Clean equipment as needed with 10% sodium hypochlorite solution or another agent effective against MRSA. Surgical instruments should be disposable or sterilized after each use.
At the patient’s home. Instruct patients to clean wounds wearing fresh disposable gloves each time and to cover wounds with new, dry dressings. Tell families to avoid sharing linens and clothing unless they have been washed in hot soap and water and dried in a heated dryer. MRSA can live for weeks to months on surfaces exposed to infected wounds,10 and these surfaces can be disinfected with a 10% bleach solution.
Sports environments. Athletes with CA-MRSA infections should not compete unless the wound can be completely covered with a dry dressing. Recommend to those in charge of school or commercial facilities that, in cases of confirmed MRSA infection, they routinely clean locker rooms and sports equipment with either a 10% bleach solution or commercial disinfectant. There is no evidence, however, that more widespread or vigorous cleaning—such as dismantling a training room and all its cardio-fitness equipment for disinfecting—prevents the spread of MRSA.
Encourage athletes to wash their hands properly. Communal towels should be washed in hot water (>140°F) with bleach before reuse. Personal equipment should be cleaned per the instructions of the manufacturer. Athletes should use a clean towel to provide a barrier between their skin and the surfaces of weight-room or cardio-fitness equipment. They should also clean equipment before and after use with an appropriate cleanser, such as a disinfectant hand-wipe.
Unproductive efforts you can avoid. Screening household contacts for MRSA is not useful, and attempts to eliminate colonization are generally ineffective. In a large military study, use of intranasal mupirocin failed to decrease nasal carriage of MRSA and the incidence of MRSA infections.11 The MRSA nasal colonization rate was 3.9%; 121 individuals with MRSA colonization needed to be treated with nasal mupirocin to prevent 1 MRSA infection in the total study population.
More complex antibiotic regimens are sometimes used in an attempt to eradicate MRSA carriage, though they also have limited effectiveness and carry the general risks of antibiotic use (gastrointestinal disturbance, allergic reaction, etc). If your office is considering an eradication attempt, consult with an infectious disease clinician first.