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Methicillin-resistant Staphylococcus aureus: implications for the 1990s and effective control measures
R P Wenzel1, M D Nettleman, R N Jones
1Department of Internal Medicine, University of Iowa College of Medicine, Iowa City 52242.
Abstract:
Data from around the world verify the escalating incidence of infections caused by methicillin-resistant Staphylococcus aureus (MRSA). Since MRSA are spread primarily on the hands of health care workers, rates of infection are a function of infection control activities within institutions. Moreover, infections with MRSA are serious and often life-threatening. Thus, there are compelling medical and ethical reasons to invest in control measures. Currently available data suggest the efficacy of three measures: (a) identification of the entire patient reservoir (cases and carriers) for purposes of isolation; (b) strict handwashing between patients to prevent transmission; and (c) treatment of the carrier state in health care workers and patients during periods of high infection rates with safe and effective topical agents such as mupirocin.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) infections are increasing globally. Strict infection control, including patient isolation, handwashing, and carrier treatment with mupirocin, is crucial for healthcare settings.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Antimicrobial Resistance
Background:
- Escalating global incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections.
- MRSA transmission primarily occurs via healthcare worker hands, highlighting institutional infection control importance.
- MRSA infections pose serious, life-threatening risks, necessitating robust control strategies.
Purpose of the Study:
- To outline effective control measures against MRSA in healthcare settings.
- To emphasize the medical and ethical imperatives for investing in MRSA infection control.
- To present evidence-based strategies for reducing MRSA transmission and infection rates.
Main Methods:
- Identification and isolation of all patient reservoirs (cases and carriers).
- Implementation of strict handwashing protocols between patient contacts.
- Topical treatment of MRSA carrier states in healthcare workers and patients using agents like mupirocin during high-incidence periods.
Main Results:
- Data support the efficacy of a multi-faceted approach to MRSA control.
- Isolation of infected and colonized individuals is a key component.
- Adherence to hand hygiene practices significantly reduces transmission.
- Mupirocin demonstrates safety and effectiveness in treating the carrier state.
Conclusions:
- A combination of patient isolation, rigorous hand hygiene, and carrier state treatment is effective in controlling MRSA.
- Investment in these infection control measures is medically and ethically justified.
- Mupirocin is a valuable tool for managing MRSA carriers during outbreaks.