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Diseases & Topics

Community-Associated MRSA

Managing CA-MRSA in Incarcerated Populations

N.C. Public Health Recommendations

Community-associated MRSA outbreaks, including skin and soft tissue infections as well as invasive infections, have been reported among persons incarcerated in prisons and jails. Some estimates of MRSA colonization in prisons are as high as 80-90%. Crowding and sharing of contaminated personal items may contribute to MRSA spread among incarcerated persons.

Responsibilities for Medical Care and Public Health Management

  • For persons incarcerated in county jails, medical care responsibilities reside with the county sheriff. Jail health plans must be reviewed and approved by Local Health Department Directors.
  • For persons incarcerated in state institutions, wardens have responsibility for medical care.
  • State public health staff may collaborate as needed in outbreaks involving state or county institutions. Correctional health care staff are key partners in MRSA prevention and control. Efforts and education should involve detention staff as well—they will likely have concerns about their own risks as well as roles in MRSA prevention and control among incarcerated persons.

Prevention and Control Measures

Prevention and control measures for MRSA in correctional settings include:

  • Skin infection screening and monitoring (e.g., maintaining a log of skin infections and visual skin screening on intake).
  • Culturing suspect lesions and providing targeted antimicrobial therapy.
  • Efforts to improve inmate hygiene (e.g., education about appropriate hand and body hygiene, appropriate laundering techniques, measures to limit use of shared items, and greater availability of soap).
  • Improved access to wound care and trained health-care staff.

Information for Visitors

The risk of transmission to visitors who have casual contact with inmates is low provided that inmates with draining lesions keep the lesions completely and adequately covered and that the visitors do not share personal items such as towels or toiletries that may have been soiled with drainage from an infected wound. Shared contact with non-personal items such as pens, paper, or books does not pose a risk of infection. Hand hygiene is the single most important factor in preventing the spread of MRSA. Visitors in direct contact with inmates who have confirmed or suspected MRSA infections should perform appropriate hand hygiene (wash with soap and water or use alcohol-based hand sanitizer) after contact.

For Additional Information