Methicillin-Resistant Staphylococcus Aureus

U.S. Centres for Disease Control and Prevention

• Methicillin-resistant Staphylococcus aureus (MRSA) Basics

Provincial Infectious Disease Advisory Committee (PIDAC)

• MRSA Information Sheet for Patients and Visitors - Annex A: Screening, Testing and Surveillance for Antibiotic-Resistant Organisms (AROs) in All Health Care Setting - p.54-55.

Public Health Agency of Canada

• Community-Acquired MRSA Fact Sheet

No exclusion necessary unless too ill to participate in regular activities.

Follow the direction of your healthcare provider or occupational health at your workplace.

Note: Exclusion guidelines may differ for healthcare workers.

Refer to PIDAC: Appendix D: Sample Investigation Protocols for MRSA and VRE in Acute Care Facilities for sample investigation protocols for MRSA present at admission to acute care or suspected health care associated MRSA.

Screening

All health care facilities should institute a screening program and targeted surveillance for MRSA in order to implement infection prevention and control measures as early as possible to reduce the risk of transmission to others. Public Health Ontario's Antibiotic Resistant Organism (ARO) Risk Factor-Based Screening Guidance for All Health Care Settings checklist can be used or adapted by any health care setting as a screening tool for all AROs.

Additional Precautions

Initiate contact precautions upon receipt of positive culture result for MRSA or with admission of flagged MRSA positive client/patient/resident or high-risk individual pending culture results. Add droplet precautions if culture positive in sputum and client/patient/resident is coughing. In addition to routine practices, contact precautions include:

• For acute care - private/single room with a dedicated toilet and patient sink, gloves and gown when within the client/patient/room or bed space.
• For long-term care - placement of residents requiring contact precautions should be reviewed on a case by case basis, gloves and gown are required for activities that involve direct care where the health care provider's skin or clothing may come in direct contact with the resident or items in the resident's room or bed space.
• For ambulatory care/clinic settings - place individuals in an examination room or cubicle as soon as possible, gloves and gown are required for activities that involve direct care where the health care provider's skin or clothing may come in direct contact with the individual or items in the examination room/cubicle.
• Dedicated equipment or adequate cleaning and disinfection of shared equipment, including transport equipment.

Refer to the PIDAC document Routine Practices and Additional Precautions in All Health Care Settings for additional information.

Cleaning and Disinfection

No special approach is required to clean and disinfect rooms/bed spaces that housed clients/patients/residents colonized or infected with MRSA beyond what is recommended for the rooms of all patients in contact precautions, and no special handling or precautions are required for linen. For clients/patients/residents on contact precautions, there must be a process in place to ensure that there has been adequate cleaning and disinfection of the space and shared equipment following discharge or transfer. See the PIDAC document Best Practices for Environmental Cleaning for Infection Prevention and Control, p. 107-109 for additional information.

Public Health Ontario Laboratory performs confirmatory testing for MRSA, see MRSA - Methicillin Resistant Staphylococcus aureus - Confirmation for additional information.

Staff working in a health care setting can review the Staff Fact Sheet (p.50) found in the PIDAC document Annex A: Screening, Testing and Surveillance for Antibiotic-resistant Organisms (AROs).