MRSA and Staph in Child Care Settings

What do staph or MRSA infections look like?

Mild skin infections may look like a pimple or boil and can be red, swollen, painful, or have pus or other drainage. More serious infections may cause pneumonia, bloodstream infections, or surgical wound infections.

How does staph spread?

• Direct skin-to-skin contact
• Contact with contaminated items or surfaces

Staph bacteria can live in the nose or on the skin without causing problems. Infection can occur when bacteria enter through breaks in the skin.

Prevention basics

Practical advice for parents

• Clean wounds and cover them with a clean, dry bandage. Wounds that do not heal properly need medical attention. Laboratory testing ordered by a healthcare provider is needed to determine whether an infection is caused by MRSA.
• Teach children to wash their hands regularly (for example, before eating and after toileting). For hygiene resources, visit: Healthy habits: coughing and sneezing .
• Use antibiotics properly: take all doses as prescribed, even if symptoms improve, unless your provider says to stop. Do not share prescriptions.
• Children in sports should wash hands after each practice/game and shower as soon as possible. Do not share equipment, uniforms, towels, or other personal items. Wash uniforms and towels with detergent after each use and dry in a hot dryer.
• Tell your childcare provider when your child has an infection.

Program responsibilities

• Ensure the program’s policies and procedures are followed consistently.
• Encourage handwashing upon entry, before eating, and after toileting.
• Child day care centers and group day care homes should consult with the program’s health consultant.
• Observe children for open wounds. If wounds are draining or contain pus, exclude the child until evaluated by a healthcare provider and the wound is addressed appropriately.
• When wound care is necessary, wear gloves. If a dressing is no longer intact and needs replacing, secure the soiled dressing and keep it out of reach of children.
• Refer parents to a licensed healthcare provider. Skin infections may need incision/drainage and/or antibiotics based on laboratory testing.

Control of spread in child care settings

• Children or staff who are colonized or infected with MRSA do not need to be routinely excluded from the classroom.
• Keep open wounds covered with a clean, dry dressing taped on all four sides. Bandages should be changed at home.
• Diapers are not bandages because they do not stay dry and must be changed often.
• Exclusion should be reserved for those with wound drainage that cannot remain covered and contained with a clean, dry dressing taped on all four sides.
• If MRSA occurs within the program, consult with the program’s health consultant or the local health department to determine whether some or all parents and staff should be notified.
• Children with weakened immune systems may be at higher risk for severe illness if infected. They should follow the same prevention measures as others.
• Wear gloves if you expect contact with non-intact skin or mucous membranes. Wash hands immediately after removing gloves.
• Use good personal hygiene and handwashing with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.
• Clean potentially contaminated surfaces (e.g., changing tables, high chairs, play tables, doorknobs) with an EPA-registered disinfectant labeled effective against MRSA and follow the manufacturer’s directions (including contact time). Household bleach may also be used per appropriate guidance and label directions; prepare fresh solutions daily.
• Clean and disinfect cots regularly (at least daily) and use pillow protectors.
• If linens and clothing are washed onsite: wash with detergent and dry in a hot dryer.
• Clean and sanitize mouth toys between children.

More information

If you have additional questions about MRSA, contact your health consultant, your local health department, or the Epidemiology and Emerging Infections Program (860-509-7994).

This fact sheet is for informational purposes only. It should not be used for self-diagnosis or as a substitute for consultation with a health care provider. If you think that you might have this infection, or have questions about the disease described above, consult your health care provider.

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