MRSA AND OTHER RESISTANT GERMS
3 Class Hours
Objectives: At the end of this class, you will be
1. Discuss the difference between
bacteria and viruses.
2. Explain why some antibiotics no longer
3. Describe MRSA and how to prevent it.
Germs are all
around us and in us. Some of these germs help us. Others lead to an infection.
Many harmful germs can be killed with antibiotics. Others, over time, have
changed their structure to protect themselves from medicines. These germs have
become resistant to antibiotics. This has become, and continues to become, a
very severe problem. People that have these resistant germs may die because our
antibiotics do not kill them.
What Are Germs?
Our world is
filled with many very, very, tiny living beings. These living things consist of
one cell, the most basic unit of life, but these single cells do sometimes
group up and form large clumps. These beings are found in the water, in dirt,
in the air, on the body, and inside the human body. The human eye can not see
these tiny beings. Special microscopes are used to see them in the lab. There are couple of types
of these beings. There are bacteria, viruses and fungi.
Some of these
tiny living beings are good. They help us to stay in good health. For example,
we have good ones in our intestinal system. They keep us from getting other
infections. These beings are called resident flora because they live in
the normal human body. Some of these good ones live in one part of the body
without leading to illness, but they can make us sick when they move to another
part of the body. For example, E. coli lives in the large bowel, but, when it
moves to the urine tract, it will cause an infection. This is the reason that
the female must always wipe from the front to the back and not from the back to
the front after using the toilet.
Some of these
tiny beings that are found in and on the normal human body are below.
Skin and nose- Staph
Bowels- Step and E. coli
beings, called germs, harm us. They can cause an infection in a normal
person and people with some illnesses. For example, the strep germ can cause a
sore throat or a bad infection in a child that is healthy. The flu virus can
cause the flu and the person will become ill. The AIDS virus leads to HIV/AIDS.
The TB bacteria causes TB.
Some of these
germs are very strong and powerful. Others are weak. Some can lead to a small
infection. Others can lead to a very serious infection and even death. Some,
like the common cold, do not cause a lot of damage. Others like HIV can lead to
a very bad infection and even death. Some germs affect a small area. Others
affect the entire body. For example, the skin can get a very small infection
that does not travel to other parts of the body. These sores usually heal on
their own in a short time unless the person has a problem with healing. But,
other germs, like Staph, can travel in the blood and infect the entire
body. These infections are very serious. They often lead to death.
come and go very quickly (acute) and some will be in the person for the rest of
their life (chronic). For example, a common cold comes on and goes away very
fast. HIV lasts a entire life time.
Who Gets Infections Fastest?
There are some
groups of people that are at great risk. These groups include:
People with serious diseases (AIDS/HIV, cancer)
People taking some medicines (cancer medicines)
People getting some treatments (catheters, IVs)
People that live and/or work in crowded places (prisons,
People who do not get vaccines
Some cells that
are normally found around our body in the world, on our own body and in our
body do not cause infection unless the person has a serious disease. For
example, people with cancer and HIV will get infections that other normal
people do not get. They get them because their body is weak and not able to
fight the germs off. People with this problem will become infected faster than
people who are well.
Old people are
at risk because their body gets a weak immune system as they get older. People
with this problem will become infected faster than people who are younger. They
can not fight off germs as well as younger people. Some medicines, like
steroids, and treatments, like an IV and chemo for cancer, make it harder for
people to fight off the germs. Chemo makes the body and the immune system weak.
IVs allow germs on the outside of the body to enter the body and infect the
inside of the body. These people will get infections faster and more often than
people who are not taking these medicines and treatments.
crowded places are also at risk because they are near other people who can spread
the germ from person to person. People in jail, people on an airplane, people
who live in a groups setting, like a nursing home, college dorm, boarding house
or hospital, and young children in schools are examples.
people used to die from some infections, like smallpox, until a vaccine or shot
was used to prevent it. Infants, young children, older adults and people with a
long term chroinic disease should get certain vaccines to prevent infections.
For example, an infant and young child will begin to get a number of them after
they are born to protect them. They will get shots so they cannot get things
like mumps and measles. Older people and people with a chronc disease, like
lung disease, should get the flu shot to protect themselves
against the flu.
The Chain of Infection: How Germs
spread to a person when germs:
- are able
to leave the body,
- have a
means of transportation and
- can enter
Germs are everywhere. They are in the air, on our body,
in our body, on our clothes, on and in food, in liquids, in human waste, on
table tops, bed sheets, flowers and everywhere else.
Nursing assistants can do many things to prevent the
spread of germs. We must keep foods safe. We must make sure that patients'
rooms are clean and without dust. Even dust carries germs through the air.
Nursing assistants cannot prevent germs from leaving
someone's body. Germs will leave a person's body when they cough, sneeze, move
their bowels and when they have a draining wound. We have no control over a
sneeze and a cough, but we do have control over the tissues that someone is
using when they sneeze or cough. Tissues are a way for germs to move from one
person to another.
