A positive screening test result usually means that there is asymptomatic MRSA colonisation in the nose, axilla or groin, which is often harmless in otherwise healthy people. It is however important to reduce this bacterial load as much as possible.

Where do you find MRSA:

• Anterior nares
• Axilla, groin, perineum, rectum
• Dermatic skin, skin ulcers
• I.V. sites
• Indwelling catheters
• Tracheostomy tubes
• Feeding tubes
• Wounds

The MRSA treatment – is a decolonisation treatment to remove the bacteria:

a) Chlorhexidine gluconate 4% in a sulfactant solution – to be used once a day. Use neat solution to wash all over the person’s body and rinse off with clean water. Wash the hair of the person infected on 2 occasions, ideally day 1 and 5 of the treatment.

b1) Mupirocin 2% nasal ointment – apply a small amount to the inner surface of both nostrils three times daily for 5 days.

b2) Naseptin nasal ointment to be used if your patient is intolerant to mupirocin and use four times daily for 10 days. Naseptin contain peanut oil, so avoid in nuts allergy.

​b3) Prontoderm gel light to be used three times daily for 5 days if there is a nuts allergy and Naseptin can’t be used.

During the decolonisation process, the infected person should be placed in a private room, have a wash every day using Chlorhexidine solution, ideally using a fresh towel to dry each time. The person should also wear a new set of clothes each day and try to change his/her bedding on a daily basis. The resulting laundry should be washed at a high temperature separately from other people’s clothes and bedding.

When dealing with MRSA patients:

–  Hand hygiene is very important

–  When dealing with open wounds always use:

• Gloves, Mask, Gown (use protective equipment)
• Contact isolation
• Barrier precautions

–  Book MRSA patients at the end of the clinic day (to limit the spread of infection)

–  Educate patient about MRSA at home

–  Educate office staff about reducing MRSA spread

– Adequate supplies of liquid soap, hand rub, towels, yellow bins and sharps containers should be made available wherever care is delivered.

–  Short term care plan must be written