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Periop conference mrsa and mssa - sep 11 2010

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Maureen Spencer, RN, M.Ed.
Maureen Spencer, RN, M.Ed.
1 von 46
Maureen Spencer, RN,M.Ed., CIC Infection Control Manager New England Baptist Hospital Boston, Ma. Email: [email_address] 617 754-5332 www.workingtowardzero.com
What is Staphylococcus aureus ? ,[object Object],[object Object]
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]
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]
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]
Hospital Equipment ,[object Object],[object Object],[object Object]
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]
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]
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]
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
MRSA Patient Rooms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MRSA contamination in precaution rooms ,[object Object],[object Object],[object Object],[object Object],[object Object]
[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]
Decolonization 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
In Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Periop conference mrsa and mssa - sep 11 2010

  • 1. Maureen Spencer, RN,M.Ed., CIC Infection Control Manager New England Baptist Hospital Boston, Ma. Email: [email_address] 617 754-5332 www.workingtowardzero.com
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  • 33. 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
  • 34.
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  • 43. What were the outcomes?
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Hinweis der Redaktion

  1. 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.