Public Facilities Take Precautions Against Staph
By Ryan Schlehuber

A strain of bacterial infection that's resistant to some antibiotics was reported at Rudyard Area Schools last month, prompting health officials to urge cleaning and disinfecting of public facilities. The bacteria, Staphylococcus aureus, or "staph" for short, has plagued hospitals for decades, but now is spreading to other institutions, like schools and prisons. Staph continues to infect long term care patients at Mackinac Straits Hospital in St. Ignace and prisoners at the Kinross and Hiawatha correctional facilities. It has caused two deaths on the East Coast.

Resistant to broad-spectrum antibiotics, it is known in the medical world as methicillin-resistant Staphylococcus aureus, or MRSA.

MRSA is a skin infection that can be transmitted between people from skin-to-skin contact or by sharing exercise equipment, clothing, or towels, according to the Michigan Department of Community Health. A staph infection can cause a variety of symptoms, from skin infections and food poisoning to severe invasive disease, which can result in septicemia or death.

After one adult was found infected with MRSA at Rudyard Area Schools last month, extra measures were taken to disinfect rooms and exercise equipment.

"The first thing we did was change how we were cleaning rooms," said Nathan Bootz, Rudyard superintendent. "There is a difference in just cleaning a room and disinfecting it now."

The school hired another custodian to be sure the school is being thoroughly disinfected.

School districts at St. Ignace, DeTour, and Cedarville, have reported no MRSA cases so far but are providing teachers, staff, students, and parents with information as to how to prevent the spread of MRSA. The information reinforces the importance of good personal hygiene, such as washing hands, properly covering wounds, and avoiding sharing personal hygiene accessories, such as razors or bar soap, and not sharing jerseys or towels at sporting events.

Erica Mattson, who oversees the fitness center at the Little Bear East Arena in St. Ignace, said the custodial staff now uses a cleaning product that is powerful enough to kill bacteria, and noted protective gloves and mask must be worn when using it. The fitness center has a policy that users must spray and wipe down any equipment, using a less potent disinfectant, once they are done with it, she said.

Eight to 10 patients at Mackinac Straits Hospital Long Term Care Facility may have MRSA now, said Barb Davis, the hospital's Long Term Care director of nursing.

"If we were to test every one of our patients, we may have as many as 50% of them test positive for MRSA," she said, pointing out that, for a long term facility, this is nothing new.

"We've dealt with it for many years," she said. "Our policy with controlling the spread of MRSA is the same as it was eight years ago, when I became infection staph nurse."

Patients with MRSA are isolated from other patients. Those who come into contact with an infected patient must wear protective gloves, gowns, and masks, discarding them once they leave the room. Hospitals also require visitors to wash their hands before and after visiting. Kinross Correctional Facility has also seen MRSA for several years, according to Michael Sibbald, an administrative assistant at the facility. He said at least one case is found at the prison each month.

Both the Kinross and Hiawatha facilities at Kinross have recently instituted a policy to dedicate a day of thorough cleaning once or twice a month.

"We are putting a little bit more emphasis on cleaning and have incorporated more stringent cleanup requirements," he said.

Prisoners with MRSA are isolated to their cells until the infection is remedied, Mr. Sibbald said.

Michigan has yet to seen an outbreak of MRSA, defined as three or more cases in one area, according to Dr. Eden Wells, a medical epidemiologist with the Department of Community Health.

"I think, because of the unfortunate deaths of two people from the East Coast who were diagnosed with MRSA coinciding with recent articles in medical journals, the buzz of MRSA has increased," she said. "Even though it may not be at a point where we have to panic, continuous awareness is good as long as people are walking away with the right information."

MRSA is not as contagious as, say, influenza, said Dr. Wells, but overusing antibiotics to treat people with possible MRSA infections is a cause for alarm.

"These concerns are valid because this bacteria has developed resistance to some antibiotics because of unnecessary use of antibiotics,"

she said.

Mrs. Davis agrees.

"If we're not careful, excessive use or overuse of antibiotics could develop a strain that becomes a super bug that may eventually be resistant to all known antibiotics," said Mrs. Davis. "Our society is at a point where we demand antibiotics when, in many cases, it is not necessary. We need to get to the point where we recognize when we have to use antibiotics and when we don't have to."

With a collaborative effort among the state, hospitals, private practitioners, and other health care agencies, an effort to educate physicians and patients on how to treat MRSAis paying off, said Dr. Wells.

"The key is doctors have to think about whether antibiotics are needed or if the infection can be removed by other means, such as surgically removing it from the area under sterile equipment," said Dr. Wells. "I think we are on the right path with making the public aware of this potential 'super bug' and preventing it from spreading."

Teaching people to keep up with personal hygiene and continuing to maintain efforts to stop the spread of MRSA and other bacterial strains is the hardest part, said Mrs. Davis.

"As well as continuous education on how to prevent the spread of infectious diseases like MRSA, we also have to keep up with our personal hygiene and follow health care advisement," she said. "It's something we have to live with. It's not going to disappear forever, but there are ways of controlling it and stopping it from spreading."

Cleanse Hands Frequently To Prevent Spread of Staph

Symptoms are skin infections, such as boils or red, swollen, irritated skin lesions. Staph can also cause pneumonia, surgical site infections, and bloodstream or urinary tract infections. Infections are treatable by a doctor.

According to the Centers for Disease Control, the spread of staph bacteria can be prevented by thoroughly and frequently washing hands with soap and water or using an alcohol-based hand sanitizer; keeping cuts and scrapes clean and covered; avoiding contact with other people's wounds or bandages, and avoiding sharing personal items such as towels or razors.

Athletes should wash their hands and consider showering after each practice and game, the Michigan Department of Community Health advises.

Parents should ensure that children do not share equipment or uniforms.

Symptoms that may indicate a staph infection, such as a wound that does not heal properly, should be seen by a physician, the CDC advises.