Practical experience with patients infected or colonized with a methicillin - resistant strain of Staphylococcus aureus (MRSA).

Purpose: To present the range of diseases produced by a methicillin-resistant strain of Staphylococcus aureus (MRSA). To assess the efficacy of procedures likely to cure MRSA infections and possibly to eradicate colonization. Methods: Clinical trial studying the course of MRSA infections or colonization of in-patients, treated at the Department of Infectious Diseases of the Teaching Hospital Na Bulovce, Prague, between 1 January 2004 and 31 August 2005. The trial also took into account the results of these patients follow-up as out-patients. Results: Included in the trial were 59 patients-22 presenting MRSA infections and 37 MRSA colonization. In 14 patients we found simultaneous colonization in several anatomical sites, while in 15 patients we saw, in addition to the MRSA infection, colonization at another site. Among the infections most frequent were infections of soft tissues (11), while colonization occured chiefly in the nasal mucosa (14) and in skin defects (8). In the treatment of mild infections we had good results with co-trimoxazole, in the treatment of colonizations mupirocine in the form of ointment (Bactroban ung.). During a six-month follow-up of 25 MRSA-positive patients at our Out-patient Dpt. we saw the disappearance of the MRSA strain in 7 subjects (28 %). Conclusion: In a significant proportion of MRSA-positive patients the MRSA strain disappears either after treatment or spontaneously. The development of MRSA colonization may be studied in out-patient follow-up.