Experience applying the UK meticillin-resistant Staphylococcus aureus (MRSA) guidelines in a tertiary referral hospital in the United Arab Emirates 1999-2002: same guidelines, different cultures.

Meticillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen worldwide. There are few reports concerning MRSA in the United Arab Emirates (UAE). We report our experience with MRSA in a 400-bed tertiary referral hospital in the UAE, which followed the UK MRSA guidelines. MRSA data were reviewed to include demographic and clinical data on all new MRSA cases; a review of the ward environment including number of single rooms, sinks, toilets and bathrooms, frequency of cleaning; cultural observations; and number of infection control personnel per beds. MRSA was an uncommon pathogen. There were 90 new MRSA cases from 1999 to 2002 including two clusters of MRSA. While the procedures followed were the same as those in the UK, there were differences in the hospital environment compared with the UK and in cultural aspects of the patients' behaviour. At least 70% of inpatients were in single rooms with ensuite bathrooms. It was rare for more than two patients to share a toilet or bathroom. There were fewer than recommended infection control personnel and no antibiotic restriction policy in the hospital. Cleaners were on the wards for >100 h per week and were available 24 h per day for rapid response. We conclude that there are many factors that influence the management and control of MRSA, including cultural and social behaviour.