What is MRSA?
MRSA is the type of bacteria causes "staph" infections that are resistant to treatment with usual antibiotics.

MRSA occurs most frequently among patients who undergo invasive medical procedures or who have weakened immune systems and are being treated in hospitals and health care facilities such as nursing homes and dialysis centers. MRSA in health care settings commonly causes serious and potentially life-threatening infections, such as bloodstream infections, surgical site infections or pneumonia.

In addition to health care-associated infections, MRSA can also infect people in the community at large. Such infections are generally mild and affect the skin with pimples or boils that can be swollen, painful and drain pus. These skin infections often occur in otherwise healthy people.

How MRSA Spreads in Health Care Settings
In the case of MRSA, patients who already have a MRSA infection or who carry the bacteria on their bodies but do not have symptoms ("colonized" with MRSA bacteria) are the most common sources of transmission.

The main mode of transmission to other patients is through human hands, especially health care workers' hands. Hands may become contaminated with MRSA bacteria by contact with infected or colonized patients. If a health care worker does not wash with soap and water or use an alcohol-based hand sanitizer after contact with a patient, the bacteria can be spread when the health care worker touches other patients.

MRSA and the Expensive Results of Antimicrobial Resistance
Along with MRSA, many significant infection-causing bacteria in the world are becoming resistant to the most commonly prescribed antimicrobial treatments. What causes this and what does it mean?

Antimicrobial resistance occurs when bacteria change or adapt in a way that allows them to survive in the presence of antibiotics designed to kill them. In some cases, bacteria become so resistant that no available antibiotics are effective against them. At this time, treatment options still exist for health care associated MRSA.

People infected with antibiotic-resistant organisms like MRSA are more likely to have longer and more expensive hospital stays, and may be more likely to die because of the infection. When the drug of choice for treating their infection does not work, they require treatment with second- or third-choice medicines that may be less effective, more toxic and more expensive.

MRSA: a Growing Problem in the Health Care Setting, But One With a Cure

MRSA infections are becoming more prevalent in health care settings. According to CDC data, the proportion of infections that are antimicrobial-resistant has been growing. In 1974, MRSA infections accounted for two percent of the total number of staph infections; in 1995, it was 22 percent; and in 2004 it was 63 percent.

Most MRSA infections appear to occur in health care settings, rather than out in the community. The 2007 JAMA study found that about 85 percent of all invasive MRSA infections were connected with health care settings. In contrast, about 14 percent of reported infections were considered community-associated, which means that the infection occurred in people without documented evidence of risks connected to a health care setting.

In terms of numbers of people affected, it is estimated that in 2005 about 94,360 people developed a serious MRSA infection. About 18,650 persons died during a hospital stay of causes related to serious MRSA infections. People 65 years old or older were most likely to get an invasive infection, and black people were affected at twice the rate of whites, which could be due to higher rates of chronic illness among blacks.
"
These numbers show that many families are being affected by these drug-resistant infections," said Denise Cardo, MD, Director of CDC's Division of Health Care Quality Promotion.

The good news is that MRSA is preventable. "Health care facilities need to make MRSA prevention a greater priority. The closer we get to 100 percent compliance with CDC recommendations, the greater the impact on patient health and safety," Cardo said. The first step to prevent MRSA is to prevent health care infections in general. Infection control guidelines produced by CDC and the Health care Infection Control and Prevention Advisory Committee (HICPAC) are central to the prevention and control of health care infections and, ultimately, MRSA in health care settings.

HANTAVIRUS PULMONARY SYNDROME(HPS)

Hantavirus Pulmonary Syndrome (HPS) is a deadly disease from rodents. Humans can contract the disease when they meet infected rodents or their urine and droppings. HPS was first recognized in 1993 and has since been identified throughout the United States. Although rare, HPS is potentially deadly. Rodent control in and around the home remains the primary strategy for preventing Hantavirus infection.

What Are The Symptoms of HPS?
Early Symptoms
Early symptoms include fatigue, fever and muscle aches, especially in the large muscle groups-thighs, hips, back, and sometimes shoulders. These symptoms are universal. There may also be headaches, dizziness, chills, and abdominal problems, such as nausea, vomiting, diarrhea, and abdominal pain. About half of all HPS patients experience these symptoms.

Late Symptoms
Four to ten days after the initial phase of illness, the late symptoms of HPS appear. These include coughing and shortness of breath, with the sensation of, as one survivor put it, a "...tight band around my chest and a pillow over my face" as the lungs fill with fluid.

Uncommon Symptoms
Earache, sore throat, runny nose, and rash are very uncommon symptoms of HPS.

How Long After Contracting the Virus Do Symptoms Appear?
Due to the small number of HPS cases, the "incubation time" is not positively known. However, based on limited information, it appears that symptoms may develop between 1 and 5 weeks after exposure to urine, droppings, or saliva of infected rodents.

Another important point to remember from the data that the CDC Special Pathogens Branch keeps on all reported cases of HPS, is that it appears many people who have become ill were in a situation where they did not see rodents or rodent droppings. Other people have had frequent contact with rodents and their droppings before becoming ill. This apparent inconsistency makes it very difficult to pin down the precise time when the virus was transmitted.

Clean Up Infested Areas, Using Safety Precautions

• Put on latex rubber gloves before cleaning up!
• Do not stir up dust by sweeping up or vacuuming up droppings, urine or nesting materials.
• Instead, thoroughly wet contaminated areas with detergent or liquid to deactivate the virus. Most general-purpose disinfectants and household detergents are effective. However, a hypo chloride solution prepared by mixing 1 and 1/2 cups of household bleach in 1 gallon of water may be used in place of commercial disinfectant. When using the chlorine solution, avoid spilling the mixture on clothing or other items that may be damaged.
• Once everything is wet, take up contaminated materials with a damp towel, then mop or sponge the area with disinfectant.
• Spray dead rodents with disinfectant, then double-bag along with all cleaning materials and bury or burn—or throw out in appropriate waste disposal system. If burning or burying is not feasible, contact your local or state health department about other disposal methods.
• Finally, disinfect gloves before taking them off with disinfectant or soap and water. After taking off the clean gloves, thoroughly wash hands with soap and warm water.
• When going into cabins or outbuildings (or work areas) that have been closed for a while, open them up and air out before cleaning.

Strength and Quantity of Hypochlorite Solutions (Bleach)
Special Pathogens Branch recommends a 10% bleach solution be used to inactivate Hantaviruses.

Questions? Call the Infection Control and Clinical Safety Department Manager, Sandra O'Kelly, RN at 751-5763.