If you think you have an infected wound, see a medical care provider. MRSA can be diagnosed only through a lab test. 

MRSA infections can be treated; treatment depends on the site and severity of the infection. Not all infections require oral antibiotics. However, if antibiotics are prescribed, take them exactly as instructed. If the infection has not improved within a few days after seeing a health care provider, contact your provider again.

Yes. A Staph or MRSA skin infection may come back after it is cured. To prevent this from happening, follow your health care provider's directions while you have the infection, and practice the hygiene steps described below.

Practice good hygiene:

• Keep your hands clean by washing them thoroughly with soap and water or using an alcohol-based hand sanitizer.
• Keep cuts and scrapes clean and covered with a bandage until healed.
• Avoid contact with other people's wounds or bandages.
• Avoid sharing personal items such as towels or razors.
• Teach children to wash their hands regularly, especially before eating and after using the bathroom.
• Be sure your family members use antibiotics properly. Take all that are prescribed, even if the symptoms stop before the prescription is used up. Do not share prescriptions.
• Children who participate in sports should wash their hands after each practice and game. They should not share equipment, uniforms, towels, or other personal items such as razors. Always wash uniforms and towels with hot water and detergent after each use.

MRSA is transmitted most frequently by direct skin-to-skin contact. You can protect yourself from infections by practicing good hygiene. Keep your hands clean by washing with soap and water or using an alcohol-based hand rub, and shower after working out. Cover scrapes or cuts with a clean, dry bandage. Avoid sharing personal items such as towels or razors. Use a barrier such as clothing or a towel between your skin and shared equipment. Wipe equipment surfaces before and after use.

You can keep from spreading Staph or MRSA skin infections to others by following these steps:

• Cover your wound. Keep wounds that are draining fluid or pus covered with clean, dry bandages. Drainage from infected wounds may contain Staph and MRSA. Follow your health care provider's instructions on proper wound care. Discard bandages or tape with the regular trash.
• Clean your hands frequently. You and your family members should wash your hands frequently with soap and warm water or use an alcohol-based hand sanitizer, especially after changing the bandage or touching the infected wound. The same goes for anyone else in close contact.
• Do not share personal items. Avoid sharing personal items such as towels, washcloths, razors, clothing, or uniforms that may have been exposed to the infected wound or bandage. Wash sheets, towels, and clothes with hot water and laundry detergent. Dry clothes in a hot dryer, rather than air-drying, to help kill bacteria.
• Talk to your doctor. Tell health care providers who treat you that you have or had a Staph or MRSA skin infection.

See below for advice for coaches and teachers. The Massachusetts Department of Health and the Tacoma-Pierce County Department of Health in the State of Washington have developed excellent MRSA materials aimed at schools. Below, you will find links to their websites and to other resources that may be useful.

Athletic Facilities

If my child uses athletic facilities (such as the weight room) or is involved in athletics, what additional measures can be taken to prevent and control MRSA infections within the athletic setting?

Athletes, athletic personnel, and parents can help prevent and control MRSA infections within athletic settings by following these simple health and hygiene practices:

