Anti-Bacterial Skin Disinfectants in the Reduction of Methicillin Resistant Staphylococcus Aureus (MRSA) Skin Colonisation

Abstract

In health care establishments there has been an emergence of multiply resistant organisms such as methicillin resistant staphylococcus aureus (MRSA). This has highlighted the need to re-evaluate not only, medical, nursing and infection control practices, but the methods of management and treatment in an attempt to reduce/eradicate the spread of the organism from patients and therefore minimise the risks of cross infection. As part of the routine care and management of patients with MRSA, antibacterial agents are widely used as body washes to reduce/eradicate skin colonisation of the organism. The aim of this research was to investigate the effectiveness of washing with chlorhexidine, triclosan or a soap solution for eradication of MRSA from patients following one course of body washes. Whilst the overall numbers were too small to reach statistical significance, this research project has served to demonstrate that in the clinical environment there is little difference between triclosan, chorhexidine or soap. Minimum inhibitory concentration (MIC) testing demonstrated that triclosan was more active than chlorhexidine against MRSA, which in turn was better than soap. This would suggest that when selecting a bodywash the effectiveness of the agent used is influenced by its application. From a review of the literature and the evidence presented in this study the use of topical mupirocin to eradicate nasal carriage of MRSA was shown to have had little effect. Given the potential for antibiotic resistance, consideration should be given to the routine use of mupirocin for nasal carriage of MRSA. Therefore, infection control programmes aimed at reducing MRSA skin colonisation should consider both the residual effects of antibacterials in relation to the patient's length of stay, giving consideration to the use of antibacterials for ‘short stay’ patients and the patient's clinical condition and the environment in which they are nursed.