STRATEGIES FOR CONTROLLING METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS IN HOSPITALS

In areas where the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) is very low, aggressive strategies, which appear to have been effective, such as those used in the Netherlands and western Aus tralia, may be feasible. In hospitals where MRSA is epidemic or highly endemic, less rigorous strategies are appropriate. However, which iso lation techniques and barrier precautions are optimal is controversial . In addition, there is no consensus regarding the epidemiological imp ortance of environmental contamination. Rapid detection of MRSA, promp t implementation of barrier precautions and prospective surveillance a re essential components of a successful control programme. Eradicating nasal carriage of MRSA among patients and personnel can be useful dur ing epidemics, but the cost-effectiveness of using this approach in ho spitals where the prevalence of MRSA is low is unknown. Additional stu dies of this issue need to include surveillance for mupirocin-resistan t strains.