DISASTER RECOVERY FACT SHEET
Methicillin-Resistant Staphylococcus aureus (MRSA) Information for Clinicians
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General Information
- Though once found almost exclusively in healthcare settings, strains of Staphylococcus aureus resistant to beta-lactam antibiotics (MRSA) are increasingly common as a cause of skin and soft tissue infections in patients who have no previous contact with healthcare. These strains are sometimes referred to as “community-associated MRSA”.
Clinical Features
- MRSA infections often begin as skin or soft tissue lesions such as a boil or abscess and/or cellulitis.
- Patients frequently report a lesion that looks to them like a “spider bite.”
- Other more severe manifestations such as bloodstream infections or pneumonia are less common.
Diagnosis
- Obtain material for culture from skin lesions such as swab of pus or drainage.
- Use microbiologic culture results to guide appropriate antibiotic selection.
Treatment
- Mild (afebrile, looks healthy) to Moderate (febrile, appears ill) Skin Infections
- First-line treatment for mild abscesses is incision and drainage.
- If antibiotic treatment is clinically indicated, it should be guided by the susceptibility profile of the organism.
- If MRSA, avoid beta-lactam antibiotics (e.g., cephalexin).
- Most MRSA in community settings have been susceptible to trimethoprim-sulfamethoxazole and doxycycline. Clindamycin is also an option, but some isolates that appear susceptible to clindamycin have inducible resistance. Clindamycin susceptibility should be confirmed with a “D-test”.
- Severe Infection (e.g., appears toxic, vital signs unstable, sepsis-syndrome)
- Intravenous therapy for MRSA is preferred in these cases. Vancomycin remains a first-line therapy for MRSA.
- Final therapy based on results of culture and susceptibility testing.
- Consult with infectious disease and critical care specialist.
Infection Control Recommendations
- Use standard precautions
- Perform hand hygiene (handwashing or using alcohol hand gel)
- After touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn.
- Between patients.
- When moving from a contaminated body site to a clean site on the same patient.
- Wear gloves when managing wounds/
- Wear gown, and mask/eye protection or face shield for procedures that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions.
- Clean surfaces of exam rooms with commercial disinfectant or a 1:100 solution of diluted bleach (1 tablespoon bleach in 1 quart water).
Prevention Messages for Patients
- Keep wounds and lesions covered with clean, dry bandages.
- Wash hands or use alcohol hand gels after touching infected skin or bandages.
- Avoid sharing personal items (e.g., towels, washcloths, razors).
- Be on the lookout for similar infections in family members and/or close contacts.
Page last modified September 21, 2005