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Healthcare-Associated MRSA Infections in the U.S.

• mrsa
• Why the decrease in MRSA?

mrsa

John L Brown, FCI, 9 Oct 2010 12:09 AM EST

Competing interests: None declared

I've not seen a decrease in MRSA skin infections. MRSA does seem to occur in clusters, though.

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Why the decrease in MRSA?

Jared S. Ellis, Jackson AL, 28 Nov 2010 3:24 AM EST

Competing interests: None declared

Specialty: Family Medicine

About 2005 I saw in my practice a significant jump in MRSA infections, typically superficial abscesses, some complicated, but most noncomplicated. We quickly created a poster on WORD advising what it is, needing early treatment and often needing I and D. We then emphasized the need for contact precaution and eradication of MRSA from the body and house, namely by: Hibiclens or Betacept for all in the household over 1, daily for 2 weeks. Bactroban ointment BID in nares x 5 days for all, and applied under fingernails, cuticles, in the axillae and groin and umbilicius. We recommended single using towels/ not sharing, and wash immediately. We recommended discarding bar soap and use pump liquid soap and use deoderant sprayl Advised to soak reusalble razors in alcohol after each use. For all draining abscess with cultured them (about 94% MRSA, 5 % MSSA, and 1 % other (Citrobacter, Psuedomonas, et). We cultured the nares of the index case and sometimes family members when we didnt get a positive Staph culture. We emphasized need for identifying their contacts and treating them similarly. Most index patients did recieve antibiotics, namely Bactrim and clindamyin, infrequently doxycycline or Levaquin. Response rates with appropriate draining were near 100% and though not calculated, there seemed to be a large drop in recurrent cases and somewhat decreased overall case rate. We attribute this to our edcuation and therapeutic efforts.

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