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CA-MRSA:The Emerging Pathogen
By Suzanne M. Bonner, RN, CMSRN, BSNNursing made Incredibly Easy! March/April 20092.0 ANCC contact hoursOnline: www.nursingcenter.com
© 2009 by Lippincott Williams & Wilkins. All world rights reserved.
CA-MRSA Facts
On the rise in EDs across the country
Frequent cause of skin and soft tissue infections (pimples, boils, and abscesses)
Has a specific gene pattern or “fingerprint” (different from HA-MRSA)
The median age of patients with CA-MRSA is 30 (compared with age 70 for HA-MRSA)
Sensitive to: trimethoprim-sulfamethoxazole, gentamicin, tetracycline, and clindamycin
Picturing CA-MRSA Infection
Risk Factors
Children (especially in day-care centers)
Large groups of people living in close quarters (such as soldiers or prisoners)
Those who play contact sports (such as wrestling, football, fencing, and rugby)
I.V. drug users
Homeless persons
Men who are sexually active with other men
Risk Factors
Ethnic groups: Pacific Islanders, Native Americans, Native Alaskans, and Native Canadians
Theorized that lack of infection control may be responsible for CA-MRSA in these groups, according to the CDC
Treatment
75% of CA-MRSA infections are soft tissue infections
Incision and drainage of the boil, abscess, or soft tissue area
May or may not be followed by antibiotics, depending on the patient’s comorbidities, the size of the affected area, and the presence of fever or other symptoms
A culture of the wound should be done to determine what antibiotic to use
In several states MRSA is a reportable disease (check with your state’s health department)
Prevention and Patient Teaching
CA-MRSA is very contagious
Encourage use of frequent hand washing and hand sanitizer use
Teach your patient and his family members how to prevent its spread in the household: Proper hand washing before and after wound
cleaning Avoid skin-to-skin contact Don’t share personal items (such as razors, towels,
and clothing) Wash clothes, bed linens, or towels that have come
in contact with the wound with water and detergent and use a dryer
Sports Team Prevention
Disinfect equipment
Ensure appropriate laundering of uniforms, clothing, towels, and linens
The surface of equipment in a gym or health club should be wiped down with a clean towel before and after use
Keep wounds covered
Refrain from participating in sports until wounds are completely healed