Set a protocol for HCWs with CA-MRSA wounds

APIC conducts study to measure prevalence

The emergence of community-associated methicillin resistant Staphylococcus aureus (MRSA) has raised concerns about how to prevent hospital-based outbreaks.

Although an estimated 30% of health care workers are colonized with S. aureus, the Centers for Disease Control and Prevention is not recommending widespread efforts to decolonize, says Elizabeth Bolyard, RN, MPH, technical information specialist with the CDC's division of healthcare quality promotion. "If we try to decolonize everyone, we're going to have staph resistant to that [antimicrobial agent]," she says. "We don't see many people who are colonized actually transmitting disease."

However, health care workers with a draining wound should not work until it's healed, she notes.

Hospitals should develop a clear protocol for han-dling employees with an MRSA infection, advises Sue Sebazco, RN, BS, CIC, past president of the Associa-tion for Professionals in Infection Control and Epidemio-logy (APIC) and infection control/employee health director at Arlington (TX) Memorial Hospital.

That may include working with an employee's health care provider to ensure appropriate treatment and furlough if the employee has an infected wound and is involved in direct patient care, she says. A clear directive ensures that "employees are handled as consistently as possible," she says.

A CDC study found about 126,000 hospitalizations annually from 1999 to 2000 with MRSA as a diagnosis.1 APIC planned to conduct a prevalence study in October to gain a better understanding of community- and hospital-acquired MRSA. Hospitals and long-term care facilities agreed to report the prevalence among patients on a single designated day.

The APIC study is an effort to get a better handle on the actual burden of MRSA, says Denise Graham, senior director of public policy for APIC in Washington, DC.

"It's difficult to advocate for additional resources if we don't have some sort of baseline," she says.

APIC also is releasing a tool kit to help facilities reduce MRSA. It will be available at the APIC web site,

(Editor's note: Strategies for prevention and control of community-acquired MRSA are available at


1. Kuehnert MJ, Hill HA, Kupronis BA, et al. Methicillin-resistant-Staphylococcus aureus hospitalizations, United States. Emerg Infect Dis June 2006. Available at