What steps might be taken to reduce the risk of methicillin resistant Staphylococcus aureus infection in local schools and gyms?

In the community, contact your doctor if you think you have an infection. Early treatment is very important.

Índice Show

Source Control
Hand Hygiene
Patient Care Equipment
Education of Patient, Families and Visitors
Handling of Laundry

Wash your hands often, and always after changing the bandage or touching the infection. Use soap and water, or use an alcohol-based hand sanitizer.
Do not treat the infection yourself, and do not pick or pop the sore.
Cover the infection with dry bandages.
Do not share personal items such as towels or razors.
Wipe down non-washable equipment with an antibacterial solution, especially before being used by another person.
Clean surfaces (counter tops, door knobs) with a standard disinfectant on a regular basis.
Wash sheets, towels, and clothes with water and laundry detergent. Use a dryer to dry the items completely.
If prescribed antibiotics, take all of the medicine as prescribed by your medical health professional. Finish your antibiotics as instructed, even if you feel better. If your healthcare professional tells you to stop taking antibiotics, return the unused medicine to your pharmacy.
Do not share antibiotics with anyone, do not use leftover antibiotics, and do not use antibiotics that were prescribed to another person.

The prevention of MRSA infections in health care is based upon standard infection control precautions, which include routine practices, and contact precautions as required for all antibiotic-resistant organisms. Steps include, but are not limited to:

Source Control

Contact precautions should be used with patients with known or suspected infections. It is not necessary to wait for testing to confirm a diagnosis. Use contact precautions (e.g., procedures to prevent droplet or aerosols). Post signs at the entrance to patient area. Single patient rooms may be used with designated toilets and sinks. Separating patients by 2 metres may also be used when a respiratory infection is present.

Hand Hygiene

Hand hygiene can be performed with an alcohol-based hand rub or with soap and water. Alcohol-based hand rub is used at the point of care in healthcare settings when hands are not visibly soiled. If hands are visibly soiled, wash with soap and water.

Gloving

Wear gloves when touching blood, body fluids and contaminated items. Remove gloves between patient contacts and clean hands immediately.

Masking

Wear a mask and eye protection, or face shields, or masks with a visor attachment during procedures that are likely to generate splashes or droplets of respiratory secretions, blood, or body fluids.

Gowning

Long-sleeved cuffed gowns are not routine, but may be needed in specific situations. Follow your organization’s policies.

Patient Care Equipment

Appropriate cleaning, disinfection and sterilization of patient care equipment and rooms are important in limiting the transmission of organisms. Equipment may be dedicated to a single patient when possible. Surfaces that are likely to be touched or used should be cleaned and disinfected more frequently (e.g., bedrails, tables, call bells, door knobs, bathroom facilities, etc.).

Education of Patient, Families and Visitors

All people involved should be educated about the importance of the precautions being used to help prevent the transmission of the disease. Hand hygiene is particularly important.

Handling of Laundry

In healthcare settings, while care should be taken when handling soiled linen, special handling of linen from patients with additional precautions is not required. When at home, linens, wash towels and bed linens in a washing machine set to the hottest water setting (with added bleach, if possible) and dry them in a hot dryer. Wash gym and athletic clothes after each wearing.

For further information refer to Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings (2107) from the Public Health Agency of Canada.

See the OSH Answers on Antibiotic/Antimicrobial Resistance in Bacteria and Organisms for more information.

By Ralph Morris, MD, MPH, and Bruce K. Bernard, PhD
March 11, 2016

A healthy workout in the gym should leave you with a feeling of well-being and nothing worse than a duffle bag full of sweaty clothes. It should not leave you with a MRSA skin infection.

What is MRSA?

MRSA, or “Methicillin-resistant Staphylococcus aureus,” is a type of staph bacteria that is, according to the US Centers for Disease Control and Prevention (CDC), resistant to common antibiotics. CDC reports that about two in every 100 people carry MRSA on their bodies, with no symptoms of infection.

A MRSA infection may at first be mistaken for a spider bite. It may appear as a bump or infected area on the skin and could be accompanied by a fever. The CDC website provides photos of MRSA skin infections to help the public identify this potentially serious infection.

Older people and those with compromised immune systems are most vulnerable to MRSA infection. For that reason, healthcare facilities are the most common environment of MRSA transmission. In otherwise healthy people, however, MRSA infections are usually mild and improve after a few days of oral antibiotic treatment if the infection is sensitive to the antibiotic. Those infections are called “community-associated MRSA,” and are common in environments in which healthy people interact in close quarters; your gym is just such an environment.

Within the gym, intentional skin-to-skin contact (e.g., during wrestling and martial arts training) and unintentional skin contact between teammates during practice and competition (e. g., volleyball) are documented risk factors for MRSA transmission, according to a 2008 review of MRSA infection in athletes1. Skin damage during exercise, e.g., mat burns, broken blisters, and other workout related injuries that abrade the skin, represent another common risk factor, particularly if broken skin contacts MRSA-contaminated surfaces.

Tips for avoiding MRSA infections at the gym:

WASH YOUR HANDS – thoroughly with soap and water before and after your workout and after using the bathroom; bar soap should not be shared during MRSA outbreaks; use liquid soap instead
SHOWER – promptly after any skin-to-skin contact; use liquid soap
OTHER PEOPLE’S OPEN WOUNDS – don’t touch wounds or bandages
YOUR OWN OPEN WOUNDS –
- Cover and protect with clean bandages
- Avoid using whirlpools, therapy pools and swimming pools
DISINFECT EQUIPMENT – wipe down exercise equipment (e.g., wrestling mats and the bench press), before and after use, with disinfecting wipes; use bleach wipes or other EPA-registered products that are effective against MRSA.
DON’T SHARE –
- Razors with others; according to the 2008 review of MRSA transmission in the gym, razors create tiny lacerations, which increase the risk of acquiring MRSA from others
- Towels with others; if shared towels have not been laundered between uses, they may be contaminated with MRSA
AVOID REUSING UNLAUNDERED EXERCISE CLOTHES – use fresh, clean clothes for each workout
LAUNDER – sweaty gym clothes and towels promptly after your workout; if laundering instructions permit, use chlorine bleach

A final tip: Keep up the good work at the gym. In the grand scheme of things, the benefits of working out greatly overshadow the risk of MRSA infection. Why not increase your benefits by following these tips?

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

Bruce Bernard, PhD, is President of SRA Consulting, Inc., and Associate Editor of the International Journal of Toxicology, and lives in Cambridge, MD.

Click here to download this article.

1 Cohen, P.R. (2008). “The skin in the gym: a comprehensive review of the cutaneous manifestations of community-acquired methicillin-resistant Staphylococcus aureus infection in athletes,” Clinics in Dermatology, 26, 16-26.