Effective control of methicillin-resistant Staphylococcus aureus in a burn unit.
Methicillin-resistant Staph, aureus (MRSA) colonization and infection was studied in 231 patients who were admitted to our burn unit and remained for 3 days or more between 1986 and 1994 (patients with inhalation injury only and no burn wound were excluded). The study was divided into two periods: from 1988 to 1989 and from 1990 to 1994. MRSA was found in 80 patients. They increased from 1986 to 1988, slightly decreasing thereafter. In 1994 the incidence of MRSA was 4.3 per cent. The number of strains of MRSA isolated from burn wounds was significantly reduced in the later period. Comparing the two periods, isolation of patients from MRSA, prevention of contamination during care, and reduction in the number of patients initially given second- or third-generation cephem antibiotics were performed more strictly in the later period. The effectiveness of these measures was confirmed. Moreover, the first operation was carried out significantly earlier in the later period. Early excision and early closure of the wound was more effective in preventing and controlling MRSA colonization and infection.