Nosocomial methicillin-resistant Staphylococcus aureus (MRSA) and epidermidis (MRSE) infections in orthopaedic surgery. Importance, prophylaxis and therapy

MRSA/MRSE infections are a major problem in hospitals and although in ortho paedic units the incidence is low awareness of this problem is necessary. O nce a MRSA strain has been isolated the strict use of the hygiene precautio ns has to be applied to avoid epidemic spread of the strain. The patient ha s to be isolated. The staff has to use gloves and gowns whilst treating the patient. A antimicrobiel hand wash solution has to be used after taking of f the gloves and before leaving the isolation room. Patient and staff have to be informed about the pathogenity and the way of infection spread so tha t infection precaution rules are fulfilled. Antibiotics should only be used in clinically well defined cases and the overall use of antibiotics should be reduced to lower the incidence of MRSA/E isolates. The problems of an M RSA case and its successful treatment are demonstrated.