Methicillin-resistant Staphylococcus aureus (MRSA) - clinical implications

The isolation rate of MRSA from Staphylococcus aureus infections rose to 8.7 % in German hospitals between 1990 and 1995. Patients undergoing surgical treatment or physiotherapy showed a threefold increase in the risk of being colonized or infected with MRSA. Surgical wound infection is the most frequent among MRSA-induced infections (28%). The main transmission path of MRSA inside a hospital is bacterial spread from one patient to another through contact with the hands of nursing staff. Therefore, the crucial strategy in avoiding the spread of bacteria is strict hygiene management through hand disinfection. The most widespread therapeutic regimen for simultaneous eradication of nasal colonization and treatment of infection on other body sites is mupirocin nasal ointment combined with parenteral vancomycin application. The non-indicated use of vancomycin, e. g., for perioperative prophylaxis or prevention of catheter-induced infections, should be avoided, especially after the appearance of vancomycin-intermediately sensitive S. aureus (VISA) strains that have been reported recently from Japan and the USA.