associated with healthcare settings

mrsa thumb

Preventing Methicillin-Resistant Staphylococcus aureus (MRSA) Infections

Before a person can develop an infection with MRSA, they must first become contaminated and then colonized with the antibiotic-resistant strain of bacteria. MRSA transmission occurs by contact with contaminated hands, equipment or environmental surfaces. MRSA is known for its ability to survive and proliferate on virtually all surfaces, which have patient or healthcare worker contact. In addition, studies have shown that clinicians’ personal protective equipment (PPE), such as gowns and gloves, become contaminated with MRSA after caring for colonized or infected patients. This PPE can then potentially serve as a source for healthcare worker, patient or environmental contamination unless changed according to Standard Precaution or Contact Precaution protocols.3


The following guidelines, which are important in helping prevent the spread of MRSA, have been adapted from CDC Standard Precautions and Transmission-Based Contact Precautions.

Exam Gloves

Gloves should be:

  • Worn when touching blood, body fluids, secretions and excretions or contaminated items, mucous membranes and non-intact skin
  • Selected with the appropriate durability for the task at hand
  • Changed between patients, and between tasks and procedures on the same patient after contact with possibly infected material
  • Removed promptly after use and before touching non-contaminated items and surfaces
  • Hands should be washed when gloves are removed
  • Worn for all contact with patients known or suspected to be colonized or infected with MRSA

Facial Protection

Masks should be worn:

  • During procedures and patient care activities likely to generate splashes or sprays of blood, body fluids or secretions
  • When caring for patients with open tracheostomies and the potential for projectile secretions
  • In circumstances where there is evidence of transmission from heavily colonized sources such as burn wounds

Protective Apparel

Gowns should be:

  • Worn to protect skin and prevent soiling of clothing during procedures and patient care activities when contact of clothing or exposed skin with blood or body fluids, secretions and excretions is anticipated
  • Selected according to the patient care activity, removed promptly if soiled, and hands cleansed thoroughly after removal
  • Worn for all contacts with patients known or suspected to be colonized or infected with MRSA

Hand Hygiene

Hand washing with soap and water should be performed:

Surgical Sites

To reduce migration of bacteria into surgical sites, the CDC recommends:
Multiple pre-operative skin preparation procedures to reduce the patient’s skin flora including:

  • Preoperative antiseptic showering
  • Patient skin preparation in the operating room with antiseptic scrubs and solutions

Environmental Decontamination

According to CDC Standard Precautions, environmental decontamination using an EPA-registered disinfectant is essential for control of pathogens such as MRSA that may contaminate patient care areas.

  • Use dedicated supplies and personnel to clean areas under Contact Precautions
  • Consider disposable supplies, and change mop heads frequently
  • Use the correct cleaning solutions
  • Prioritize room cleaning of patients on Contact Precautions



Foot Notes:
  1. www.cdc.gov/ncidod/dhqp/ar_MRSA_spotlight_2006.html
  2. Elixhauser, A. (AHRQ) and Steiner, C. (AHRQ). Infections with Methicillin-Resistant Staphylococcus aureus (MRSA) in U.S. Hospitals, 1993-2005. HCUP Statistical Brief #35, July 2007. Agency for Healthcare Research and Quality, Rockville, MD.
  3. MRSA: Time for Action Study Guide, p.11. Halyard Knowledge Network Video Education Program. 2007.
  4. CDC. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007.
    www.cdc.gov/ncidod/dhqp/gl_isolation.html.
  5. CDC/HICPAC. Guidelines for Hand Hygiene in Healthcare Settings. October 25, 2002 / 51(RR16);1-44.
  6. APIC Text of Infection Control and Epidemiology. 2nd Edition. January 2005.