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2007 MRSA Policy
|MRSA Patient Information Leaflet (75 kB)|
|Health Protection Agency Staphylococcus aureus Information|
|Department of Health Simple Guide to MRSA|
Page updated 21 January 2009
Use diligent hand hygiene (See Section on Hand Hygiene) to prevent the spread of MRSA
Screen for MRSA before major surgery and on admission to the ICU
Use Staphylococcal Decontamination Protocol for staff and patients without wounds
Apply Staphylococcal Decontamination Protocol for 3-5 days pre-operatively
Isolate patients with infected wounds and respiratory tract colonisation
Staphylococcus aureus colonises the nose, and sometimes the axillae, hair, throat and perineum. Commonly it causes wound infection, superficial or deep, sometimes with blood stream spread (bacteraemia). Occasionally patients may die from overwhelming sepsis due to Staphylococcus aureus. The most likely mode of spread is by indirect contact via a staff member acting as a transient carrier of Staphylococcus aureus on the hands, transferring the organism from one patient to another. Many more patients and staff are colonised with Staphylococcus aureus than have overt infections. Hand carriage is temporary. Staff transmit the organism to susceptible patients without being aware that they are carriers. Therefore, meticulous hand hygiene before patient contact is essential to prevent transmission.
Hospital-acquired infection leads to a prolonged stay in hospital. In addition, Staphylococcus aureus strains which are resistant to methicillin (MRSA) are difficult to treat. If resistant to methicillin, these strains are also resistant to flucloxacillin and all ß-lactam antibiotics. Usually they are also resistant to other valuable antibiotics. Furthermore, some epidemic strains of MRSA appear to spread more easily from patient to patient than other strains. As time passes, it is expected that more and more people in the community will be colonised with MRSA than with methicillin sensitive staphylococci.
A patient with MRSA will be identified in the laboratory because a specimen (often a wound swab) has been sent from the ward. The ward and medical staff will be notified of the results by the Infection Control Team.
Each member of the Health Care Team is responsible for protecting patients from infection by:
Coia JE, Duckworth GJ, Edwards DI et al; Joint Working Party of the British Society of Antimicrobial Chemotherapy; Hospital Infection Society; Infection Control Nurses Association. Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect. 2006 May;63 Suppl 1:S1-44. Epub 2006 Apr 3. Review. Erratum in: J Hosp Infect. 2006 Sep;64(1):97-8.
British Society for Antimicrobial Chemotherapy, The Hospital Infection Society and the Infection Control Nurses Association. Revised Guidelines for the control of methicillin resistant Stapyhylococcus aureus infection in hospitals. J Hosp Infect 1998; 39 :253-290.
Fraise AP, Mitchell K, O'Brien SJ, Oldfield K, Wise R. Methicillin-resistant Staphylococcus aureus (MRSA) in nursing homes in a major UK city: an anonymised point prevalence survey . Epidemiol Infect 1997: 118(1) :1-5.
Speller DCE, Johnson AP, James D, Marples RR, Charlett A, George RC. Resistance to methicillin and other antibiotics in isolates of Staphylococcus aureus from blood and cerebrospinal fluid, England and Wales . Lancet 1997; 350 :323-5
Lynch W, Davey PG, Malek M, Byrne DJ, Napier A. Cost effectiveness analysis of the use of chlorhexidine detergent in preoperative whole-body disinfection in wound infection prophylaxis. J Hosp Infect 1992; 21 :179-191
Hershow RC, Khayr WF, Smith NL. A comparison of clinical virulence of nosocomially acquired methicillin-resistant and methicillin-sensitive Staphylococcus aureus infections in a university hospital. Infect Control Hosp Epidemiol 1992;13:587-93