Methicillin-Resistant Staphylococcus Aureus (MRSA) in the Correctional Facility
There are outbreaks of MRSA in several AFSCME institutions. MRSA is difficult to treat and can cause potentially life-threatening complications. Infection control requires strict adherence to procedures.
Staph is a bacteria commonly found on the skin and in the nose of healthy people. Some staph bacteria have developed resistance to the antibiotics most commonly used to treat infections, and are called methicillin-resistant Staphylococcus aureus, or MRSA. Staph, including MRSA, can cause minor infections such as pimples and boils, or it can cause more serious infections, such as abscesses, pneumonia, and bone or bloodstream infections.
Staph, including MRSA, is almost always spread person-to-person by skin-to-skin contact, mostly by the hands. It can also be spread by objects, such as towels and clothes, that have been contaminated with the bacteria and then are shared or used by someone else. It is not uncommon to have these infections spread among household members, sports team members, or other people who have frequent close contact or share personal items.
Who is at Risk?
Until recently, MRSA/staph infection outbreaks were confined to hospital settings. However, more and more frequently, healthy people have been getting MRSA/staph infections in the community, without contact with hospitals or healthcare facilities. Recent antibiotic use, recurrent skin diseases and crowded living conditions are risk factors for these infections. In the past few years, there have been clusters of skin and soft tissue infections in certain groups, such as prison inmates. Person to person transmission in institutional settings, usually via the hands, has been a major factor in the increase in cases. Since MRSA/staph is spread by contact, correctional officers, who work in close proximity with inmates, are at risk.
Signs and Symptoms
Pimples, rashes or pus-filled boils, especially when warm, painful, red or swollen, can indicate a staph infection. Staph is confirmed by lab analysis of a swab sample. A swab can be taken from inside the nose or from a draining sore. If the infection is determined to be staph, a second test is usually done to determine if it is MRSA.
Treatment, Prevention and Controls
Most staph infections are treated with good wound care: keeping the wound clean, dry and covered. Abscesses may be drained, treated and covered. However, if the body cannot fight the infection on its own, antibiotics may be used.
The best way to fight staph and MRSA infections is to prevent bacterial growth on surfaces and direct contact with infected individuals. Frequent hand washing, or the use of alcohol-based hand sanitizers if soap and water are not available, has been shown to be the most effective in controlling the spread. MRSA/staph can be removed from the hands by washing with soap and water. Regular cleaning and disinfection of surfaces, such as toilets, shower areas and fitness equipment is essential. Standard precautions should always be followed. Workers should take care to protect their own skin, and cover any open sores or wounds.
What Are Standard Precautions?
Standard Precautions refer to the infection control practice of treating all patients’ blood, body fluids, secretions, excretions (except sweat), non-intact skin and mucous membranes as infectious. Standard Precautions include hand hygiene and, depending on the anticipated exposure, use of a barrier (gloves, gown, mask, eye protection or face shield) between persons. Equipment or items in a patient’s environment that was likely contaminated must be handled in a way to prevent disease transmission.
How can MRSA/staph infections be prevented and controlled in correctional facilities?
- Routinely wash hands with soap and running water for at least 15 seconds before eating, after using the lavatory, when hands are visibly dirty, and when there has been contact with blood or other body fluids. Use a hand-sanitizing gel or a disposable anti-microbial wipe if soap and water are not available.
- Wear gloves during pat downs. When open skin contact is likely, change gloves between inmates.
- Use appropriate personal protective equipment when you expect contact with blood or body fluids.
- Wear gloves when handling dirty laundry. Launder sheets, towels, uniforms and underclothing with hot water and detergent and dry on the hottest setting or use a detergent which has the same effect.
- Regularly clean and disinfect hard surfaces and high traffic areas such as sinks, showers and toilets.
- Disinfect fitness equipment after each use.
- Disinfect portable equipment, such as handcuffs, shackles, pagers, cell phones and stethoscopes.
- Do not share any personal items, such as razors, towels or combs.
- Treat wound bandages as medical waste. Never place them in the general trash.
- Do not transfer inmates with contagious MRSA. It is recommended that a screening protocol be put in place for all incoming persons.
- Maintain a log of all skin lesions and infections. Outbreaks of MRSA should be reported to local public health officials as required.
- Provide correctional staff and inmate education.
Attention to hygiene and infection control continue to be the most effective methods for dealing with these types of infections.
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