Why tackling MRSA needs a comprehensive approach.
Methicillin-resistant Staphylococcus aureus (MRSA) causes a fifth of hospital-acquired infections and many other bacteria now show increased resistance to antibacterials. In some parts of the world, community-associated MRSA infections cause a growing number of infections (Fridkin et al, 2005). Attempts to control the spread of MRSA rely on several factors: detecting and isolating infected or colonized patients (cordon sanitaire), rational antibiotic prescribing, hand hygiene and cleanliness. Nurses are key to implementing all of these measures. This article examines the epidemiology of MRSA, as exemplifying an antibiotic-resistant bacterium, and reviews the evidence for the various interventions. A single measure alone is unlikely to eradicate MRSA from either hospitals or the community; indeed, eradicating MRSA is probably impossible. However, a comprehensive approach, including, in particular, good hand hygiene, could reduce the morbidity and mortality arising from MRSA and other hospital-acquired infections.
Fairclough
Sarah J
SJ
Epsom and St Helier University Hospitals NHS Trust, London.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002353:Carrier State / Q000517:prevention & control; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D014943:Global Health; D006235:Hand Disinfection; D006292:Health Priorities; D006301:Health Services Needs and Demand; D017052:Hospital Mortality; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D016106:Methicillin Resistance / Q000235:genetics; D009017:Morbidity; D024802:Nurse's Role; D011159:Population Surveillance; D011634:Public Health / Q000379:methods; D012307:Risk Factors; D012641:Selection, Genetic; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000235:genetics; D013222:State Medicine / Q000458:organization & administration; D006113:United Kingdom / Q000453:epidemiology
D000900:Anti-Bacterial Agents