COMMUNITY ACQUIRED MRSA

1. COMMUNITY ACQUIRED MRSA MARGARET TEITELBAUM RN,BSN,CSN SCHOOL NURSE/HEALTH EDUCATOR WESTFIELD HIGH SCHOOL

2. TOPICS TO BE COVERED • INTRODUCTION—WHAT IS MRSA • RISK FACTORS AND TRANSMISSION OF CA—MRSA • SCHOOL NURSE’S ROLE IN ASSESSMENT OF CA MRSA • INFECTION CONTROL IS KEY • PROTECTING YOURSELF • PROTOCOL FOR COMMUNICABLE DISEASE IN SCHOOLS • COMMUNICATION BETWEEN HOME AND SCHOOL

3. INTRODUCTION • STAPHLOCOCCUS AUREUS BACTERIA IDENTIFIED IN THE 1880’S • PENICILLIN DISCOVERED 1941 USED TREAT • 1960’S BACTERIA BECAME RESISTANT TO PENICILLIN • 1960 METHICILLIN USED TREAT STAPH • 1961 METHICILLIN RESISTANT STAPHLOCOCCUS AUREUS WAS IDENTIFIED IN HOSPITAL SETTING • NOT RESPONDING TO TREATMENT USING COMMON ANTIBIOTICS LIKE PENICILLIN AND CEPHLOSPORINS

4. LATE 1990’S • MRSA EMERGED IN THE COMMUNITY SETTING CA-MRSA MOST INFECTIONS CAUSED BY STAPH ARE SKIN AND SOFT TISSUE INFECTIONS

5. RISK FACTORS AND TRANSMISSION OFCA-MRSA • OFTEN CA-MRSA IS TRANSMITTED BY CONTAMINATED HANDS (skin to skin contact) • CONTACT WITH CONTAMINATED OBJECTS ( CONTAMINATED WITH BODILIY FLUIDS) FOR EX:, SHARING TOWELS, PERSONAL ATHLETIC EQUIPMENT, COMMONLY SHARED SURFACES • INDIVIDUALS WITH LOSS OF SKIN INTEGRITY ie, CUTS, SCRAPES, OPEN WOUNDS, NICKS TO SKIN OR TURF BURNS

6. OTHER FACTORS ASSOCIATED WITHINFECTION • CROWED LIVING CONDITIONS • POOR HYGIENE • HISTORY OF DERMATOLOGIC CONDITIONS • FAMILY MEMBERS WHO WORK IN HEALTH CARE SETTING • STUDENT ATHLETES CONTACT SPORTS • PHYSICAL CONTACT WITH PERSON DRAINING WOUND • SHARING EQUIPMENT

7. INFECTION CONTROL IS KEY • SCHOOL NURSE CONSULT WITH LOCAL HEALTH DEPARTMENT INQUIRE RE: CASES • SCHOOL NURSE ENGAGE IN CAREFUL SURVEILLANCE OF STUDENTS WITH OPEN WOUNDS AND FOLLOW EXISTING POLICY LESIONS AS A RESULT OF SPIDER BITE, INFECTED BOIL OR PIMPLE, OR ANY SKIN INFECTION RED, SWOLLEN, WITH PURULENT DISCHARGE FOLLOW UP WITH ANY STUDENTS WHO HAVE COME IN CONTACT WITH STUDENTS WITH CA-MRSA

8. PROTECTING YOURSELF • HAND WASHING and the use of alcohol based hand rubs have been shown to reduce the transmission of resistant bacteria(visibly soiiled –soap and water--- alcohol bsed hand rubs less soiled fast acting • SCHOOL ATHLETES SHOULD SHOWER AFTER PARTICIPATING IN CONTACT SPORTS • WASH SCRAPES, CUTS, AND ABRASIONS WITH SOAP AND WATER • AVOID SHARING PERSONAL ITEMS • LINENS AND CLOTHING NOT CONTAMINATED WITH BODILY FLUIDS WASH WITH FAMILY LAUNDRY • REPORT ANY SUSPICIOUS SKIN INFECTION TO THE SCHOOL NURSE AND THE TRAINER • KEEP LESIONS CLEAN AND DRY AND COVER WITH BANDAGES UNTIL WOUND IS DRY AND HEALED • DO NOT SHARE PERSONAL ITEMS, IE, SOAPS, CLOTHING, RAZORS • REGULARLY CLEAN COMMONLY TOUCHED SURFACES IN HOME AND SCHOOL

9. PROTOCOL FOR INFECTION CONTROL IN SCHOOLS • PARENT IS TO NOTIFY SCHOOL IF CHILD ABSENT DUE TO SERIOUS ILLNESS OR COMMUNICABLE DISEASE • PHYSICIAN’S NOTE IS REQUIRED FOR A STUDENT WHO HAS RECOVERED • SCHOOL NURSE IS TO SEE THE STUDENT ON RETURN TO SCHOOL • DRAINING SORES MUST BE COVERED

10. EARLY DETECTION AND TREATMENT IS KEY • PROACTIVE EDUCATION • AGGRESSIVE DIAGNOSTIC EFFORTS • COMMUNICATION BETWEEN PATIENT, FAMILY AND HEALTH CARE PROVIDERS IMPORTANT • ENCOURAGED STUDENTS REPORT SUSPICIOUS • SKIN LESIONS

11. RESOURCES FOR MORE INFORMATION • CENTER FOR DISEASE CONTROL • www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_