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MRSA

MRSA

Methicillin-resistant Staphylococcus aureus (MRSA) was one of the first organisms which highlighted the dangers of hospital-acquired infections.

Who should be screened for MRSA?
  • all patients awaiting elective admissions (exceptions include day patients having terminations of pregnancy and ophthalmic surgery. Patients admitted to mental health trusts are also excluded)
  • from 2011 all emergency admissions will be screened

How should a patient be screened for MRSA?
  • nasal swab and skin lesions or wounds
  • the swab should be wiped around the inside rim of a patient's nose for 5 seconds
  • the microbiology form must be labelled 'MRSA screen'

Suppression of MRSA from a carrier once identified
  • nose: mupirocin 2% in white soft paraffin, tds for 5 days
  • skin: chlorhexidine gluconate, od for 5 days. Apply all over but particularly to the axilla, groin and perineum

The following antibiotics are commonly used in the treatment of MRSA infections:
  • vancomycin
  • teicoplanin
  • linezolid

Some strains may be sensitive to the antibiotics listed below but they should not generally be used alone because resistance may develop:
  • rifampicin
  • macrolides
  • tetracyclines
  • aminoglycosides
  • clindamycin

Relatively new antibiotics such as linezolid, quinupristin/dalfopristin combinations and tigecycline have activity against MRSA but should be reserved for resistant cases

Interaction of MRSA (green bacteria) with a human white cell. The bacteria shown is strain MRSA252, a leading cause of hospital-associated infections in the United States and United Kingdom. Credit: NIAID
+PassMedicine Notes

Methicillin-resistant Staphylococcus aureus (MRSA) was one of the first organisms which highlighted the dangers of hospital-acquired infections.

Who should be screened for MRSA?
  • all patients awaiting elective admissions (exceptions include day patients having terminations of pregnancy and ophthalmic surgery. Patients admitted to mental health trusts are also excluded)
  • from 2011 all emergency admissions will be screened
How should a patient be screened for MRSA?
  • nasal swab and skin lesions or wounds
  • the swab should be wiped around the inside rim of a patient's nose for 5 seconds
  • the microbiology form must be labelled 'MRSA screen'
Suppression of MRSA from a carrier once identified
  • nose: mupirocin 2% in white soft paraffin, tds for 5 days
  • skin: chlorhexidine gluconate, od for 5 days. Apply all over but particularly to the axilla, groin and perineum
The following antibiotics are commonly used in the treatment of MRSA infections:
  • vancomycin
  • teicoplanin
  • linezolid
Some strains may be sensitive to the antibiotics listed below but they should not generally be used alone because resistance may develop:
  • rifampicin
  • macrolides
  • tetracyclines
  • aminoglycosides
  • clindamycin

Relatively new antibiotics such as linezolid, quinupristin/dalfopristin combinations and tigecycline have activity against MRSA but should be reserved for resistant cases

pdd128.jpg Interaction of MRSA (green bacteria) with a human white cell. The bacteria shown is strain MRSA252, a leading cause of hospital-associated infections in the United States and United Kingdom. Credit: NIAID

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