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Staphylococcus aureus:  MSSA (Methicillin sensitive Staph aureus) MRSA (Methicillin resistant Staph aureus) Maureen Spencer, RN,M.Ed., CIC Infection Control Manager New England Baptist Hospital Boston, Ma.  Email:  [email_address] 617 754-5332
What is  Staphylococcus aureus ? ,[object Object],[object Object]
Staph aureus Antibiotic Resistance
Overview of Antibiotic Resistance ,[object Object],[object Object],[object Object],[object Object]
Past 60 years – Resistance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is MRSA? ,[object Object],[object Object]
How Does it Get Resistant? ,[object Object],[object Object],[object Object]
Penicillin Binding Protein 2a ,[object Object],[object Object],[object Object]
CA-MRSA and HA-MRSA ,[object Object],[object Object],[object Object],[object Object]
Differences in Strains ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Community-acquired (CA)-MRSA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Severe CA-MRSA – Not PVL ,[object Object],[object Object],[object Object],[object Object]
Phenol Soluble Modulin Protein ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vancomycin Resistance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
New, lethal MRSA strain emerges…… ,[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology and  Populations at Risk
Epidemiology of MRSA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MRSA Cases in California Skyrocket   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Populations at Risk for CA-MRSA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pets can carry MRSA   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],2008 MRSA pneumonia College Students
2006-2007: Child Deaths Due to MRSA ,[object Object],[object Object]
MRSA Hitting Gay Men   ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],H1N1, MRSA can be dangerous combination
CDC – H1N1 Co-infections ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Dramatic Increase in Ocular  MRSA Documented   ,[object Object],[object Object],[object Object],[object Object]
2007 - More MRSA news   ,[object Object],[object Object],[object Object],[object Object],[object Object]
MRSA Skin/Soft Tissue   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factors for  Acquiring HA-MRSA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hospital Equipment ,[object Object],[object Object],[object Object]
Colonization vs Infection and Treatment
Staph aureus Colonization ,[object Object],[object Object],[object Object]
MRSA Colonization ,[object Object],[object Object],[object Object],[object Object],[object Object]
Rate of MRSA and MSSA in Surgeons and Residents ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Higher Rate of Infection if  Colonized ,[object Object],[object Object],[object Object],[object Object]
Infection with MRSA ,[object Object],[object Object],[object Object],[object Object]
CA-MRSA – “Spider Bite”
Treatment of Soft Tissue Infections ,[object Object],[object Object],[object Object]
Antimicrobial Agents for  Treating MRSA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
New Antibiotics for MRSA ,[object Object],[object Object],[object Object],[object Object]
Transmission
MRSA Transmission ,[object Object],[object Object],[object Object]
Outbreaks in Sports Teams ,[object Object],[object Object],[object Object],[object Object]
CA-MRSA in Sports Teams ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sources for Transmission ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Transmission: Hands Most Common Where have your hands been?
Prevention: Wash and Sanitize Alcohol Foam, Liquid and Hand Wipes At NEBH all patients admitted receive package of alcohol wipes In each patient room, outside rooms, cafeteria and other areas Wash hands often – before eating, before leaving work, after contamination, after bathroom
Hand Hygiene Observations
Why so much MRSA in young people now?
Could it be due to the   Increase in  Sugar Consumption ,[object Object],[object Object],[object Object],[object Object]
  High-Calorie Beverages   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
High-Calorie Beverages ,[object Object],[object Object],[object Object],[object Object]
Sugar Depresses Immunity ,[object Object],[object Object]
Sugar and Immune Cells ,[object Object],[object Object],[object Object]
Remember: November 2007 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sources in Hospital Settings
MRSA Patient Rooms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Computers on Wheels, Dynamaps, Rollboards, IV Poles, Phones
Environmental Surfaces ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GI Colonization with MRSA ,[object Object],[object Object],[object Object]
MRSA contamination in precaution rooms ,[object Object],[object Object],[object Object],[object Object],[object Object]
Environment of Care
Clean Patient Care Equipment ,[object Object],[object Object],[object Object]
Housekeeping ,[object Object],[object Object],[object Object]
Disinfectants and Curtains ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MRSA and MSSA Eradication Program ,[object Object],[object Object]
February 2006  Anonymous Nares Cultures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment Protocol ,[object Object],[object Object],[object Object]
What were the outcomes?
MRSA/MSSA Eradication Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],% MRSA and  Staph aureus  SSI
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],% MRSA SSI in  MRSA +  Screened Patients
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],%  Staph aureus (MSSA)  SSI in  Screen + Patients
Reduction in Number of SSI and % Due to MRSA and MSSA
In Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thank You   M.  R.  S.  A. Make  Resistance  Stay  Away
How Does it Get Resistant? ,[object Object],[object Object],[object Object]

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Mrsa and mssa mna nov 12 2010

Hinweis der Redaktion

  1. Cost saving measure in 2002 was to outsource EVS We worked with each department to write all the equipment that needed to be cleaned, how often and with what type of
  2. We conducted another anonymous surveillance culture study in Feb 2006 – 133 spine patients noses were cultured in the OR 29% grew out Staph aureus and 4% were positive for MRSA – which was undiagnosed and therefore surgical prophylaxis with Vancomycin was not administered and no precautions were used in the OR, PACU or nursing units. These patients may also Have been discharged to a rehab facility with no flagging for precautions.