Prevention and Treatment
Hospitals have had infection control measures in place for many years. Additional infection control and prevention strategies have been implemented in recent years at many health care institutions to detect methicillin resistant Staphylococcus aureus (MRSA) infection or colonization. Screening for MRSA colonization has become standard in those admitted to intensive care units (ICUs) and may be done for those newly admitted to a health care facility and for health care workers if there has been an outbreak of MRSA infections. Those who test positive for MRSA may be isolated to prevent the spread to others and/or decolonized with a nasal antibiotic ointment and daily cleansing with special antimicrobial wipes.
MRSA screening testing options:
- A nasal culture (collected by inserting a swab inside the nose) is used to screen healthy people to determine whether someone has been colonized with MRSA and is a carrier. If S. aureus are present, susceptibility testing is performed to determine whether the isolate is resistant to specific antibiotics that would commonly be used to treat an S. aureus infection.
- Nasal swabs may also be collected to detect MRSA colonization based on rapid molecular tests, which do not grow the bacteria but detect their presence and antibiotic resistance by identifying the gene responsible for the methicillin resistance.
A recent study comparing prevention strategies for bloodstream infections found that screening for MRSA and treating those who were positive was not as effective at reducing these infections as administering the nasal antibiotic and antimicrobial wipes to all patients admitted to the ICU. As a result, policies in health care institutions may change in the future and less screening may be performed in these settings. However, additional studies will need to be performed and the regulatory requirement for MRSA screening that exists in some states would have to be changed before hospitals could forego their MRSA screening policy.
Currently, people with serious invasive MRSA infections, such as sepsis, are usually treated with vancomycin. This is an antibiotic that must be administered intravenously (IV), often for several weeks. In most cases, vancomycin will help to eliminate the MRSA infection, but it does not prevent/eradicate colonization.
Infection control has become the primary focus of MRSA containment. National efforts are underway to raise awareness in the community about the existence of MRSA and to encourage preventive measures, such as covering wounds and better hygiene (such as routine cleaning of shared equipment, frequent hand washing and/or the use of alcohol-based hand gels). For more on the proper way to wash your hands, visit this Centers for Disease Control and Prevention (CDC) web site.
Many sports teams and institutions have put procedures in place to more rapidly recognize and address MRSA infections. Health care providers are being urged to order cultures and susceptibility testing routinely with outpatient skin and wound infections, to monitor the affected person carefully for effectiveness of treatment, and to be alert for the possibility of CA-MRSA. Outbreaks of CA-MRSA are being investigated and traced back to their source in order to identify the cause, to determine whether other people may have unrecognized MRSA infections or colonization, and to reduce the potential for additional cases.