Tissues and our hands are vehicles for germs, just like a
car is a vehicle for us to move from one place to another. We cannot get too
far away to a store, work or church unless we have a car or another mode of
transportation to get us from our house to where we want to go.
Germs cannot move from one place to another unless they,
too, have a means of transportation. If we take this away from them, they
cannot move from one person to another. Tissues, hands and all other items that
have, or may have, body fluids can move germs from one person to another. We
can stop the spread of infection when we take the germs’ transportation away.
We can break the cycle of infection and stop infections
from moving from one person to another when we:
- wash our
hands properly before and after EVERY patient contact,
- wash our
hands properly before and after EACH task we do,
all items that have, or may have, germs in the proper way and
- do other
simple things like keeping dirty bed sheets away from our clothing.
What Kinds of Living Things Can
Lead to An Infection?
A number of
other things can lead to an infection. Some of these things are:
Bacteria (strep, staph)
Virus (HIV, common cold)
Fungus (yeast like candida, and molds)
Worms (hook worm and tape worm)
Insects (flea, tick and mite)
What is the Difference Between Bacteria and Viruses?
Bacteria are single-cell beings that are found all over the world, in the
air, on things like door knobs, inside the body and outside of the body. Most
will not cause us to become sick when we are normal and not weak. Some help us
to stay well. Still more can make us very sick. Some of the infections that
they can cause are:
A virus is smaller than a bacteria. They can not
live outside of the body. They invade the healthy cells of the body and they
multiply. A virus can lead to:
- Some ear
What is an Antibiotic?
An antibiotic is
a drug that fights bacteria. The first one was penicillin. It was discovered in
1927. This was a very big thing. Many people died from a lot of infections
before this time. After this time, many of these infections could be cured.
People no longer got sick and died from many kinds of bacteria.
Some of these
drugs are made from things that are made by nature (fungus). Others are not
found in nature. They are made in the lab by a sceintist. Some of these drugs
kill the germ. Others stop the growth and multiplication of the germ.
These Drugs Kill Bacteria.
They do NOT Kill a Virus.
They do NOT Kill a Cold.
They do NOT Kill the Flu.
Do Antibiotics Always Work?
The answer to
this question is NO. They do not always work. Over the last many years people
took these drugs when they were not needed. They took these drugs over and over
for things like a cold and the flu which they do not kill. People took these
drugs over and over again even though they do not fight a cold or a flu. A cold and the flu are viruses not
a bacteria. As said before, these drugs only work with
Why Do People Take These Drugs for
Doctors give these drugs to the patient because the
patient asks for them. People think that these drugs will kill the cold or flu
germ when we know that they do not. Many doctors give these drugs to the person
who asks for them simply because they do not want their patient to go to
another doctor to get these drugs when they say “no”. People have to learn
about these drugs. People have to learn what these drugs are used. They have to
learn what they should NOT be used for. People have to learn that these drugs
are used for a strep throat but NOT for a cold or the flu. Doctors also have to
learn how to say no to their patients.
Doctors have to stop giving these drugs to people with a
cold or the flu. Doctors must not give these drugs to people unless the doctor
knows that the person has an infection from a bacteria.
This is done by taking a culture and waiting to see what is found under the
microscope. After the germ is seen and identified, the next step is to find out
which drug, if any, can be used to fight this specific germ. Then, and only
then, should the doctor give an antibiotic to a patient.
Why Do Some Germs Resist
People and other
living things, like germs, learn. They learn how to solve a problem when there
is one. People learn how to go to the bank and put money into it when they get
a phone bill. People learn how to wear warm clothes when it is cold outside.
The police learn how important a bullet proof vest is when they are out in the
streets. These vests save their life. Soldiers learn to wear body armour so
they do not get killed by the enemy’s bullets.
learn. They learn how to change when they sense that an antibiotic is in their
area. They put on and wear a “bullet proof vest” to protect themselves.
When they are safe, they multiply into many, many other germs with the same
protection. The more people take antibiotics, the more these germs resist the
antibiotics. They protect themselves. Soon, the antibiotics do not work
anymore. They can no longer kills the germs. They are
now useless. For example, in the past TB was killed with a special drug. Now,
some TB drugs are useless because the germ has learned to resist it. Also, the staph
bacteria used to be killed with antibiotics. Now, staph resists these drugs.
This happens because some people have taken too many over their life time. They
have abused these drugs. Now, they may get an infection that can not be cured.
These drugs are also found in food, water and some soaps so this ads to the
This is a problem for the person BUT IT IS ALSO A PROBLEM
FOR OTHER PEOPLE.
This person can
spread this germ to other people who will also not be cured because the germ
will resist antibiotics. One of the biggest threats to the lives of our
patients is the drug resistant staph germ. This staph spreads
from person to person and anitibiotics are not always able to kill it. This staph
germ is called MRSA.
Everyone must be VERY concerned about MRSA!
What is MRSA?
MRSA is an
infection that is caused by the Staphylococcus aureus bacteria or staph.
It is also called MRSA. MRSA stands for methicillin-resistant Staphylococcus
aureus. It is a kind of germ that resists antibiotics. It can sometimes
lead to death.
