The household environment may play an important role in MRSA transmission.[60]Mork RL, Hogan PG, Muenks CE, et al. Longitudinal, strain-specific Staphylococcus aureus introduction and transmission events in households of children with community-associated meticillin-resistant S aureus skin and soft tissue infection: a prospective cohort study. Lancet Infect Dis. 2020 Feb;20(2):188-98.
http://www.ncbi.nlm.nih.gov/pubmed/31784369?tool=bestpractice.com
Patient education is important to prevent the spread of community-associated MRSA infection to other people. Preventative measures include:
CDC: Methicillin-resistant Staphylococcus aureus (MRSA)
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Washing hands
Bathing regularly
Avoiding shared items that may be contaminated, such as towels and razors
Keeping all wounds clean and covered
Adequately cleaning any shared equipment, such as those at gyms and spas.[3]Gorwitz RJ. A review of community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections. Pediatr Infect Dis J. 2008 Jan;27(1):1-7.
http://www.ncbi.nlm.nih.gov/pubmed/18162929?tool=bestpractice.com
Infection control measures to prevent transmission of MRSA in hospitals and other long-term care facilities include:[61]Popovich KJ, Aureden K, Ham DC, et al. SHEA/IDSA/APIC Practice Recommendation: Strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in acute-care hospitals: 2022 Update. Infect Control Hosp Epidemiol. 2023 Jun 29;44(7):1-29.
https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/sheaidsaapic-practice-recommendation-strategies-to-prevent-methicillinresistant-staphylococcus-aureus-transmission-and-infection-in-acutecare-hospitals-2022-update/5DB835D2E13F7E813A8A2FD7CB8386BD
http://www.ncbi.nlm.nih.gov/pubmed/37381690?tool=bestpractice.com
[62]Coia JE, Wilson JA, Bak A, et al. Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect. 2021 Dec;118S:S1-39.
https://www.journalofhospitalinfection.com/article/S0195-6701(21)00360-1/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34757174?tool=bestpractice.com
Proper hand hygiene (for both healthcare personnel and patients)[63]Sroka S, Gastmeier P, Meyer E. Impact of alcohol hand-rub use on meticillin-resistant Staphylococcus aureus: an analysis of the literature. J Hosp Infect. 2010 Mar;74(3):204-11.
http://www.ncbi.nlm.nih.gov/pubmed/20061061?tool=bestpractice.com
Barrier precautions (gowns and gloves)
Appropriate handling of laundry
Contact isolation precautions for MRSA-colonised and MRSA-infected patients in single-patient rooms, if available[3]Gorwitz RJ. A review of community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections. Pediatr Infect Dis J. 2008 Jan;27(1):1-7.
http://www.ncbi.nlm.nih.gov/pubmed/18162929?tool=bestpractice.com
Cleaning and disinfection of equipment and the environment
MRSA monitoring programme to identify patients with a current or prior history of MRSA and track hospital-acquired infections.
Decolonisation regimens have also been used. These have included topical and systemic antibiotics, as well as antiseptic body washes.[50]Huang SS, Septimus E, Kleinman K, et al. Targeted versus universal decolonization to prevent ICU infection. N Engl J Med. 2013 Jun 13;368(24):2255-65.
http://www.nejm.org/doi/full/10.1056/NEJMoa1207290#t=article
http://www.ncbi.nlm.nih.gov/pubmed/23718152?tool=bestpractice.com
In one study, of hospitalised patients colonised with MRSA, post-discharge decolonisation and hygiene education had a significantly reduced risk of developing MRSA infection than patients who received hygiene education alone.[64]Huang SS, Singh R, McKinnell JA, et al. Decolonization to reduce postdischarge infection risk among MRSA carriers. N Engl J Med. 2019 Feb 14;380(7):638-50.
https://www.nejm.org/doi/full/10.1056/NEJMoa1716771
http://www.ncbi.nlm.nih.gov/pubmed/30763195?tool=bestpractice.com
Decolonisation of surgical patients with an antistaphylococcal agent in the pre-operative setting is recommended in US guidelines, particularly for orthopaedic and cardiothoracic procedures.[65]Calderwood MS, Anderson DJ, Bratzler DW, et al. Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update. Infect Control Hosp Epidemiol. 2023 May;44(5):695-720.
https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/strategies-to-prevent-surgical-site-infections-in-acutecare-hospitals-2022-update/2F824B9ADD6066B29F89C8A2A127A9DC
http://www.ncbi.nlm.nih.gov/pubmed/37137483?tool=bestpractice.com