Methicillin-Resistant Staphylococcus Aureus (MRSA)

Background

Suspect MRSA infection/carrier in patients who present with:

1. multiple skin sites
2. recurrent infection
3. pt who has been in close contact of person with Hx of MRSA
4. infection showing early necrosis
5. two kinds: hospital acquired and community acquired
   1. Hospital acquired tends to be multi-drug resistant, most commonly seen in ventilator associated pneumonia, post operative infections, and catheter associated infections
   2. Community acquired tends to be resistant to beta-lactams, most commonly seen in soft tissue infections and rarely in necrotizing pneumonia

Prevention

1. good hand hygiene
2. avoid sharing personal items with carriers
3. wash common household items with bleach and hot water
4. wash soiled sheets, towels, clothes in hot water with bleach and dry in hot dryer
5. Eradicate carriers:
6. mupirocin 2%: apply to each nostril TID x 5days
7. Hibiclens wash daily x 5 days
8. consider oral antibiotics

Treatment

1. Antibiotics
   1. Keflex + Bactrim DS
   2. clindamycin
   3. doxycycline
   4. Vancomycin IV if severe infection/sepsis
2. I&D if abscess
   1. (antibiotics not needed if no e/o cellulitis)

Source

Adapted from Donaldson