MRSA protection measures as care staff

Question

Hello,
I work at a care home and have also contact to MRSA infected patients. The hygienic standards for dealing with MRSA are admittedly respected by me, however in spite of this I like to do the best I can, in order to avoid a transmission to me and in the end to my child suffering from CF.
Now my thoughts:
Does it make sense, if I clean myself after work (I work only 5-6 days a month) e.g. with Prontoderm® foam, instead of normal shampoo? Do you know anything else in order to decrease the risk of a colonization? I would simply like to do everything that is possible, at the same time I do not want to drive myself crasy, as I depend on the work and love to be a nurse.
Many thanks,
Best regards,

Answer

Dear questioner,
the question, if certain occupational groups, that are working in the health care system and have probably here a (more frequent) contact to carriers of MRSA, pose an increased risk of susceptible members of the household with a risk factor for a colonization with MRSA (e.g. also CF), is asked frequently and is totally understandable.
The common opinion is that this is not the case if the work is done in accordance with the regulations and with the pertaining hygiene standards, as the measures to prevent a spreading of infectious germs, that have to be followed when dealing with every patient (basis hygiene), are also applicable to prevent a transmission of MRSA. When special hygiene standards are taken into account when dealing with a known/possible carrier of MRSA, the transmission to the staff and a further transmission to the family of the staff is regarded as very unlikely. In case of a transmission to contact persons one would expect primarily an inconsequent performance of those hygienic measures during the "all day work" as the most possible reason.
The other way round, no measure gives absolute security concerning an MRSA transmission. Furthermore, MRSA is not transmitted exclusively in the health care system as e.g. also contact to animals (dog, cat) can play a role. Additionally, common recommendations for infection prevention of MRSA are orientated towards the known circumstances (the transmission happens generally via the hands; a typical reservoir is the nasal vestibule) and towards the practicability.
Body washes are sensible in order to decontaminate a known MRSA carrier state. The colonization of the skin and mucosa of MRSA exposed people (e.g. health care staff) can occur partly only temporarily (in so far there are no underlying skin diseases like eczema, atopic eczema). If body washes reduce hereby the risk of a colonization with MRSA is not known. A justifiable recommendation can not be drawn about this. If possible with an acceptable effort, nothing speaks against (according to my opinion) a "body shower after done work" as an individual measure. The usage of a special MRSA-deconatmination solution would I regard as exaggerated. A possible effect does not depend on the frequency of the working days, as the statistical risk to have acquired MRSA is distributed equally in principle.
The much more important measures are however undisputedly the consequent hygienic disinfection of the hands, the final hand disinfection at the end of the working day, the focused usage of a mouth-nose- face mask (e.g. when doing the beds of MRSA carriers) and the hygienic impeccable usage of the working clothes however also of pens and cell phose (link to a German website with information about this).
Best regards,
Michael Hogardt

30.06.2014