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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79 MAY/JUNE 2018 ● TVPJOURNAL.COM CLINICAL INSIGHTS ■ Pet owners who are also health care providers or veterinary personnel should take extra care at work to perform good hand hygiene and use gloves appropriately. ■ Continue all precautions until the patient's infection has healed, antibiotics have been discontinued and the patient has had two consecutive negative cultures (see screening recommendations below). ■ If family members are immunocompromised, or at higher risk (eg, HIV/AIDS, cancer or transplant patients), consider temporary removal of the pet from the home until cleared of the infection. Note that if a pet's infection is caused by MRSP, implementing these recommendations with special attention to the pet areas will help prevent colonization of other household pets, which could become prolonged carriers. 10 An animal patient had MRSA cultured from a surgical wound or deep skin infection. What precautions should my veterinary staff take? ■ Bring patients directly into an exam room when presenting for an appointment and do not allow them to mingle with other clients and their animals. ■ House hospitalized animals with known MRSA infections in an isolation suite or away from other patients with their own dedicated equipment and materials. ■ All staff should wear gloves and gowns when handling and caring for the patient until the animal is cleared of MRSA infection. ■ When performing bandage changes, keep the dirty bandage materials separate from the clean bandage materials. Gloves should be changed in between handling the dirty and clean materials. To prevent cross-contamination, any equipment or unused bandage materials should be discarded or sterilized prior to next use. (Do not return unused or partial rolls of bandage materials to the drawer or cabinet without first autoclaving.) ■ Clean and disinfect (according to disinfectant manufacturer's instructions) the table, floor and other hand contact areas (door knobs, cabinet handles, faucet handles) in the area where any procedures are performed and/or where the patient was housed during their visit. ■ Hands should be thoroughly washed when interaction with the patient is complete. ■ Staff with skin wounds or who are immunocompromised should not clean patient's wounds. ■ All precautions (gowns, gloves, prevention of co- mingling, and isolation in hospital) should be taken until the patient's infection has healed, antibiotics have been discontinued and the patient has had two negative consecutive cultures (see screening recommendations below). ■ These infection control recommendations should be followed for patients with MRSP infections as well. How do I screen a patient for MRSA if needed? ■ Use sterile cotton swabs to sample at least two areas on each patient. The pharynx, perineum and corner of the mouth are the most sensitive sites, 11,12 but others have sampled just the nares and perineum. ■ Swabs can be pooled and submitted as one sample. ■ Order a culture and sensitivity and let the laboratory know that you are specifically screening for MRSA. ■ Repeat, if applicable, a minimum of 7 days later. REDUCE TRANSMISSION A person with a MRSA infection should limit contact with their pets until the infection has cleared. This means avoiding kissing, close cuddling, co-sleeping, and allowing pets to lick skin or wounds. Studios

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