Today's Veterinary Practice

MAY-JUN 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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78 MANAGEMENT STRATEGIES Similarly, veterinary personnel have a higher risk of MRSA colonization than the general population. 1,7 Current studies have shown a prevalence ranging from 4-18% in veterinary personnel compared to 1-3% in the general population, 1 underscoring the importance of good hand hygiene and appropriate use of gloves in the veterinary setting. Q AND A: A member of a client's household has been diagnosed with a MRSA infection. Are the household pets at risk? ■ Yes, the pets are at risk for colonization with MRSA, but the risk is very low. The risk of infection in pets is even lower. ■ It is recommended to limit the infected person's contact with household pets until the person is cleared of the infection. This includes no kissing, no close cuddling, no co-sleeping, and not allowing pets to lick skin or wounds. ■ Encourage your clients to follow their human home health-care instructions carefully to minimize transmission of MRSA to other family members and pets. ■ Handwashing frequency and duration for the infected person and family members providing care should be increased, and especially performed before and after contact with the pets. ■ Increase routine cleaning of clothing, the environment (paying close attention to hand contact areas), and human and pet bedding during treatment. Should I test the pets if a human household member is infected with MRSA? ■ No, in the case of a human MRSA infection, the household pets do not need to be tested. If a test were positive, it would likely reflect transient colonization of the pet and no treatment would be needed. 1,2,9 If a single test were negative, it would not rule out colonization. A pet owner who is a health care provider is colonized with MRSA. Previous decolonization attempts have failed. Should we consider the household pets as a possible source? ■ Yes, this an appropriate situation in which to consider testing the pets. The goal in these situations is to prevent on-going MRSA transmission between humans and between human and animal household members so that colonization can be eradicated in the health care provider. Veterinarians and health care providers should coordinate concurrent testing of all human and animal household members. Two negative cultures (performed a minimum of 7 days apart) are needed to call an animal negative. (Please see screening recommendations below.) If animals test positive, they should be isolated or temporarily removed from the home for 3-4 weeks to eliminate ongoing exchange. Positive animals do not need to be treated for MRSA, as colonization is transient and will likely resolve within approximately 3 weeks.2 Temporary caretakers should wash their hands before and after contact with the pet and avoid kissing and cuddling; however, the risk of infection is low. An animal patient had MRSA cultured from a surgical wound or deep skin infection. What precautions should the owners take? ■ Limit contact with the pet while the pet is being treated. This means no kissing, no close cuddling, no co-sleeping, and not allowing pets to lick human skin or wounds. ■ Increase frequency of handwashing in the house, including before and after contact with the pet, their bedding, and any item with which the pet has contact. ■ People with skin wounds, infections, recent surgery, or who are immunocompromised should not care for the pet during this time. ■ Wash hands and wear gloves for wound care and dispose of used bandage material immediately. Change gloves before handling clean bandage material. Thoroughly wash hands after removing gloves. ■ Increase routine cleaning of the environment, paying close attention to hand contact areas, such as door knobs and light switches. Hand contact areas and pet water/food bowls should be cleaned at least once a day. Pet bedding should be laundered daily. ■ Keep pets isolated to an easily cleaned area of the house. Keep pets off beds and pillows used by people and away from carpeted and upholstered surfaces.

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