[Methicillin-resistant Staphylococcus aureus (MRSA), a predictor of the end of the antibiotic era--diagnosis, epidemiology, therapy and dissemination prevention]

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent nosocomial pathogen worldwide, especially in large teaching hospitals. After the beginning of the war in Croatia, we have noticed a substantial increase in MRSA incidence in our country too. Mechanisms of resistance to methicillin differ from those mediated by the beta-lactamase production, and strains resistant to methicillin are at the same time resistant to the whole group of beta-lactam antibiotics. These strains represent a great therapeutic problem because there is often no antibiotic but vancomycin to be used for the treatment of MRSA infections. Vancomycin is an expensive and in long term therapy not well tolerated antibiotic, so to prevent the spread of these resistant strains is of ultimate importance. Among the general precautions hand washing is the single most important preventive measure. For MRSA strains additional precautions like patient isolation and tagging of discharged patient's notes should be implemented as well.