MRSA can be
found in health care places, like hospitals and nursing homes. It is also found
in the community. The people that are most at risk for it are old people and
people that are weak and cannot fight it off. Now, however, more and more
healthy people are getting it. For example, people that go to a gym may get it
when they share towels and other personal things.
infections, including MRSA, start with small red skin bumps that look like a
pimple or a spider bite. These bumps then turn into a deep
and painful abscesses. Sometimes these germs stay on the skin and do not
travel to other parts of the body. At other times, they can enter the bones,
blood, heart and other parts of the body. Many get pneumonia.
Staph is normally found on the skin or
in the nose of about one-third of people. Most do not get sick from it although
they can pass these germs to other people who may not be as lucky. These people
can get sick from it.
Who is At Risk
groups are at great risk for the community form of this germ:
People that do sports
that involve skin to skin touch and possible cuts and scrapes (football,
People that share
towels, razors, uniforms, etc.
People with a weak
People that live in
crowded places (group homes, dorms, prisons)
People that live in
People that have close
contact with people that work in health care
groups are at risk for the health care related MRSA:
People who are, or have
been, in a hospital or another health care facility like a group home, assisted
living house or a nursing home
Old people, weak
people, people with wounds or burns
People with things that
have been placed inside of their body (feeding tubes, IV lines, etc.)
People who are getting
How Is It
The first step is to find out that
a person has an infection. The signs of infection are wound:
pus or other fluid
coming from it, and
The second step
is to find out exactly what germ is at work. Lab tests are done to find out if
it is MRSA. MRSA becomes the known cause when it is found in a skin or nose lab sample.
At the current
time, some antibiotics can still fight MRSA for some people and not others. The
last step is treatment. Some can be drained by the doctor without using any
drugs. This is done whenever possible. Others need an antibiotic in the hopes
that the infection can be cured.
Prevention: What You Can Do in Healthcare
Health care is
fighting back against MRSA. They are watching how people work and what they do,
or do not, follow basic infection control practices. They are also using
special things like catheters that are coated with an antibiotic in order to
prevent an infection.
The best way to
prevent it, however, is still with good handwashing. Yes, regular and simple
handwashing. Handwashing and infection control procedures prevent MRSA. Things
like gloves and gowns also help.
People that have
MRSA are placed in isolation to prevent its spread to other people, including
other patients, staff and visitors. Handwashing and wearing special things,
like a gown, must be done by all people who go into that room.
patients to wash their hands often. Below, you will learn about when and often
all people including your patients, must wash their hands.
to wash your hands
People must wash
your hands when they touch people, surfaces and objects. Germs add up and add up the more that people
touch things during the day. Germs enter the body whenever a
people touches the nose mouth or eyes. So, people must wash their hands
over and over again many times throughout the day.
Also, people must
always wash their hands before they:
care for a person,
make a meal, and
always wash their hands after they:
care for a person,
make a meal especially when it is raw
meat or poultry,
use the toilet,
change a diaper,
touch an animal, an animal toy, a
leash or waste,
notice that the hands are dirty,
blow the nose, cough, or sneeze and
handle garbage or other dirty items
to wash the hands
It is best to
wash the hands with regular soap and water. Hand sanitizers do not replace good
hand washing with soap and water.
These are the
simple hand washing steps:
1. Wet the hands
with running water.
2. Apply soap.
3. Lather the
soap up well.
4. Rub the hands
strongly and with vigor for at least 20 seconds. Remember to scrub and rub ALL
surfaces. Do not forget the wrists, the backs of the hands, between the fingers
and under the fingernails.
5. Rinse well.
6. Dry the hands
with a clean paper towel or an air dryer.
7. Use a towel to
turn off the faucet. Do not touch it with clean hands. It is dirty.
to use an alcohol-based hand sanitizer
These are a alternative to soap and water when soap and water is not
available. These are the simple steps to use them:
it to the palm of the hand to completely wet the hands with it.
2. Rub your all
parts of the hands until they are dry. This may take up to 25 seconds until
they are dry.
You Can Do in Your Own Community
Wash your hands. Carry, and use, a
small bottle of hand sanitizer containing at least 60 percent alcohol for times
when you do not have soap and water.
Keep personal items personal. Do not
share things like towels, sheets, clothing or razors.
Keep all sores covered. Keep cuts
clean and covered until they are all healed.
Shower after all sports activities.
If you have an infected area, contact
your doctor and get tested.
Do NOT abuse antibiotics.
You must help
your young patients to learn how and when to wash their hands. Show them how to
do it. Remind them to do it when it is necessary. Teach them to sing the
"Happy Birthday" song two times before they stop rubbing their hands
during the washing process.
Hand washing is
very important for young children especially when they are sick or in groups
outside of their own private home.
is very serious. It can lead to death. Nursing assistants and others in
healthcare must follow proper infection control and hand washing procedures so
their patients will be free of this infection.
© 2010 Alene Burke
for Disease Control and Prevention (2009). “Get Smart: Know When Antibiotics Work” http://www.cdc.gov/getsmart/antibiotic-use/anitbiotic-resistance-faqs.html