Page 191 - policy and procedure infection control

Policies and Procedures on Infection Control

• Use an antibacterial (chlorhexidine gluconate 0.2%) mouth wash two times per day.
• If after two courses of mupirocin treatment the nasal carriage is not eradicated, it
is important that mupirocin is stopped because the risk of resistance will develop.
3. Wound treatment

Colonisation or infection caused by MRSA may delay wound healing. These general
principles can be applied:
• Clean wound with sterile water.
• Use povidone-iodine or silver sulphadiazine preparations where possible.
• Cover wound with an appropriate dressing.
• DO NOT USE TOPICAL ANTIBIOTICS FOR LOCALISED WOUND INFECTION

4. Systemic infection
• With the emergence of resistance to the penicillinase-resistant penicillins, the
glycopeptides agent vancomycin became the treatment of choice for infections
cause by MRSA.
• Vancomycin can have serious side effects, include ototoxicity, nephrotoxicity,
‘red man syndrome’ and allergic reactions
• Alternative antibiotics to treat MRSA include linezolid, rifampicin, fucidic acid,
tigecycline, quinopristin/dalfopristin and teicoplanin
• Avoid using rifampicin or fucidic acid as single agent because of rapid
development of resistance.

13.2.7Infection Control And Prevention
• The preventive measures of infection control for MRSA follows the contact based
precautions which includes hand hygiene, isolation, gloving, linen handling and
environmental cleaning.
• Hand hygiene is the single most important factor in preventing the spread of MRSA,
therefore the 5 moments shall be adhered to at all times.
• Gloves should be worn for any contact with blood/body fluids, secretions and
excretions wounds, invasive site, or mucous membrane of a patient
• Gowns may be worn if splashing or extensive soiling is likely.
• Masks and eye protection are indicated if exposure to aerosols generated by coughing
patient is likely or when irrigating wounds.
• Daily routine cleaning of formites must be done with a disinfectant (70% alcohol)
and performed in a sanitary manner as is done in all rooms regardless of the presence
of MRSA. Terminal cleaning shall be performed upon patient discharge. Equipment
should be routinely cleaned, disinfected or sterilized per institution policy.
• The MRSA colonized or infected patient should be isolated in single room if available
or cohort with other known MRSA patient.
• Contact based precaution should be strictly adhered to at all times, irrespectively of isolation.

180 Ministry of Health Malaysia