The control of MRSA

Abstract

The control of methicillin-resistant Staphylococcus aureus (MRSA) has been largely debated and it is still a controversial issue in many hospitals worldwide. In 2008, the European Antimicrobial Resistance Surveillance System (EARSS) reported an increased incidence of MRSA bacteraemia compared to 2007 (4.8 versus 3.5 per 100,000 patient-days), despite a decreasing trend in MRSA proportion across several European countries. Control measures used to reduce the prevalence of hospital-acquired infections due to MRSA include implementation of hand hygiene, active surveillance cultures, screening at hospital admission and discharge, pre-emptive and contact isolation, cohorting, decolonisation, and antibiotic stewardship. Implementation of hand hygiene has been proven as one of the most effective strategy in the control of MRSA, while the role of screening is still controversial. Recent data showed that decolonisation with mupirocin nasal ointment and chlorhexidine soap before surgical procedures reduces the incidence of S. aureus infections, including surgical site infections. Regardless the lack of robust evidence clearly in favour of a specific control measure, at the moment, the best program to control MRSA spreading in hospital and community has to include a multifaceted approach, involving infectious diseases physicians, microbiologists, pharmacists and public health officers.