Community-Acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA)

We have had a number of calls over the past six months asking about individuals diagnosed with MRSA and being treated in their homes instead of a hospital setting. The most common questions are:

  • Can they come home?
  • Do they pose a risk to others?
  • Is the staff at risk?

It is understandable that agencies may be concerned with MRSA in the group home setting after hearing about “super bugs” in the news over the past few years, but how worried do you need to be?

    What is MRSA?

    Methicillin-Resistant Staphylococcus Aureus (MRSA) is a type of bacteria that causes infections in different parts of the body. The infection is difficult to treat because the bacteria are resistant to commonly prescribed antibiotics such as penicillin.

    There are different types of MRSA:

    • Healthcare-associated (HC-MRSA) or Hospital-acquired Infections (HAI) MRSAis the most common form. It often affects individuals that have a weakened immune system while in a hospital, nursing home or other healthcare facility. Infections can appear in surgical wounds, the bloodstream, lungs, feeding tubes, and urinary catheters.
    • Community-acquired MRSA (CA-MRSA) is a relatively new type of MRSA. CA-MRSA can affect otherwise healthy individuals who have not been hospitalized or had a medical procedure within the past year. These infections are less dangerous and usually result in skin infections.

    How does MRSA spread from one individual to another?

    MRSA usually spreads from one individual to another through direct skin contact or contact with shared items or surfaces that have touched infected skin (e.g., towel, equipment surface). Settings that make it easier for MRSA to be transmitted often involve the “Five C's”:

    • Crowding
    • Frequent skin-to-skin Contact
    • Compromised skin (i.e., cuts or abrasions)
    • Contaminated items and surfaces; and
    • Lack of Cleanliness.

    How can we prevent the spread of an individual infected with MRSA in a group home setting?

    In a group home setting, the infected individual DOES NOT need to be in isolation. However, to avoid the transmission to another individual some precautions are necessary:

    • The number one preventative measure for staff and individuals living in the group home is frequent hand washing with soap and water or frequent use of an alcohol-based hand sanitizer (at least 70% alcohol).
    • Cuts, abrasions, or wounds need to be covered with clean, dry bandages until healed.
    • Personal items such as towels, clothing, razors, and ointments should NEVER be shared.
    • Surfaces that are highly touched such as door knobs and countertops should be more frequently disinfected with a hospital grade disinfectant.
    • Washrooms, bathtubs, and showers should be thoroughly disinfected after each use by the infected individual.
    • Individuals clothing should be washed separately.

    What does it mean for the individual diagnosed with an MRSA infection?

    Most MRSA infections are diagnosed by “culture and antibiotic sensitivity” testing of Staphylococcus Aureus bacteria in the infected site.

    If the individual you are supporting has a community-acquired MRSA, the treatment will most likely be oral and topical antibiotics. The individual will be treated at home. If the individual has a healthcare-associated MRSA, they will be treated in hospital with intravenous antibiotics.

    In both cases, the individual will need to be retested for MRSA once the prescribed antibiotics are finished to determine if the infection is gone or if the antibiotic treatment must be repeated.

    When should you contact the individual’s Primary Health Care Practitioner (PHCP)?

    You should keep an eye on minor skin problems such as pimples, cuts and scrapes and insect bites. If the individual you are supporting develops what looks like cellulitis (skin red and warm to the touch with marked edges), abscess, or draining pus or if they develop a fever, you should contact their PHCP.

    With the proper precautions, CA-MRSA can be managed safely in the group home setting without risking housemates or staff. If you have any questions about supporting individuals in Developmental Services with CA-MRSA, feel free to contact us at dslearning@rotaryhome.on.ca or your local health department.

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