Healthcare-Associated Antibiotic-Resistant Staph Infection (HA-MRSA)

What is antibiotic-resistant staph infection?

Antibiotic-resistant staph infection is an infection caused by a type of bacteria that cannot be killed by many commonly used antibiotics. This makes it hard to treat and stop the infection. The bacteria causing these infections are a type of Staphylococcus bacteria. They are often simply called staph. A commonly used name for resistant staph bacteria is methicillin-resistant staphylococcus aureus, or MRSA (often pronounced as “mer-suh”).

The infection is said to be healthcare-associated if it happens after:

• at least 72 hours in the hospital
• treatment in a dialysis center, or
• use of medical equipment such as a catheter

What is the cause?

Staph bacteria are a common cause of skin infections. Most of the skin infections are minor (such as pimples and boils) and heal on their own without antibiotics. However, sometimes the bacteria infect the blood, urinary tract, lungs, or surgical wounds and cause very serious illness. The widespread use of antibiotics has caused some of these bacteria to change and become resistant to antibiotics. This can make it hard to treat these serious infections.

MRSA may spread in a hospital or clinic from:

• the hands of healthcare workers
• poorly cleaned medical equipment that is shared with others, such as a stethoscope
• contact with other items and surfaces that have staph on them, such as bedrails, bed linens, and medical equipment
• contact with visitors who have staph

What are the symptoms?

When staph infects the skin, it may look like a pimple or boil. The skin may be red, swollen, or painful. You may have pus or other drainage. The infection may look like a rash, with redness and oozing or crusting.

When the infection is inside the body, the symptoms can be very different, depending on where the infection is. Symptoms may include:

• high fever
• pain
• trouble breathing
• confusion
• very low blood pressure
• loss of consciousness

The infection can lead to shock. If it is not treated or cannot be treated, it may cause death.

How is it diagnosed?

The infected area will be tested. It may be tested with:

• a swab of the surgical wound
• a sample of sputum (fluid coughed up from the lungs)
• a blood sample

If bacteria can be grown from the sample in the lab, the bacteria are tested to see what antibiotics can kill them.

How is it treated?

The infection will be treated with the type of antibiotic that is most likely to kill the bacteria. If you are given an antibiotic, take all of the doses, even if the infection is getting better, unless your provider tells you to stop taking it. Not finishing your antibiotic may cause more resistant bacteria to develop. Do not share antibiotics with other people or save them for another time.

If you are having any of the more serious symptoms listed above, you will stay at the hospital. You will get your antibiotic treatment by vein through an IV (intravenous line) until you are well enough to finish your antibiotics at home. You may be in the hospital 1 to 3 days or for a week or two, depending on your underlying medical condition and how sick you were when your infection was diagnosed.

How long will the effects last?

How long it takes to cure the infection depends on a number of things, for example:

• your health before the infection
• how severe the infection was when treatment began
• where the infection is in your body
• how well the antibiotic can kill the bacteria

How can HA-MRSA infections be prevented?

The US Centers for Disease Control and Prevention (CDC) is working with healthcare providers to ensure that they are doing everything they can to prevent MRSA. Examples are:

• education and training of all healthcare workers, including teaching about such simple tasks as correct handwashing procedures after caring for each patient
• checking how well healthcare workers, including doctors, are following recommended prevention practices
• taking special precautions with patients known to be infected with staph
• using antibiotics only when medically needed
• teaching visitors how they can help prevent spreading infection when they visit a healthcare facility

While you are hospitalized with MRSA, you may have “Contact Precautions.” This means that:

• You may stay in a private room or share a room with another patient who has MRSA.
• All healthcare providers, hospital workers, and visitors will wash their hands and wear gloves and gowns to protect their clothing when they come into your room.
• Staff and visitors will remove their gowns and gloves when leaving your room and wash their hands again.
• You may be asked to stay in your room.
• If you are allowed to leave your room, you may be asked to stay out of common areas, such as gift shops, cafeterias, and restrooms.

How should I take care of myself at home?

• Follow all of your healthcare provider’s instructions.
• Finish all of your antibiotic as instructed, unless your provider tells you something different.
• Wash your hands often, especially before and after bandage or dressing changes. Keep used (dirty) bandages and dressings in a separate container so that no family members will come into contact with them. Dispose of them as your healthcare provider tells you.
• Don’t share any personal items, such as razors, towels, and bed linens.
• Wash and dry your clothes, towels, and bed linens on the hottest settings recommended on the labels.
• Tell all of your healthcare providers and people working with them that you have MRSA.

How can I help prevent HA-MRSA?

You or your family members should speak up about any concerns about your care when you are in the hospital. You may need to remind the hospital staff to wash their hands, clean their stethoscope, and not use anything that has fallen on the floor. You may feel uneasy about offering these reminders, but it is in your best interest. You can let your providers know that you are aware of the risks of MRSA and you want to work with them to avoid getting infected while you are in the hospital. You can also remind visitors to practice good hygiene when they are with you.

Here are some other guidelines for preventing MRSA infections:

• Do not overuse antibiotics. Take them only when needed and take them exactly as instructed. Don’t share antibiotics with other people, and don’t save them for another time. If you are having problems with an antibiotic, tell your healthcare provider and ask what your options are.
• Wash your hands regularly and well with soap and water.
• When you are in public places, clean your hands and your children’s hands with alcohol-based hand sanitizer.
• Don’t visit at the hospital if you have a rash or an open wound.

You can get more information from the Centers for Disease Control (CDC): http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/MRSA_tagged.pdf.