Methicillin-resistant Staphylococcus aureus: A review and practice suggestions for manual therapists

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a term used to denote strains of S. aureus that have developed resistance to the drug methicillin and other antibiotics. MRSA has emerged as the most common cause of severe nosocomial infections in many countries and is associated with difficult to treat skin, blood, and respiratory infections in a wide variety of communities. Many manual therapists practice in environments such as military treatment facilities, hospitals, athletic training facilities, and sports injury clinics where MRSA is a common community-acquired infection.

Purpose: To provide a practical overview of MRSA as it applies to the manual therapy professions (e.g., physical and occupational therapy, athletic training, chiropractic, osteopathy, massage).

Methods: PubMed and CINAHL were searched for manuscripts pertinent to hospital and community acquired MRSA. This information was synthesized into a narrative overview for the manual therapy practitioner.

Discussion: This review covers the public health importance of MRSA in the outpatient setting, important clinical features, epidemiology, and preventive measures used to control the spread of this virulent pathogen in manual therapy work environments. Pertinent pharmaceutical management of MRSA and its association with musculoskeletal conditions, such as the association of tendinopathy with the use of fluoroquinolones, are also presented.

Conclusion: MRSA is a health risk to manual therapists, the patients and athletes they contact, and the community. This presentation provides a framework to better understand MRSA and how to control its transmission for manual therapist in their work environments and the community.