Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria which, if found on the skin, can be removed using topical medications.
- MRSA does not present a risk to other healthy people
- To reduce the risk of transmission staff should use good aseptic technique for the management of wounds, and should follow Hand Hygiene, Personal Protective Equipment (PPE) and Cleaning Equipment & Environment regulations at all times.
Topical Treatment Regimen
The treatment regimen consists of two separate treatments which must be started on the same day:
- Hair and body treatment → wash the whole body (paying particular attention to hair, loin, armpits, nostrils) using a small amount of antibacterial solution (e.g., Chlorhexidine 4%, Octenisan or Prontoderm Foam) every day, for five days.
- Nasal treatment → apply Mupirocin 2% nasal ointment (Bactroban) to the inside of the nostrils, three times daily for five days
NB. Dermatology patients should not use Chlorhexidine 4%
Please advise all patients to use clean towels, bedding and clothing each day during their treatment.
On redressing, bactroban or polymyxin/bacitracin ointment can also be directly applied to small wounds caused by the infection. However, avoid using on PEG sites, trachy tubes and large wounds.
Mupirocin-resistant MRSA
Some strains of MRSA are resistant to mupirocin, so can’t be treated using this antibiotic. Alternatively, treat by applying Naseptin (chlorhexidine/neomycin) to the anterior nares four times daily, for ten days.
NB. Patients with a nut allergy must not be given Naseptin
Completion of treatment regimen
Further screening of patients that have completed the topical treatment regimen is not required unless advised by your local Community IPC or HP Team.
PVL-Positive Staphylococcus Aureus
MRSA can produce a toxin called PVL. PVL can cause recurrent skin and soft tissue infections (SSTIs), which can be treated using the same regimen as above. Rarely, PVL can cause serious diseases, such as pneumonia. If this is suspected, patients must be urgently referred to hospital care.
For further advice on treating MRSA, by borough:
- Lambeth and Southwark: contact King's College Hospital on 02032994360 or 02032994358
- Lewisham: contact the Microbiology Department at University Hospital Lewisham on 0208 333 3262 between 9am and 5pm, or on 0208 333 3000 if out of hours