Methicillin-resistant staphylococcus aureus

The last decade has witnessed a remarkable rise in the number of reported outbreaks of hospital-acquired infections caused by Methicillin-resistant Staphylococcus aureus [MRSA] world-wide. A notable feature of these bacterial strains is the ease with which they acquired resistance to many antibiotics, spread within an Institution and the uniform problem of control and limited choice of effective treatment of the serious infections that they cause. Immunocompromised, debilitated patients and patients with open wounds, particularly burn patients, are at risk of infection by these strains and a number of relatively high mortality rates have been reported amongst those with MRSA septicaemia during outbreaks. The reservoir of MRSA in outbreaks of hospital-acquired infection include, infected and colonized patients, ambulant patient-carriers, health-care providers and sometimes, the inanimate hospital environment. Breach of infection control practices by doctors and nurses, lack of facilities to implement infection control policies and excessive use of antimicrobial agents play significant roles in the occurrence of outbreaks within a hospital. The main sites of MRSA colonization in a hospital setting include skin, mucous membranes and respiratory secretions while the most common MRSA infections include wound and skin infections, bacteraemia, pneumonia and urinary tract infection. Unfortunately, the antimicrobial agents that are available against MRSA are often potentially toxic, limited in number, difficult to administer and expensive. There are also uncertainties in the efficacy of topical antibiotic and antiseptic preparations, although results with mupirocin seem to be good. There is no consensus regarding which control measures are most appropriate and many different approaches, depending on local resources and interest of the authorities, are often used when hospitals encounter patients with MRSA