Makindo Medical Notes.com

Up to 33% of the general population at any one time are colonised with Staphylococcus aureus (including MRSA) on areas of their body, e.g. nose,skin, axilla, groin.

About

• MRSA is methicillin-resistant Staphylococcus aureus,a potentially dangerous type of staph bacteria
• It is resistant to certain antibiotics and may cause skin and other infections. MRSA is not usually a risk to healthy people.
• Research has shown that healthcare workers, who become colonised, have acquired the bacteria through their work
• The MRSA is usually present for a short time only.

Aetiology

• MRSA will not be susceptible to flucloxacillin and possibly a range of other antibiotics.

Patients at risk

• Patients with an underlying illness.
• Older people – particularly if they have a chronic illness.
• The very ill – patients in intensive care.
• Those with open wounds or who have had major surgery.
• Patients with invasive devices such as urinary catheters.

Clinical

Investigations

Pathology

Suppression Management

• Body and hair treatment: An antibacterial solution for body and hair treatment, e.g. Octenisan, Hibiscrub, or Prontoderm Foam (see Appendix 2), daily for 5 days, following the manufacturer’s instructions. The use of Hibiscrub is not advised, therefore, use Octenisan or Prontoderm Foam, daily for 5 days
• Nasal treatment: Nasal Mupirocin 2% ointment, e.g. Bactroban nasal, three times a day for 5 days. For patients who have a resistance to Mupirocin, Naseptin nasal ointment should be used 4 times a day for 10 days, following the manufacturer’s instructions

Acute Management

• For patients known to be MRSA positive or who have risk factors replace amoxicillin or flucloxacillin with IV Teicoplanin 400mg IV (600mg if patient is >100kg)
• For those who have MRSA sepsis also consider adding IV Vancomycin 1 g BD given over 100 mins, Assumes normal renal function

References