The infection control management of MRSA in acute care

Abstract

Many acute care facilities report endemic methicillin-resistant Staphylococcus aureus (MRSA), while others describe the occurence of sporadic disease outbreaks. The timely implementation of effective infection control measures is essential to minimise the incidence of MRSA cases and the magnitude of disease outbreaks. Mangement strategies for the containment and control of MRSA currently vary between facilities and demonstrate varying levels of effectiveness. This review sought to systematically review the best available research regarding the efficacy of infection control practices in controlling endemic MRSA or MRSA outbreaks in the acute hospital setting. It updates an original review published in 2002.Fourteen papers met the inclusion criteria for this review. Of these, 11 papers achieved a quality schore above the threshold and were included in the review. Of the included papers, five describe MRSA outbreaks, while the remaining six describe endemic MRSA. All included studies used either exploratory descriptive or comparative designs. The varying combination of interventions described in the included studies make it impossible to differentiate the efficacy of individual or even groups of interventions. The fact that most studies reported positive findings may reflect the bias towards publication of effective interventions.This review provides evidence that the use of multifaceted strategies can reduce nosocomial MRSA transmission in both outbreaks of MRSA and settings where MRSA is endemic. The heterogeneous nature of the topic, combinations of interventions implemented and methodological weaknesses of the studies impairs the ability to aggregate data and develop specific recommendations for practice