Prevention and Control of CA-MRSA in Child Care Settings
(Community-Associated Methicillin-Resistant Staphylococcus Aureus)
Please refer to the NYS Department of Health CA-MRSA Fact Sheet for general overview of what MRSA is as well as these guidelines. Cases of CA-MRSA infection in child care settings and schools can cause anxiety for parents and staff. This information is intended to provide guidelines for control and prevention of MRSA infections.
Risk Factor: Young Age - CA-MRSA can be particularly dangerous in children. Often entering the body through a cut or scrape, MRSA can quickly cause a widespread infection. Children may be more susceptible because their immune systems aren’t fully developed or they don’t have antibodies to some common germs.
Prevention: Staph infections start when staph enters the body through a break in the skin. Since MRSA is most frequently transmitted by direct skin-to-skin contact, preventing and controlling the infection in the child care setting is best achieved by practicing good infection control/hygiene policies and procedures in your program.
Hand washing is the most effective method of preventing the spread of MRSA. Providers’ and children’s hands should be washed vigorously with soap and running water (using proper hand washing techniques) at the following times and whenever hands are contaminated with any body waste or secretions,(runny noses, spit, vomit and blood) or are visibly dirty:
Wash Hands Before:
- child care begins and departure from program
- food preparation, handling or serving
- setting the table
Wash Hands Before and After:
- eating meals and snacks
- feeding a child
- giving or applying medication
- wearing gloves for any purpose
Wash Hands After:
- handling pets or other animals
- coming inside from outdoors
- toileting, diapering, assisting with toilet use
- cleaning up
Additional Prevention/Control Measures:
- Wash any cut or break in the skin with soap and water and apply a clean bandage.
- Bandages should remain on cuts until the wound is healed.
- Change bandages whenever they become soiled, dirty or loose.
- Avoid contact with other people’s wounds or bandages. If it is necessary for staff to assist with a child’s bandage, that person should wear gloves, place used bandage in the trash and wash their hands and forearms immediately after removing gloves.
- Avoid sharing personal items such as cloth towels, blankets or clothing.
- Any children or staff with symptoms of MRSA should contact their health care provider immediately.
When to Exclude From Child Care:
Unless directed by a physician, children with MRSA should not be excluded from child care programs. However, if a child or staff member with MRSA has draining wounds or skin sores that cannot be covered, contained or a bandage maintained intact and dry, they should be excluded from the program until skin is intact.
It is not necessary to inform the entire child care community about a single MRSA infection in your program and care should be taken to maintain the child’s privacy rights with this or any health issues.
If an outbreak or an increase in MRSA infections occurs within the child care population, or if transmission is identified in your program, you should contact the Suffolk County Dept. of Health at (631) 853-3055.
Parent/staff notification should be based on consultation with the Suffolk County Dept. of Health.
Cleaning and Sanitizing:
As well as good hand washing practices, proper cleaning and sanitizing of equipment, toys, and objects used or touched by children in the program must be properly cleaned and sanitized. Refer to the New York State Office of Children and Family Services website for these regulations and procedures.
The following procedures should be used for cleaning and sanitizing non-porous hard surfaces such as tables, countertops and diapering surfaces. It is especially important to follow these steps when a surface has been contaminated by blood or bodily fluids.
Spray Bleach Solution # 1 For Food Contact Surfaces:
Wash the surface with soap and water.
Rinse until clear
Spray the surface with a solution of 1/2 teaspoon of bleach to 1 quart of water until it glistens
Let sit for 2 minutes
Wipe with paper towel or let air dry.
Spray Bleach Solution # 2 For diapering surfaces or surfaces that have been contaminated by blood or bodily fluids:
- Put on gloves
- Wash the surface with soap and water
- Rinse in running water until the water runs clear
- Spray the surface with a solution of 1 tablespoon of bleach to 1 quart of water until it glistens
- Let sit for 2 minutes
- Wipe with paper towel or let air dry
- Dispose of contaminated cleaning supplies in a plastic bag and secure
- Remove gloves and dispose of them in a plastic lined receptacle
- Wash hands thoroughly with soap under running water
Soaking Bleach Solution for sanitizing toys that have been mouthed by children:
Wash the toys in warm soapy water, using a scrub brush to clean crevices and hard to reach places.
Rinse in running water until water runs clear.
Place toys in soaking solution of 1 teaspoon of bleach to 1 gallon of water
Soak for 5 minutes
Rinse with cool water
Let toys air-dry
New York State Department of Health
Suffolk County Deptartment of Health
Center for Disease Control
For additional questions regarding MRSA please contact our Health Care Consultants @ 631-462-0303 or
call the Suffolk County Dept. of Health @ 631-853-3055