Infection control. Beating the bug.

Abstract

Strains of Staphylococcus aureus resistant to methicillin were first described soon after the introduction of this antibiotic. Methicillin, the first of the anti-staphylococcal penicillins, was soon replaced by cloxacillin and flucloxacillin, which have the advantage of good oral absorption, but strains of Staphylococcus aureus that are resistant to methicillin are invariably resistant to cloxacillin, flucloxacillin and the cephalosporins. A number of outbreaks of MRSA occurred in the 1960s, but the problem disappeared in the 1970s, which has been referred to as 'the decade of complacency'. In the early 1980s MRSA re-emerged as a significant cause of hospital-acquired infection in many countries, including England (London area), Eire (Dublin), Australia (Perth), Saudi Arabia and the USA. Epidemic strains of MRSA are distinguished by the ability to colonise skin very effectively. They are spread rapidly between patients via the hands of medical, nursing and paramedical staff. Most district general hospitals no longer have an isolation ward; patients with infections are generally nursed in side rooms.