Keeping MRSA out of a district general hospital

This study describes a three-year audit of methicillin-resistant Staphylococcus aureus (MRSA) in a district general hospital and surrounding community. Despite a continuing increase in new cases of MRSA both nationally and locally, and the transfer of patients with MRSA from outside, the hospital remains free from endemic MRSA, albeit with occasional sporadic cases. This is attributed to the presence of a Control of Infection team who have introduced and implemented various policies to control MRSA. These include prompt screening of hospital transfers, an effective topical regimen, attention to environmental cleaning, treatment for established infection, tailored protocol for colonized urinary catheters and an educational programme for staff. Some of these policies have been extended into the community. This report also presents data from 172 cases of MRSA, including carriage rate, infection site, antibiogram, phage-typing, treatment and/or clearance outcome and preliminary evaluation of pathogenicity. A questionnaire has been formulated to assess colonization vs infection. Future strategies will be required if the status quo is to be maintained. (C) 1999 The Hospital Infection Society.