Massage Therapy and Drug Resistant Staph Infections

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Commonly referred to as “staph,” the bacteria Staphylococcus aureus (S.aureus, is found just about everywhere on the human body as well as on dry surfaces, such as doorknobs and countertops). Most of the time the human body’s natural defenses easily fight off any potential infection. Sometimes though, the presence of S. aureus can lead to serious infection that resists treatment.

Bacterial staph infections are nothing new. They have been around since the beginning of time. The use of various natural substances – such as garlic, honey or certain mosses – to fight infection has been around for more than 3,000 years. But, the role bacteria plays in the spreading of infection has really only been understood by the medical profession for less than 300 years.

Whether it is from our own overuse of modern antibiotics, or the routine use of prophylactic antibiotics used in animal feed, many types of bacteria have evolved to become resistant to a large number of commonly prescribed antibiotics used to treat infections.

There are two forms of antibiotic resistant to staph bacteria:

HA-MRSA (Healthcare Associated – Methicillin Resistant Staphylococcus Aureus): HA-MRSA is rarely found outside the hospital setting, is highly resistant to most antibiotics and first appeared in the 1950s.
CA-MRSA (Community Associated – MRSA): It was recently discovered that another strain of MRSA was being found in non-hospital settings, such as nursing homes, prisons and athletic facilities. This form is differentiated by the designation CA-MRSA and is considered to be a highly communicable community-acquired infection that, though serious, more readily responds to treatment than HA-MRSA.

At Risk Populations

Certain populations are more susceptible than others to MRSA related infections, and it would not be unusual to see massage clients from these populations:

Persons with weakened immune systems, such as those with HIV/AIDS, hepatitis and rheumatoid arthritis, as well as cancer patients
Diabetics
Young children
The elderly
Patients and staff staying or working in a healthcare facility for an extended time, such as nursing homes
Persons confined or restricted in confined spaces, such as prisoners
Athletes, particularly those involved in contact sports or weight training

Transmission

MRSA can be transmitted two ways:

through direct infection and
through toxins that the bacteria produce.

Direct infection is responsible for skin infections which may start when the bacteria enters through some sort of break in the skin. This could be a cut, an insect bite or rash. Toxins can be introduced through the ingestion of improperly prepared or stored food, especially diary based sauces, salad dressings and pastries.

The MRSA bacteria can live on inanimate objects for hours, days and even months depending on several factors: including the type of surface, the general environment and the amount of germs present. They can be spread from one person to another through contaminated linens, massage tabletops and other materials found in a massage practice, as well as from personal contact with an infected person.

Avoiding MRSA

Preventing MRSA is much easier than fighting it once an infection occurs. While MRSA is resistant to antibiotics, it is easily removed by using simple cleaning methods. You may also want to follow the basic rules of universal precautions, the same methods we learn in working with clients who may be immunocompromised by HIV/AIDS.

One of the best ways to combat MRSA is by washing your hands with warm soap and water before and after each client as well as after changing massage linens.
Wipe down the massage table before and after each client.
Never use massage linens for more than one client. Remove and wash linens within 24 hours of each use.
If you have a cut on your finger, make sure it is covered when working with a client. Use a finger cot in addition to a bandage to avoid contamination.
Keep your office, treatment room and bathroom facilities clean. Have a cleaning regimen that includes the wiping down of any surfaces that may come in contact with skin, including tabletops, water coolers and sinks.
Any open wound on a client is an area of precaution and should not be worked on directly or in the surrounding area. If working in an adjacent area, make sure the wound is covered and that you do not come into direct contact with it.

What Does MRSA Look Like?

Will you know if a client has CA-MRSA? Just looking at an infected sore will not tell you that the bacteria involved is antibiotic resistant. The only way to determine with accuracy is for the client to be seen by a doctor and have the site analyzed. It is imperative to get to medical facilities quickly as this particular type of infection can spread rapidly and, if left untreated, can cause a great deal of damage.

In the initial stages, an MRSA infection can look like a small pimple or insect bite. Within a short time it may take on the appearance of a larger boil, surrounded by reddened skin and may be accompanied by fever and/or a rash. Left unattended the infection can lead to systemic infection, toxic shock or even necrotizing faciitis. Any open wound that does not heal, appears inflamed and/or develops pus should be looked at by a physician as soon as possible.

To Bleach Or Not to Bleach

According to the Centers for Disease Control (CDC) it is not necessary to use hot water and bleach to kill MRSA on inanimate surfaces. The CDC claims that laundry washed in detergent and the warmest water recommended for that particular fabric is sufficient for removing possible contamination by MRSA. As a general disinfectant the CDC recommends using an EPA-registered product rather than bleach. If that is not available, chlorine bleach, which is a broad-spectrum disinfectant, can be a useful alternative. Do not use bleach full strength. Rather, use a solution equivalent to ¼ cup of bleach to one gallon of water, and never mix it with other cleaning agents.

There are many natural, environmentally friendly products on the market that have been shown to be effective as disinfectants. Vinegar is well known for its cleaning and disinfecting qualities (the smell does dissipate within a short time). There are also many essential oils that have antibacterial properties including tea tree oil and the oils of lemon, pine, chamomile, clove and thyme among others. Make sure you are familiar with the use of essential oils and their properties before creating any cleaning recipes on your own.

Maintaining a clean office in your practice is one of the best ways to assure that both you and your clients are safe from the spreading of germs or bacteria.

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