Methicillin-resistant Staphylococcus aureus (MRSA) is a type of staph bacteria resistant to several common antibiotics, including methicillin, penicillin, and amoxicillin. This resistance makes MRSA infections significantly harder to treat and increases the risk of severe illness, especially if the infection enters the bloodstream or lungs. Controlling MRSA is a public health priority requiring a multi-faceted approach across various settings. The best strategy involves universal hygiene measures, strict protocols in healthcare environments, targeted community actions, and medical decolonization when necessary.
Universal Infection Prevention Measures
The foundation of MRSA control in any environment, from a hospital to a gym, is consistent hand hygiene. Hands should be washed with soap and water for at least 20 seconds, especially after coughing or sneezing, before eating, and after using the restroom. If soap and water are unavailable, an alcohol-based hand sanitizer containing at least 60% alcohol can be used as an alternative.
Routine cleaning of frequently touched surfaces is a basic measure to disrupt transmission. MRSA bacteria can survive on surfaces like doorknobs, remote controls, and athletic equipment for hours to weeks. Using a standard detergent or an Environmental Protection Agency (EPA)-registered disinfectant on high-contact areas helps eliminate the bacteria. This cleanliness is essential because MRSA can be transmitted through contact with contaminated objects.
Protocols in Healthcare Facilities
Healthcare facilities require rigorous control measures due to the high concentration of vulnerable patients. One primary intervention is the use of Contact Precautions for patients known to be colonized or infected with MRSA. These precautions involve healthcare workers wearing gowns and gloves before entering the patient’s room and discarding them before leaving, followed immediately by hand hygiene.
Patient isolation and cohorting are central components, often involving placing MRSA-positive patients in a private room or grouping them with others who have the same organism. Many facilities implement Active Surveillance Testing (AST), screening high-risk patients (e.g., those in ICUs) upon admission or transfer to detect asymptomatic carriers. Identifying carriers allows for prompt isolation and decolonization measures, preventing further spread.
Rigorous environmental cleaning and disinfection are necessary within clinical settings. Frequently touched surfaces and medical equipment must be disinfected frequently using hospital-grade products effective against MRSA. Terminal cleaning, performed after a patient is discharged, ensures the room is safe for the next occupant. These protocols have contributed to a decline in healthcare-associated MRSA infections over the last decade.
Preventing Transmission in Home and Community Settings
Community control of MRSA focuses on managing skin integrity and preventing the sharing of personal items. Any cuts, scrapes, or open wounds should be kept clean and covered with a dry bandage until fully healed. Pus or drainage from an infected sore is highly contagious, and covering the area prevents the bacteria from spreading.
Individuals should avoid sharing personal items that contact the skin, such as towels, washcloths, razors, and athletic uniforms. MRSA can live on these items, making them a common vehicle for transmission in households, schools, and sports environments. Regular showering, especially after contact sports or exercise, reduces the bacterial load on the skin.
Laundry management requires specific steps for items that have touched an infected area. Soiled sheets, towels, and clothing should be washed using hot water if possible, and bleach can be added for bacterial elimination. Drying items thoroughly in a hot dryer, rather than air-drying, helps kill remaining bacteria.
Medical Decolonization Methods
For individuals colonized with MRSA, medical decolonization may be recommended to reduce the risk of future infection or transmission. The bacteria commonly colonizes the anterior nares (nostrils) and various skin folds. This targeted treatment is often used before certain high-risk surgeries or during an outbreak setting.
The standard decolonization regimen involves two primary agents used over a period of about five days. A topical antibiotic ointment, typically 2% mupirocin, is applied inside both nostrils twice daily to eliminate the nasal colonization. Simultaneously, an antiseptic body wash, such as chlorhexidine gluconate (CHG) at a 2-4% concentration, is used for daily full-body washing.
This combination is effective at reducing the MRSA burden on the skin and mucosal surfaces. This intervention must be carried out under the supervision of a healthcare provider. Unnecessary use of agents like mupirocin is restricted because it can lead to the bacteria developing resistance.