What can be done to prevent the spread of MRSA ?

There are many things that can be done (and are being done) by hospitals, other health care facilities, health care professionals and the general community to help prevent the spread of MRSA.

Hand Washing

Poor or inadequate hygiene habits are one of the main impediments to significantly reducing the spread of MRSA amongst the population.

Proper hand washing is important to prevent the spread of MRSA.  People should take precautions by thoroughly wash all parts of their hands with soap and running water for 10-15 seconds:

• before and after touching or dressing an infected area
• after using the toilet
• after blowing their nose
• before preparing, handling or eating food
• after touching or handling unwashed clothing or linen

While alcohol-based hand rubs do offer some effectiveness, a better approach is to wash hands with running water using an anti-microbial cleanser with persistent killing action, such as Chlorhexidine.

Cover Wounds

It’s important to cover boils or other skin infections with a waterproof dressing.  People who prepare or handle food must ensure they don't contaminate any food and keep any sores or skin infections completely covered with a sterile waterproof dressing.

Personal Items

Do not share items of a personal nature such as clothes, towels, bed linen, nail clippers, scissors, tweezers, razors and toothbrushes.  If you share a bed with someone, keep sores or wounds covered overnight.

Patient Screening

Hospitals and other healthcare facilities should ensure proper and active patient screening upon admission with nasal cultures to help prevent cohabitation of MRSA carriers with non-carriers, and exposure to infected surfaces.

Surface Cleansing

In healthcare facilities, MRSA can live on surfaces and fabrics, including privacy curtains or garments worn by care providers.  Complete surface cleansing is necessary to eliminate MRSA in areas where patients are recovering from invasive procedures.

Alcohol has been found to be a useful surface cleanser and sanitizer against MRSA.  Quaternary ammonium can be used in conjunction with alcohol to prolong the longevity of the sanitizing effect.

Surgical Respirators

It is understood that in the United States, the Food and Drug Administration (FDA) has cleared a surgical respirator, known as the SpectraShield 9500, that kills MRSA and other bacteria.  The respirator is said to block at least 95% of small particles in a standardized test.

Bacterial Decolonization

Following the drainage of boils or other recommended treatment for MRSA infections, patients may bathe (shower) at home using antiseptic soaps such as chlorhexidine (Hibiclens) or hexachlorophene (Phisohex). They should bathe from head to toe, and apply mupirocin (Bactroban) 2% ointment inside each nostril twice daily for 7 days, using a cotton-tipped swab.  To be on the safe side, family members or other co-habitants should follow a similar decolonization procedure.

Essential Oils

It is believed that certain essential oils such as lemongrass oil, lemon myrtle oil, mountain savory oil and melissa oil may inhibit the production of MRSA bacteria.  Tea tree oil is also effective in killing MRSA strains.

Disposal of Hospital Gowns

Proper and vigilant disposal of used paper hospital gowns could avoid the spread of MRSA infections.

Isolation from Workplaces

Workers whose wound drainage cannot be covered and contained with a clean, dry bandage and for those who cannot maintain good hygiene practices, should give serious consideration to excluding themselves from the workplace until their situation improves.

People who are infectious should ideally be excluded from workplace activities where skin-to-skin contact is likely to occur until their infections are healed.

Employers should take steps to ensure the availability of adequate facilities and equipment that encourage workers to practice good hygiene in order to prevent the spread of MRSA in the workplace.  This should include ensuring that proper surface sanitizing methods are followed and that contaminated equipment is sanitized by approved disinfectants.

Schools and Childcare Facilities

In addition to other more general hygiene precautions, specific actions that can be employed to prevent spread of MRSA in schools and childcare centers include:

• teachers, care givers, children and their families should understand the importance of proper hand washing, covering up when coughing and staying at home if sick
• hand washing supplies (soap dispensers, running water and clean paper towels) should be readily available and in easy reach
• routine activities should include adequate time for hand washing (before meals and after using the toilet)
• if open skin wounds can’t be kept covered, temporary exclusion from child care or school may be appropriate until such time as the wound has healed or drainage of pus from the wounds can be contained using a sterile sealed bandage
• common surfaces (such as counters, desks and toys) are a breeding ground for germs.  Surfaces such as these that come into contact with uncovered or poorly covered infections, should be cleansed on a daily basis with suitable detergent, and whenever visibly contaminated.

Sporting Teams and Groups

In addition to other more general hygiene precautions, steps to prevent the spread of MRSA in sports teams and groups should include:

• Temporarily sidelining of people from playing all forms of contact sports who have skin infections or open wounds that cannot be kept covered.   This should apply until such time as the wound has healed or drainage can be contained
• Exclusion of those who have skin infections or open wounds from common spas or saunas
• No sharing of towels or sports equipment that comes into contact with the skin of people who have uncovered skin wounds.

Limiting Antibiotic use

Antibiotics such as glycopeptides, cephalosporins and quinolones have been associated with an increased risk of colonisation of MRSA.  Taking action to reduce the use of classes of antibiotics that foster MRSA colonisation is recommended in current policies and guidelines.