Methicillin Resistant Staphylococcus Aureus (MRSA) in Special Populations

Schools

Although CA-MRSA has been reported in school settings, school age children are not a high-risk population and classrooms are not a high-risk environment for the spread of CAMRSA.  In Florida schools, reported CA-MRSA infections generally occur in settings where the 5 C's are present. These settings are generally sports-related and involve members of contact sports teams, such as football.

Precautionary recommendations for schools include:

• Education of students and staff in the transmission (person-to-person contact) of CA-MRSA and individual precautions emphasizing hand hygiene to reduce the likelihood of transmission.

• Do not exclude colonized individuals from routine activities. Many people are asymptomatic carriers of CA-MRSA. Focusing on carriers will not decrease transmission.

• Teachers, coaches, and staff are encouraged to look for signs and symptoms of infection and refer the individuals to their healthcare providers and report outbreaks to the local county health department.

• Regular housekeeping and cleaning regimens should be applied. Locker rooms and sports equipment should be cleaned and disinfected frequently with an EPA-approved disinfectant (used as directed).

• Laundry (uniforms, towels, etc.) should be routinely washed. Bleaching is not necessary. Items should be thoroughly dried on high heat (>160oF) and not allowed to air dry.

• Individuals with active infection should keep wounds covered with clean, dry bandages and contain any wound drainage. Infected individuals need not be isolated or excluded from school activities, unless wound drainage or other contaminated body fluids cannot be contained.

• Infected individuals may be excluded from activities that increase the chance for spreading the infection (i.e., physical education, sports activities) until lesions have resolved or can be adequately covered and contained.

• County health departments are available as resources for education and infection control plans.

• The Florida Department of Health does not recommend closing schools for cleaning. 

Athletic Settings

CA-MRSA infection has been reported in athletes and participants in contact sports at all levels.

Preventive measures to reduce infection and transmission of CA-MRSA in athletes and sports facilities should include:

• Encouraging personal hygiene among patrons and staff.

• Not allowing infected individuals with lesions that cannot be adequately covered to participate.

• Making products available (alcohol hand-sanitizers, disinfectant spray bottles, and paper towels) that allow hand hygiene and disinfection of equipment to be performed in activity areas.

• Encouraging showering at the end of activities.

• Thorough cleaning of facilities on a scheduled basis. Shared equipment and facilities, such as exercise machines and saunas, should be cleaned and disinfected daily with an EPA-registered disinfectant (used as directed).

• If laundry services are provided, washing linens, towels, and clothing and drying thoroughly at high heat (>160oF) before use. Items should not be air dried

CDC report on MRSA Infections among Competitive Sports Participants (2003)

Correctional Facilities

CA-MRSA infections and outbreaks have been observed in correctional facilities around the country, including Florida. Facilities that house inmates in closely-confined quarters provide suitable conditions for the spread of infections, including MRSA.

Basic prevention and control measures for correctional facilities should include:

• Encouraging personal hygiene, with an emphasis on hand washing and regular showering.

• Educating staff and inmates on methods of transmission, prevention, treatment, and containment of MRSA in the facility.

• Encouraging inmates to seek medical assistance for skin conditions indicative of infection or that may lead to infection.

• Housing individuals who have poor hygiene or draining lesions that cannot be contained separately from other inmates, if possible, until infection has resolved or is contained.

• Maintaining scheduled cleaning of residential quarters and medical facilities, including disinfection of shared equipment and facilities. This includes medical equipment, exercise equipment, sinks, showers, and toilets. Areas should be cleaned and disinfected using an EPA-registered disinfectant (used as directed).

• Developing and following a facility-wide infection control plan.

CDC report on MRSA Infections in Correctional Facilities (Georgia, California, and Texas, 2001-2003)

CDC report on MRSA Skin or Soft Tissue Infections in a State Prison(Mississippi, 2000)