• Wash hands frequently with soap and water, especially after using any sports facilities.
• Avoid sharing personal items such as towels, washcloths, razors, clothing, or uniforms. These and similar items may have had contact with an infected individual or potentially infectious material.
• Athletes involved in close-contact sports should receive a total body check by the appropriate athletic personnel before any game, match or tournament.
• Individuals with an infection involving drainage who are involved in close-contact sports should be excluded from participation in sporting events and practices until no drainage is present and the infected site can be adequately covered with a bandage and clothing.
• Athletes and other students should report any suspicious skin sore or boil to their health care provider, trainer or school nurse immediately. All draining wounds must be covered with clean, dry bandages during practices and games. If the draining cannot be contained, the player should be excused from activities.
• In sports involving close personal contact such as wrestling and football, players should shower with soap immediately after each practice, game, or match.
• Any cut or break in the skin should be washed with soap and water. Cuts and breaks in the skin should be covered with a new clean, dry dressing each day. Dressings should be changed before and after participation in close contact sports, and after using any sports facilities.
• Coaches and players should not allow sharing of any equipment, uniforms, or towels. Equipment and uniforms should be assigned to one individual for the whole season. After each use, uniforms and towels should be washed with detergent in hot water and dried thoroughly.
• Non-washable gear such as pads or head protectors should be wiped down with alcohol after each use.
• Athletic equipment such as weight benches, wrestling or gymnastics mats, or other equipment that might have skin contact should be disinfected regularly after each practice and in between uses. Wipe with an antibacterial solution (for example, Hibiclens) or an EPA-registered cleaner or bleach solution (1 part bleach to 9 parts water). Clean both sides of mats before rolling them up for storage.
• Students should tell their health care provider or school nurse and the appropriate athletic personnel if they have a drug-resistant Staph skin infection or have a history of Staph infections.

Remember: Routine cleaning is all that is recommended. Because the bacteria live on the skin, they may be reintroduced into any environment at any time. Therefore, hand washing and wound care remain the best means of preventing Staph infections. 

Teachers

What can teachers do to prevent the spread of MRSA in the classroom?

• Teachers can observe children for open wounds. If any wounds are draining or contain pus, teachers should refer the child to the school nurse.
• Teachers should encourage children to wash their hands often, especially before eating and after going to the bathroom.

Consider taking the following steps:

• Confirm the diagnosis. This may require contacting the doctor and family of the student to get accurate medical information to the school.
• Follow routine infection control precautions. Use the following infection control precautions with a student who has a MRSA infection:
  • Wear gloves when handling the student or touching blood, sweat, or other bodily fluids, or any items contaminated with these fluids. Gloves should be used before touching mucous membranes and non-intact skin. Gloves should be removed after use and hand washing performed before touching non-contaminated items and environmental surfaces and before tending to another student.
  • Linens (from cots, etc.) that may contain blood or other bodily fluids should be handled in a manner to prevent skin, mucous membrane and clothing exposure.
• Follow routine procedures for cleaning the environment. In general, use routine procedures with a freshly prepared solution of commercially available cleaner such as detergent, disinfectant-detergent or chemical germicide.

Children are excluded from school and childcare based on the SC School and Childcare Exclusion Rules.

• Draining Lesions: Exclude children with draining lesions that cannot be covered with a dressing, or draining lesions that are covered with a dressing but drainage saturates the dressing until drainage stops and the child has received at least 48 hours of effective antimicrobial treatment.
• Non-Draining Lesions: Children who do not have draining lesions, who have antibiotics prescribed, may return to school after they have received at least 48 hours of effective antimicrobial treatment and lesions are showing signs of healing (decreasing in size). Children who do not have draining lesions, who do not have antibiotics prescribed, may return to school once lesions are showing signs of healing (decreasing in size).
• Sports: Children with lesions on uncovered skin, or with lesions that are draining or oozing, even if covered, may not participate in close-contact sports or other athletic activities.
• Contact Precautions: Contact precautions, including appropriate disposal of possibly infectious materials, must be used if/when dressings are changed in the school or childcare setting.
• Outbreaks: DPH may change these recommendations in the event of outbreaks or clusters of illness.

Typically, it is not necessary to inform the entire school community about an MRSA infection. When MRSA occurs within the school population, the school nurse and school or district medical consultant should determine, based on their medical judgment, whether some or all parents and staff should be notified. You may contact your local public health department for guidance on responding to MRSA cases and clusters.

Students with weakened immune systems may be at risk for more severe illness if they are infected with MRSA. These students should follow the same prevention measures as all others to prevent Staph infections, including practicing good hygiene, covering wounds, cuts and abrasions with clean dry bandages, avoiding sharing personal items such as towels and razors, and contacting their doctor if they think they have an infection.