Nosocomial staphylococcal outbreaks.

Staphylococcus aureus is the most frequently isolated single bacterial species from surgical wounds. During 1954-59, S. aureus phage 80/81 was responsible for more than 20% of staphylococcal epidemics in British hospitals. With the introduction of methicillin came satisfactory treatment of staphylococcal infection, though strains of methicillin-resistant S. aureus (MRSA) were quickly discovered. Outbreaks of MRSA infection usually start with the transfer or admission of either a patient or healthcare worker colonized or infected with MRSA from another hospital or the community. Long-stay patients act as reservoirs for MRSA which spread via several modes of transmission. Hospital outbreaks of MRSA infection are difficult to control and may require stringent containment measures entailing considerable expense. Infection control is dependent on staff education programmes and surveillance. In the event of an MRSA epidemic, infection control staff may need to solicit the help of a team of trained specialists to implement intensive surveillance programmes, to identify and isolate MRSA carriers and eradicate the carriage of MRSA. Antibiotics are widely used for the prevention of infection, but control should be exercised as excessive antibiotic use has been identified as a risk factor for outbreaks of infection.