Health Topics

MRSA (Methicillin Resistant Staphylococcus aureus)

General Information about MRSA
October 2007

En Español

For specific clinical information regarding MRSA, please visit:
http://www.health.ri.gov/topics/mrsa.php

What is MRSA (Methicillin-resistant Staphylococcus aureus)?
Methicillin-resistant Staphylococcus aureus (MRSA) is a type of staph bacteria that is resistant to certain antibiotics including methicillin, oxacillin, penicillin and amoxicillin.

What is Staphylococcus aureus?
Staphylococcus aureus, often referred to simply as "staph," are bacteria commonly found on the skin or in the nose of healthy people. About 25% to 30% of people have staph bacteria in their nose, but it does not cause an infection. Sometimes, staph does cause an infection. Staph bacteria are one of the most common causes of skin infections in the United States. Most of these skin infections are minor (such as pimples and boils) and can be treated without antibiotics. However, staph bacteria also can cause serious infections (surgical wound infections, bloodstream infections, and pneumonia).

Who is affected by MRSA?
Staph infections, including MRSA, occur most frequently among persons in hospitals and other healthcare facilities who are elderly or who have weakened immune systems. MRSA has become more common in hospitals because of the heavy use of antibiotics. It spreads easily if there are not good hand-washing practices in place. A new strain of MRSA has evolved in the community, and people who have not been in the hospital are getting the infection.

What happens when someone is infected with MRSA?
As long as the germ stays only on the person’s skin, MRSA is not usually a problem. However, if the germ gets inside the body through a cut or a scrape, it can cause a skin infection, which usually starts as a boil. The bacteria can also spread to the blood, bones or vital organs, which can cause serious complications and even death.

How is MRSA treated?
Most MRSA infections are treated by good wound and skin care that includes keeping the area clean and dry, washing hands after caring for the area, carefully disposing of any bandages, and allowing your body to heal. Sometimes treatment requires the use of antibiotics. If antibiotics are needed, it is important to take all the doses you are given unless your doctor tells you to stop. If the infection has not improved in a few days after seeing your doctor, contact your doctor again.

How can we prevent the spread of MRSA?
Because MRSA is almost always spread through direct skin-to-skin contact, you can prevent the spread of MRSA by practicing good personal hygiene.

1. Wash your hands with soap and warm water. When soap and warm water are not available, use alcohol-based hand gel (at least 60% alcohol).
2. Shower after periods of physical activity such as gym class or sports practices/games.
3. Do not share personal items like towels, razors, water bottles, washcloths, clothing or uniforms. (DO NOT use gym clothes that have been collected in a lost and found box.)
4. Practice and encourage good skin care. Staph infections start when staph enter the body through a cut, scrape or other break in the skin.
5. Keep cuts and scrapes clean and covered until they are healed.
6. Avoid contact with other people’s cuts, scrapes, bandages or dressings.
7. Regularly clean sinks, showers and toilets with an EPA-approved detergent disinfectant.
8. Disinfect athletic equipment between users.
9. Launder clothing and linens (including sheets, towels, uniforms and undergarments) in hot water (140 degrees or more) and the laundry detergent you normally use. Dry on the hottest setting that the fabric will allow. Bleach can also be used as an extra precaution.
10. Tell any healthcare providers who treat you if you have or have had a staph or MRSA skin infection.

Should athletes wash their uniform every day?
Uniforms should be washed after every use. Use hot water (140 degrees or more) and the laundry detergent you normally use. Dry on the hottest setting the fabric will allow. Bleach can also be used as an extra precaution. As a reminder, students should not be sharing personal items like uniforms, athletic gear, towels or toiletries.

Should schools clean athletic equipment and mats?
Athletic equipment should be cleaned with an EPA-approved detergent disinfectant or with a solution of 1 tablespoon of bleach to 1 quart of water between users. It is also important that surfaces underneath mats be disinfected. Athletes should remember to wear a shirt when using equipment and wipe sweat off equipment/mats with their own clean towel after exercising.

Should schools disinfect desks?
In general, it is not necessary to close schools to “disinfect” them when MRSA infections occur. MRSA skin infections are transmitted primarily by skin-to-skin contact and contact with surfaces that have come into contact with someone else’s infection. Covering infected cuts, scrapes, or lesions will greatly reduce the risks of surfaces becoming contaminated with MRSA.

Can packaged bleach wipes be used to clean equipment/mats?
Equipment and surfaces should be cleaned with an EPA-approved detergent disinfectant. For a list of EPA-registered products effective against MRSA, visit http://epa.gov/oppad001/chemregindex.htm.

Should students with MRSA skin infections be excluded from attending school?
Unless directed by a physician, students with MRSA skin infections should not be excluded from attending school. Exclusion from school should be reserved for those with wound drainage (“pus”) that cannot be covered and contained with a clean, dry bandage and for those who cannot maintain good personal hygiene. Students with active infections should be excluded from activities where skin-to-skin contact is likely to occur (i.e., sports) until their infections are healed.

What should I do if I think I may have a MRSA infection?
If you think you may have a MRSA infection or you have a skin infection that does not improve, call your healthcare provider.

Where can I get more information relevant to schools?

Community onset MRSA:
http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html

Questions and Answers about MRSA for School Health Professionals: http://www.mass.gov/dph/cdc/antibiotic/mrsa_school_health.htm

MRSA Toolkit for Middle & High Schools: http://www.tpchd.org/page.php?id=364

EPA registered products effective against MRSA: http://epa.gov/oppad001/chemregindex.htm

If you have additional questions about MRSA, please contact the Office of Communicable Disease at (401) 222-2577.