Quality Matters Newsletter

VRSA? MRSA? ORSA?

Created 6/20/2012
by Malin, Tracey

Staphylococcus aureus, more commonly known as “Staph”, is one of the most common skin infections in the United States.  In fact, this organism is even found on healthy individuals. When a Staph infection does occur it is usually minor, but occasionally it can be serious, and sometimes fatal.

Over the past 50 years, Staph has become more and more resistant to the antibiotics used to treat it. Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant Staphylococcus aureus (VRSA) are two examples of Staph. Oxacillin-resistant Staphylococcus aureus (ORSA) is essentially the same thing as MRSA, and is technically the better term. Methicillin has not been commercially available for some time in the United States.  Oxacillin is in the same drug class and is the preferred drug for testing, but because of its historic role, the acronym MRSA is still frequently used.

Both MRSA and VRSA have been around for several years. The progression of resistance through multiple drugs is significant because it demonstrates that these bacteria are developing tolerance to the medication arsenal currently available.  Therefore, our best solution is prevention.

Staph bacteria are spread by contact. Individuals with a MRSA infection, and those that care for or regularly come in contact with them, should be aware of the following guidelines.

The individual with the Staph infection must:

  • Follow all directions as provided by their healthcare professional regarding wound care and medications.
  • Take any antibiotics as prescribed. They should not take half doses or stop taking the antibiotics before completing the prescribed course. 
  • Avoid sharing personal items like razors, towels, or clothing.
  • Wash hands frequently, especially if they have touched the wound or the surrounding area.
  • Keep wounds that are draining or have pus covered with clean, dry bandages until healed.
  • Change the bandages according to their physician’s direction. 

People having close physical contact with infected persons, or materials contaminated with fluids from infected persons, must:  

  • Clean their hands often. 
  • Keep any cuts/scrapes on their bodies covered with a bandage until healed.
  • Avoid ungloved contact with the individual’s wounds or material contaminated from wounds.
  • Thoroughly wash hands with undiluted soap and water before and after providing care to the individual.
  • Use a new pair of gloves for each contact.  Do not wash gloves for the purpose of reusing. This practice has been associated with the transmission of pathogens.
  • Remove gloves after contact with the infected individual, using the proper removal technique to avoid hand contamination.
  • After removing gloves and washing hands, dry hands on a disposable towel.
  • Develop a cleaning procedure which includes at least daily cleaning of the individual’s room and any frequently touched surfaces that come into direct contact with the individual’s skin (e.g., door knobs, bed rails, tables, counter tops).
  • Always discard single-use items.  
  • Ensure that reusable equipment such as stethoscopes or blood pressure cuffs are not used for the care of another person until they have been appropriately cleaned.
  • Ensure that the infected person’s clothing and linens are washed with detergent and dried completely in a clothes dryer. Using a clothes dryer rather than letting items air-dry assists in killing bacteria.
  • Use the warmest recommended temperature on labels for both washing and drying. Handle, transport, and process the individual’s clothing and linens in a way which avoids contamination of air, surfaces, and other persons.
  • The individual’s physician may have additional instructions; be sure to follow them.

Be aware that chronic medical conditions like diabetes, cancer, or HIV increase your chances of falling prey to this stubborn infection.  Hand sanitizer should not be used in place of proper handwashing. However, the use of an alcohol-based hand sanitizer containing 60-90% ethyl alcohol or isopropanol in concentration with equivalent sanitizing strength may be used in addition to proper handwashing.

We don’t need to be overly frightened; however we do need to have a heightened awareness of the risks associated with these infections. These are nasty and “intelligent” bugs, but their attack is easily preventable if we abide by a few simple rules.