Methicillin-resistant Staphylococcus aureus (MRSA) was one of the first organisms which highlighted the dangers of hospital-acquired infections.

Screening

Who should be screened for MRSA?

• all patients awaiting elective admissions (exceptions include day patients having terminations of pregnancy and ophthalmic surgery. Patients admitted to mental health trusts are also excluded)
• from 2011 all emergency admissions will be screened

How should a patient be screened for MRSA?

• nasal swab and skin lesions or wounds
• the swab should be wiped around the inside rim of a patient's nose for 5 seconds
• the microbiology form must be labelled 'MRSA screen'

Management

Suppression of MRSA from a carrier once identified

• nose: mupirocin 2% in white soft paraffin, tds for 5 days
• skin: chlorhexidine gluconate, od for 5 days. Apply all over but particularly to the axilla, groin and perineum

The following antibiotics are commonly used in the treatment of MRSA infections:

• vancomycin
• teicoplanin
• linezolid