If you work in healthcare, you already have a good idea of how to prevent staph infection, but is your organization doing enough to minimize the risks?
Thanks to better screening and prevention protocols, Staphylococcus aureus (staph) infection rates were on a steady decline in the US the last 15 years. Between 2005 and 2013, hospital-onset staph infections declined 17 percent per year, according to the Centers for Disease Control and Prevention (CDC). But progress has slowed since then. At the same time, hospital-onset rates have plateaued, staph infections have become more prevalent in communities.
“Despite the progress, staph aureus is still a leading cause of infections in American healthcare facilities, and it’s still fatal, especially as some strains become antibiotic-resistant. More than 119,000 people were diagnosed with a bloodstream staph infection in 2017, and 20,000 people died with it.
Along with current protocols, what more could your organization be doing? Here’s what you need to know about how to prevent staph infection.
What is a Staph Infection?
Staph infection is caused by Staphylococcus aureus (staph), a bacteria found on human skin and in noses. Staph is either methicillin-resistant staph (MRSA) or methicillin-susceptible Staphylococcus aureus (MSSA).
While many people fear MRSA, the scary truth is that any type of staph infection can be deadly if it gets into your bloodstream.
Most staph infections occur on or under the skin, and can result in:
- Boils: red, swollen pockets of pus
- Impetigo: a painful rash with oozy blisters
- Cellulitis: an infection that occurs under the skin and causes redness, swelling, and ulcers
- Staphylococcal scalded skin syndrome: a condition where staph produces toxins that cause fever, a rash, and sometimes blisters
Skin-related staph infections can be painful, but they aren’t usually fatal. However, if the bacteria enters your bloodstream, it can travel to your heart and cause endocarditis — a life-threatening infection of the heart’s inner lining. Staph can also cause deadly infections in other major organs, bones, and joints.
Because staph infections manifest in so many different ways and locations, the signs and symptoms vary dramatically, and so does the treatment. Physicians can often drain the infected area, and in more serious cases, remove part of the affected organ (for instance, a severely damaged heart valve). However, antibiotics are usually necessary to resolve the condition.
Considering some staph infections have become antibiotic-resistant, it’s more important than ever to understand how to prevent staph infection.
What Causes Staph Infections?
Staph is a common bacteria that can be found even in healthy individuals and usually doesn’t cause problems. Roughly one in three people (33 percent) carry staph in their nose, and two out of 100 (2 percent) carry MRSA, according to the CDC. However, most of these people never develop an infection.
Staph can be transmitted from person to person and can live for a long time on inanimate objects, but to cause an infection, it needs a way into the body. Wounds, needles, surgery, and tainted food all provide access.
Certain individuals and communities are at higher risk for developing a staph infection, including those who:
- Live in close quarters, including nursing home residents
- Are hospital inpatients (especially post-surgical patients)
- Have open wounds or eczema
- Have implantable medical devices
- Play contact sports
- Have an underlying health condition that weakens the immune system (e.g., HIV/AIDS, cancer, kidney failure)
- Inject drugs, including illicit drugs and medication such as insulin
The rise in opioid drug use might help to explain the rise in community-acquired staph infections. In 2016, intravenous drug use accounted for 9 percent of staph infections — up from 4 percent in 2011.
5 Tips for How to Prevent Staph Infection in Healthcare
Here are some tips your organization can adopt to stop staph in its tracks:
1. Emphasize the importance of proper handwashing.
Medical staff should already be familiar with proper handwashing protocols, but a friendly reminder never hurts. In fact, many hospitals encourage patients to ask clinicians whether they have washed their hands. Patients have the right to ask, and according to the National Institutes of Health, they should, because proper handwashing is the most important way to prevent staph infection.
Of course, not everyone who works in your healthcare facility is medically trained. Custodians, housekeepers, receptionists, and other supporting staff might need a quick tutorial on proper methods. So do most patients and guests.
Emphasize to patients the importance of handwashing. Encourage them to ask all visitors to wash their hands or to use a medical-grade hand sanitizer.
2. Educate patients about how to prevent staph infection.
Talk to your patients about ways to avoid staph infections. That includes keeping hands clean and wounds covered, and avoiding sharing items that touch blood or skin (e.g., needles, razors, towels, and sheets).
Also educate patients on the warning signs of sepsis — including fever, nausea and vomiting, diarrhea, dehydration, and low blood pressure.
3. Follow current staph infection prevention recommendations.
That includes protocols for preventing device- and procedure-related infections, as well as wound management protocols and proper sterile techniques. Contact precautions can also help to contain the spread of resistant infections.
These tactics alone have not eradicated staph infections in healthcare, but they’ve made a significant difference.
4. Decolonize high-risk patients.
The CDC and other medical guidelines recommend screening and decolonizing high-risk patients during high-risk periods, such as surgery, medical device use, blood transfusions, and stays in the intensive care unit.
Decolonization can be achieved using medical-grade antiseptic wipes on the skin near the surgical site and with nasal decolonization products, such as Nozin® Nasal Sanitizer® antiseptic.
Screening and decolonization could make a big difference in your organization’s staph infection rates. It helped Veterans Affairs (VA) hospitals reduce MRSA by 55 percent and MSSA by 12 percent in 2017.
5. Mine your data to find gaps in your staph prevention efforts.
How much progress do you have left to make, and what will it take to shore up any remaining vulnerabilities? To answer these questions, turn to your own data. As the CDC puts it, “Healthcare facilities can make MRSA and MSSA prevention a priority by assessing the facility’s staph infection data, implementing prevention actions, and evaluating progress.”
Nasal Decolonization: The Missing Link in Your Staph Prevention Protocol?
You can’t fight staph if you don’t know it’s there. Or can you?
Universal screening is an effective way to prevent the spread of staph infection. But it’s not the most cost-effective method, and false negatives are possible. The alternative — universal decolonization — is a faster, less error-prone, and less costly solution.
This could be dangerous with antibiotics or decolonization products that might become staph resistant. But universal decolonization with alcohol-based products, like Nozin Nasal Sanitizer, has been shown to reduce staph infection rates and staph-related costs.
For example, one 311-bed community hospital reduced surgical site staph infections by 50.7 percent over 17 months by instituting universal decolonization. Prior to this two-phase, multi-year clinical trial, the hospital treated all surgical patients with a pre/post-op chlorhexidine gluconate (CHG) bath and pre-op nasal decolonization with povidone-iodine. Patients who tested positive for MRSA were put on contact precautions.
During the clinical trial, the hospital replaced the iodine-based product with an alcohol-based product and discontinued contact precautions for MRSA-positive patients. Not only did the new protocol cut the number of post-surgical staph infections in half, but it also helped the hospital decrease the use of contact precautions by 39 percent and save $223,150 by reducing screening and contact precautions.
This is just one of many studies demonstrating the potential benefits of hospital-wide nasal decolonization. In addition to other infectious disease protocols, universal decolonization is an important component to help prevent staph infection in healthcare settings.
Contact a Nozin Advisor to learn more about nasal decolonization and to request samples.
