Methicillin-resistant Staphylococcus aureus. Management of asymptomatic colonization and outbreaks of infection in long-term care

Abstract

Asymptomatic colonization with methicillin-resistant Staphylococcus aureus (MRSA) is common in long-term care facilities, but the burden of symptomatic infection appears to be low. Patients known to be MRSA carriers should not be refused admission, and routine cultures to identify carriers are not warranted. In the absence of symptomatic MRSA, no measures beyond routine infection control and standard precautions are necessary. Increased rates of infection should prompt investigation of a potential outbreak and initiation of more drastic infection-control measures. During an outbreak, both infected and colonized residents should be isolated until transmission has been halted. Using short-term nasal application of mupirocin ointment for MRSA-colonized residents and staff implicated in the outbreak may help break the chain of transmission.