Experts offer suggestions to tell patients to reduce MRSA risk

One in three people are colonized with Staphylococcus aureus in their nose or on their skin, and while colonization of Staphylococcus aureus may not cause problems, once a person has acquired MRSA infection, they are at risk for pneumonia, as well as wound and blood infections, according to the CDC.

Infectious Disease News asked experts in the field to offer recommendations on what physicians and other health care professionals may tell patients to reduce their risk of contracting MRSA.

Michael S. Calderwood, MD, MPH
Brigham and Women’s Hospital
Harvard Medical School

Patient awareness has been increasing along with the incidence of methicillin-resistant Staphylococcus aureus (MRSA) in the community. Households represent a frequent site of transmission, with recent work suggesting that up to 50% of household contacts may be colonized with similar strains when surveying multiple sites (1,2). This proportion is higher than prior work focusing on colonization of the nares, and suggests the importance of performing surveillance on non-nasal sites of MRSA colonization. The risk of transmission within households increases with the number of household contacts and the number of children in the home, with a potential bi-directional transmission with pets (3). Carriage among household contacts is also associated with treatment failure when attempting decolonization regimens (4). This is likely due to environmental contamination as a source of transmission (5,6,7).

Michael S. Calderwood

Hand washing is key in reducing your risk of become colonized with MRSA. It is also important to keep open wounds covered until healed, to avoid sharing of towels and razors, to clean and/or cover gym equipment, and to wash after contact sports or the gym (8).

References:

(1) Clin Infect Dis 2012;54(11):1523-35.
(2) MBio 2015;6(2):e00054-15.
(3) Lancet Infect Dis 2012;12(9):703-16.
(4) J Antimicro Chemother 2011;66(10):2418-24.
(5) PLoS One 2011;6(7):e22407.
(6) PLoS One 2012;7(11):e49900.
(7) JAMA Pediatr 2014;168(11):1030-8.
(8) http://ldi.upenn.edu/uploads/media_items/preventing-mrsa-infection-in-the-community.original.pdf

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Aaron M. Milstone, MD
Johns Hopkins Children’s Center

The best defense for anyone is to practice good hand hygiene — to wash your hands.

Aaron M. Milstone

We need to educate patients that they can acquire MRSA outside of the hospital as well as inside the hospital. They can acquire MRSA in a nursing home, at a daycare center, amongst sports teams — pretty much anywhere, as MRSA is endemic in the community as much as it is in the hospital setting. The good thing is that most patients outside the hospital that are exposed to MRSA are at very low risk to get a MRSA infection. In healthy people, those infections are most often minor MRSA infections, such as boils. Severe infections are rare. Hospitalized patients are at risk for infection if they have surgery or have an indwelling medical device. Patients should be reassured that hospitals employ multiple prevention measures to keep patients safe and infection-free.

Loren G. Miller, MD, MPH
David Geffen School of Medicine, University of California, Los Angeles

Loren G. Miller

Millions of Americans are colonized with MRSA. The problem is that very few of those colonized will actually become infected with MRSA. There are no good evidence-based practices for colonized patients to reduce the risk of MRSA infections to themselves or others, other than sticking with basic hygienic measures. If there is someone in the household infected with MRSA, wounds should be kept covered and all household members should practice good hand hygiene. Alcohol hand rubs work amazingly well at killing MRSA, as does soap and water. Environmental surfaces can be disinfected well with bleach or alcohol wipes. as well as many household disinfectants.