Terminology

Terms below were taken from Association for Professionals in Infection Control Guidelines for the control of MRSA unless otherwised indicated. Terms indicating a link, lead to additional sources of information specific to that term.

• BACTERIOPHAGE see Phage below.

• BODY SUBSTANCE INSOLATION (BSI) A system of barrier techniques and practices used by health care workers to prevent contact with all moist, wet body substances, non-intact skin and mucous membranes. This is practiced for all patients at all times. One category of isolation, Respiratory Precautions, is also utilized as indicated.

• CARRIER A person who is colonized with methicillin-resistant Staphylococcus aureus (MRSA). The organism may be present in the nares (nose), sputum, urine, an open wound, in the stool or on the skin without clinical manifestations of disease. A carrier may transmit the organism to another person through direct contact, usually by contact with hands.

• COHORT A group of MRSA positive patients (infected or colonized) who are physically separated, but grouped together and cared for by staff who do not care for MRSA negative patients.

• COLONIZATION Presence of MRSA on tissue without the presence of symptoms of clinical manifestations of illness or infection. A carrier is colonized with MRSA.

• DECOLONIZATION Elimination of MRSA carrier state through use of infection control measures and/or antibiotics. This decreases the risk of transmission to high-risk individuals (immunocompromised or otherwise highly susceptible persons) or to others in an outbreak situation.

• DISINFECTION The destruction of organisms on inaminate surfaces using chemicals or physical (heat) agents Source http://www.cinetwork.com/otero/mrsa.html

• ENDEMIC The usual rate or prevalence of persons infected and/or colonized with MRSA in a facility. Endemic rate in each facility will be unique.

• EPIDEMIC The common definition of an MRSA epidemic is: 1) several (e.g. three or more nosocomially-acquired) cases which are epidemiologically associated by person, time, or place, or 2) a substantial increase in number of cases in a facility endemic for MRSA. Each facility must decide the criterion to define an outbreak.

• EPIDEMIOLOGY The study of the relationships between various factors that determine the frequency and distribution of diseases in humans and other populations Source http://www.cinetwork.com/otero/mrsa.html

• ERADICATION Elimination of infections and/or colonization of MRSA in a facility through implementation of infection control and hygiene measures and/or antibiotics.

• INFECTION Invasion and multiplication of MRSA in tissue with the manifestation of clinical symptoms of infections such as increased white blood cell counts, fever, lesions, furuncles, drainage from a break in skin continuity and erythema. Infection does warrant treatment.

• INVASIVE DISEASE Clinical manifestation of symptoms caused by MRSA such as furuncles, cellulitis, pneumonia, carbuncles, septicemia, osteomyelitis or vascular line infection.

• IN VIVO Within the living body.

• IN VITRO Observable in a test tube, in an artificial environment.

• MDRO multi-drug resistant organisms

• MODE OF TRANSMISSION The method by which MRSA is spread into the environment and to other persons. MRSA is transmitted primarily by direct person-to-person contract (i.e. from the hands of one individual to a susceptible individual). It is not thought that bed linens or environmental surfaces play a significant role in MRSA transmission. However, proper techniques for cleaning of linens and disinfection of environmental surfaces are appropriate to reduce the bacterial load.

• MORPHOLOGY The science that is concerned with the configuration or arrangement of organisms Source http://www.cinetwork.com/otero/mrsa.html

• MRSA The term used for bacteria of the Staphylococcus aureus group (S. aureus) that are resistant to the usual antibiotics used in the treatment of infections with such organisms. Traditionally MRSA stood for methicillin resistance but the term increasingly refers to a multi-drug resistant group. Such bacteria often have resistance to many antibiotics traditionally used against S.aureus. A gram-positive bacteria that grow in clusters like grapes; growth of MRSA is not inhibited by methicillin or oxacillin and many other antibiotics. Antibiotic therapy of choice for infection caused by MRSA in vancomycin, given intravenously. Oral vancomycin is not effective against MRSA.
  Other like terms or similar strains would be ORSA (oxacillin resistant) or VRSA (vancomycin resistant).
  Source DermNet New Zealand.

• NON-ACUTE CARE Includes home health care, hospice, extended care, respite, rehabilitation, nursing facility, residential care, long-term care, geriatric care, adult day care, etc.

