Methicillin-Resistant Staphylococcus aureus Colonization A Review of the Literature on Prevention and Eradication

The emergence of colonized methicillin-resistant Staphylococcus aureus (MRSA) carriers is a great threat to the health of communities nationwide. Unrecognized MRSA carriers not only have greater risk for the recurrent development of MRSA infections but these carriers also contribute to transmission in noncolonized patients. Because an increasing number of patients are diagnosed with MRSA infections in the emergency department, the purpose of this review was to determine the potential benefits and efficacy of MRSA prevention and eradication with intranasal mupirocin (Bactroban) and/or chlorhexidine (Hibiclens) body wash among colonized patients. The search results included articles published on evidence-based practice for the prevention of MRSA from 1998 to 2008. Twelve studies met the inclusion criteria to formulate the tables, and narrative synthesis was undertaken to understand the effectiveness of the treatments. The results of the synthesis showed that although the randomized controlled trials did not support the routine use of the interventions, the evidence from clinically based, nonexperimental studies did provide support for the continued use of mupirocin and/or chlorhexidine body wash to prevent and control MRSA, especially in high-risk populations. The results of this review offer guidance in MRSA prevention and eradication for providers in emergency care.