Methicillin-resistant Staphylococcus aureus bacteraemia

Twenty-eight (53%) of 53 hospital-acquired staphylococcal bacteraemias which occurred at The Royal Melbourne Hospital over a two-year period were due to methicillin-resistant Staphylococcus aureus (MRSA). Every patient with MRSA bacteraemia had a significant underlying condition predisposing to nosocomial sepsis, and each had an intravascular foreign body in situ at the time. Most were being nursed in special care areas of the hospital and had been exposed to multiple or broad-spectrum antibiotics during the month before development of bacteraemia. Patients acquiring MRSA infection should be isolated and, when the diagnosis of bacteraemia is considered, any potential primary focus should be removed. Vancomycin is the drug of choice in life-threatening MRSA infections.