• ORSA Oxacillin Resistant Staphylococcus Aureus. This is the same thing as MRSA (Methicillin Resistant Staph.Aureus). The lab test for antimicrobial efficacy in the past used Methicillin, now uses Oxacillin. Why is Oxacillin tested instead of Methicillin? Oxacillin is more resistant to degradation in storage and is more likely to detect most heteroresistant strains. In addition, Methicillin is no longer commercially available in the United States. Antimicrobials like Oxacillin and Nafcillin now are used for treatment of S. aureus infections.

• OSTEOMYLITIS The infection that causes osteomyelitis often is in another part of the body and spreads to the bone via the blood. Affected bone may have been predisposed to infection because of recent trauma. In children, the long bones are usually affected. In adults, the vertebrae and the pelvis are most commonly affected. Bone infection can be caused by bacteria or by fungus. When the bone is infected, pus is produced within the bone, which may result in an abscess. The abscess then deprives the bone of its blood supply. more on Osteomylitis

• OUTBREAK The common definition of an MRSA epidemic is: 1) several (e.g. three or more nosocomially-acquired) cases which are epidemiologically associated by person, time, or place, or 2) a substantial increase in number of cases in a facility endemic for MRSA. Each facility much decide the criterion to define an outbreak.

• PHAGE (or bacteriophage) a virus that infects bacteria and sometimes destroys them by lysis, or dissolution of the cell.

• PFGE Pulsed-Field Gel Electrophoresis

• SCALDED SKIN SYNDROME Most commonly in children and neonates. Starts abruptly with a sunburn-like rash around the mouth, rapidly turning bright red spreading in 2-3 days andpeeling within 5 days. Source http://www.cinetwork.com/otero/mrsa.html

• STAPHYLOCOCCUS AUREUS (S. aureus) Prounounced "staff" A gram-positive bacterial which grows in colonies that look like grapes; most S. aureus are sensitive to methicillin, cephalosporins, nafcillin and oxacillin.

• STYE A stye is a sore and red lump near the edge of an eyelid. It is caused by an infection at the base of an eyelash (in the follicle). Staphylococcal bacteria are the usual culprits. These bacteria normally live harmlessly on the skin, but they can cause infection if the skin is damaged. Touching mucus from the nose and then rubbing the eye is one way of moving staphylococcal bacteria to the eyelid.

• SURVEILLANCE Monitoring of patient data to determine incidence and prevalence of infections and distribution in a facility.

• SUSCEPTIBILITY TESTING A laboratory test to determine if an organism can be effectively treated with a particular antibiotic.

• TOXIC SHOCK SYNDROME A severe illness characterized by a sudden onset of high fever, profuse watery diarrhea, myalgia, followed by hypotension and, in severe cases shock. Typically occurring in young woman ages 15 - 25 using tampons. Starts abruptly during menses. Source http://www.cinetwork.com/otero/mrsa.html

• TOXINS Poisonous substances produced by some organisms to enhance their ability to cause diseaseSource http://www.cinetwork.com/otero/mrsa.html

• UNIVERSAL PRECAUTIONS A system of barrier techniques and practices used by health care workers for contact with body fluids and blood. Universal precautions is used when providing care for all patients to prevent the transmission of bloodborne pathogens.

• VECTOR A carrier, for example an animal or arthropod, which transfers an infective agent from one host to another.

• VISA What is the difference between vancomycin-susceptible S. aureus, VISA and VRSA? Most isolates of S. aureus are susceptible to vancomycin. The concentration of vancomycin required to inhibit these strains (called the minimum inhibitory concentration or MIC) is typically between 0.5 and 2 micrograms/ml. In contrast, S. aureus isolates for which vancomycin MICs are 8-16 micrograms/ml are classified as vancomycin-intermediate, and isolates for which vancomycin MICs are >32 micrograms/ml are classified as vancomycin-resistant. The definitions for classifying isolates of S. aureus are based on the laboratory breakpoints published by NCCLS.

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  ©Helen Gilson 2003-2007
  Disclaimer ~ Caveat -- I am not a nurse or doctor. Please see your physician if you think you may have any illness or infection. Do not use any information on these personal pages as a diagnostic tool or attempt to prescribe medication or treatment. No clinical decisions should be made solely on the information contained here. I try to provide quality information, but I make no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained in or linked to this web site and its associated sites.