CCHMC ORSA: GUIDE FOR PARENTS

What is Staph aureus?
Staphylococcus aureus, or "Staph" is a bacteria commonly found on the skin.

What is ORSA or MRSA?
ORSA stands for Oxacillin Resistant Staph aureus. MRSA stands for Methicillin Resistant Staph aureus. ORSA and MRSA are different names for the same bacteria.

Oxacillin and Methicillin are in the penicillin drug family, and some strains of Staph have become resistant to both of these antibiotics as well as other related antibiotics. Other drugs can be used to treat infections caused by this bacteria.

Where are ORSA, MRSA, and Staph found?
Anywhere on your skin and commonly, in your nose and other moist locations.

Who gets ORSA?

Anyone can carry ORSA on their skin (or be "colonized" with it) along with many other bacteria.

What causes an ORSA Infection?
Any break in the skin (whether an insect bite or trauma) can increase the likelihood of an infection by allowing the bacteria to enter. Some people may first notice a bump or a pimple under the skin with redness or pain.

Who is more likely to get ORSA infections?

• People who live with or are in contact with others who have ORSA.
• People with a history of dry skin, eczema, or other skin conditions
• Children with frequent bug bites or scrapes.
• Children in diapers
• People who have been on antibiotics frequently or hospitalized.
• Health care workers.

  Many people who get ORSA infections have none of the above risk factors.

No. However, it is important to tell medical providers if you have a history of ORSA

• So that the best antibiotics for you/your child can be given.
• So appropriate measures can be taken to prevent spread to others.

Does having ORSA mean something is wrong with my child's immune system?
No. ORSA infection can occur in anyone. Being diagnosed with an ORSA infection is not a sign of an immune deficiency. ORSA infections are being seen in many people with no other medical conditions or risks. Your doctor may choose to evaluate your child's immune system, if in addition to this infection, there are other reasons to be concerned.

What can I do to decrease the risk of infection with ORSA?

Keep your skin healthy

• If you/your child has a skin condition (such as eczema), use the creams and moisturizers that your doctor has instructed you to use.
• Avoid bug bites by using insect repellant.
• Avoid sunburn by using sunscreen.

Prevent spread in your family (if one person is infected)

• Encourage showers instead of baths.
• If your child is too young for a shower, have him bathe separately from other family members.
• Periodically clean any bath toys with bleach and water or run them through the dishwasher. Avoid bath toys that can not be thoroughly cleaned such as those with squeakers.
• All members of the household should routinely practice good hand washing with soap and water.
• Use separate towels and washcloths for each person in your family or use paper towels after handwashing.
• Avoid contact with persons who have draining sores. If you help care for someone with sores, wash your hands before and after caring for the skin sores.
• Generally, regular soap is fine for handwashing. Rubbing your hands with soap and water loosens bacteria, while rinsing with running water removes bacteria from your hands. Turning the faucet off with a paper towel keeps you from putting the germs back!

Your doctor may:

• Recommend a special soap (like Hibiclens® or Phisohex®) to be used once a week for 4 or more weeks for bathing. A hypoallergenic moisturizer or Vaseline® may be used on the skin after bathing in order to limit dry skin.
• Prescribe mupirocin cream/ointment (like Bactroban® or Centany®) to apply at the first break in the skin or sight of a pimple to try to prevent more serious infections.
• Recommend that you and your family use a special mupirocin ointment in the nose 2-3 times a day for 5-7 days for all household members to decrease the risk of having ORSA.
• Prescribe an oral antibiotic early in an effort to prevent serious infections.

Websites with additional information

CDC: http://www.cdc.gov/ncidod/hip/Aresist/mrsafaq.htm

Orange County California Health Dept: http://www.ochealthinfo.com/epi/mrsa/