Summary Meticillin-resistant Staphylococcus aureus (MRSA) remains endemic
in many UK hospitals. Specific guidelines for control and prevention
are justified because MRSA causes serious illness and results in significant
additional healthcare costs. Guidelines were drafted by a multi-disciplinary
group and these have been finalised following extensive consultation. The
recommendations have been graded according to the strength of evidence.
Surveillance of MRSA should be undertaken in a systematic way and should
be fed back routinely to healthcare staff. The inappropriate or unnecessary
use of antibiotics should be avoided, and this will also reduce the likelihood
of the emergence and spread of strains with reduced susceptibility
to glycopeptides, i.e. vancomycin-intermediate S. aureus/glycopeptideintermediate
S. aureus (VISA/GISA) and vancomycin-resistant S. aureus(VRSA). Screening for MRSA carriage in selected patients and clinical areas
should be performed according to locally agreed criteria based upon assessment
of the risks and consequences of transmission and infection.
Nasal and skin decolonization should be considered in certain categories
of patients. The general principles of infection control should be adopted
for patients with MRSA, including patient isolation and the appropriate
cleaning and decontamination of clinical areas. Inadequate staffing, especially
amongst nurses, contributes to the increased prevalence of MRSA.
Laboratories should notify the relevant national authorities if VISA/GISA
or VRSA isolates are identified