title: Methicillin-resistant Staphylococcus aureus: an overview for manual therapists().
abstract: OBJECTIVE
  Methicillin-resistant Staphylococcus aureus (MRSA) is associated with difficult-to-treat infections and high levels of morbidity. Manual practitioners work in environments where MRSA is a common acquired infection. The purpose of this review is to provide a practical overview of MRSA as it applies to the manual therapy professions (eg, physical and occupational therapy, athletic training, chiropractic, osteopathy, massage, sports medicine) and to discuss how to identify and prevent MRSA infections in manual therapy work environments.
  
  
  METHODS
  PubMed and CINAHL were searched from the beginning of their respective indexing years through June 2011 using the search terms MRSA, methicillin-resistant Staphylococcus aureus, and Staphylococcus aureus. Texts and authoritative Web sites were also reviewed. Pertinent articles from the authors' libraries were included if they were not already identified in the literature search. Articles were included if they were applicable to ambulatory health care environments in which manual therapists work or if the content of the article related to the clinical management of MRSA.
  
  
  RESULTS
  Following information extraction, 95 citations were included in this review, to include 76 peer-reviewed journal articles, 16 government Web sites, and 3 textbooks. Information was organized into 10 clinically relevant categories for presentation. Information was organized into the following clinically relevant categories: microbiology, development of MRSA, risk factors for infection, clinical presentation, diagnostic tests, screening tests, reporting, treatment, prevention for patients and athletes, and prevention for health care workers.
  
  
  CONCLUSIONS
  Methicillin-resistant S aureus is a health risk in the community and to patients and athletes treated by manual therapists. Manual practitioners can play an essential role in recognizing MRSA infections and helping to control its transmission in the health care environment and the community. Essential methods for protecting patients and health care workers include being aware of presenting signs, patient education, and using appropriate hand and clinic hygiene.
authors.affiliation: Chiropractor, Chiropractic Division, Department of Physical and Occupational Therapy, Naval Medical Center, San Diego, CA.
authors.forename: Bart N
authors.initials: BN
authors.lastname: Green
authors.forename: Claire D
authors.initials: CD
authors.lastname: Johnson
authors.forename: Jonathon Todd
authors.initials: JT
authors.lastname: Egan
authors.forename: Michael
authors.initials: M
authors.lastname: Rosenthal
authors.forename: Erin A
authors.initials: EA
authors.lastname: Griffith
authors.forename: Marion Willard
authors.initials: MW
authors.lastname: Evans