MRSA in afya

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single best step - hand hygiene (multi-pronged approach needed)

Methicillin-resistant Staphylococcus aureus (MRSA)
first organisms to show danger of hospital-acquired infections.

''Who to screen?''
    all elective admissions (exceptions day patients for TOP and eye surgery and mental health pts)
    all emergency admissions (from 2011)

''How to screen''
    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'

''Suppression if carrier
    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

'' useful antibiotics''
    vancomycin
    teicoplanin
    linezolid

sometimes these antibiotics may help but use in combination to decrease resistance
    rifampicin
    macrolides
    tetracyclines
    aminoglycosides
    clindamycin

new antibiotics (linezolid, quinupristin/dalfopristin combinations and tigecycline have activity against MRSA but should be reserved for resistant cases

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