MRSA decolonisation regime for adults, children and neonates

Important: Therapy

Before commencing a decolonisation regime, please ensure any clinical infections due to MRSA are treated.

NHS Grampian Staff Protocol for the Screening and Placement of Patients with Meticillin-Resistant Staphylococcus Aureus (MRSA) within NHS Healthcare Settings (excluding Care Homes)

Re-screen patient at least 2 days after the end of the decolonisation regimen. The patient should no longer be considered colonised with MRSA when 3 screens, taken at least 48 hours apart are negative.

Contact dermatologist if patient has exfoliative skin conditions eg severe eczema and requires decolonisation.

Contact Medical Microbiology if:

• Patient has received two previous courses of the decolonisation regimen and is still testing positive.
• MRSA is isolated from multiple sites, or those in whom colonisation is persistent or recurring.

Notes:

Important: Therapy

Mupirocin 2% nasal ointment applied to both nostrils three times daily for 5 days.

and

Chlorhexidine gluconate 4% solution (Hibiscrub^®) used as soap in bath or shower daily for 5 days. 

Moisten the skin, apply the undiluted antiseptic solution to all parts of the skin, beginning with the face and working downwards, paying particular attention to the armpits (axilla), groin, perineal area and skin folds. Avoid the eyes and ears. Leave for 1 minute then rinse off. Dry thoroughly using a clean towel.

Wash hair with the antiseptic solution and rinse, at least twice within the 5 day period.

Do NOT dilute the antiseptic solution in bath water.

Clean towels, clothes and bedding should be used after each body wash.

If any irritation occurs discontinue use and seek advice from the appropriate clinician.

Notes:

Mupirocin should only be used for 2 x 5 day courses (within a 6 month period) and should not be used for prolonged courses or used repeatedly (more than 2 times). 

Important: Therapy

Mupirocin 2% nasal ointment applied to both nostrils three times daily for 5 days.

and

Octenisan^® antimicrobial wash to be used as a daily wash for 5 days.

Moisten the skin, apply the undiluted antiseptic solution to all parts of the skin beginning with the face and working downwards, paying particular attention to the armpits (axilla), groin, perineal area and skin folds. Leave for 1 minute then rinse off. Dry thoroughly using a clean towel

Wash hair with the antiseptic solution and rinse at least twice within the 5 day period.

Do NOT dilute the antiseptic solution in bath water.

Clean towels, clothes and bedding should be used after each body wash.

If any irritation occurs discontinue use and seek advice from the appropriate clinician.

Notes:

Important: Therapy

Chlorhexidine with neomycin (Naseptin^® nasal cream) applied to both nostrils four times daily for 10 days

and

Chlorhexidine gluconate 4% solution (Hibiscrub^®) used as soap in bath or shower daily for 5 days.  

Moisten the skin, apply the antiseptic solution to all parts of the skin, beginning with the face and working downwards, paying particular attention to the armpits (axilla), groin, perineal area and skin folds. Avoid the eyes and ears.  Leave for 1 minute then rinse off. Dry thoroughly using a clean towel.

Wash hair with the antiseptic solution and rinse at least twice within the 5 day period.

Do NOT dilute the antiseptic solution in bath water.

Clean towels, clothes and bedding should be used after each body wash.

If any irritation occurs discontinue use and seek advice from the appropriate clinician.

Notes:

Some Naseptin^® nasal cream products contain peanut oil.  If the patient has a peanut allergy, please speak to a pharmacist to obtain a peanut oil free product.

Important: Therapy

Chlorhexidine with neomycin (Naseptin^® nasal cream) applied to both nostrils four times daily for 10 days

and

Octenisan^® antimicrobial wash to be used once daily as a wash for 5 days.

Moisten the skin and apply the undiluted antiseptic solution to all parts of the skin, beginning with the face and working downwards, paying particular attention to the armpits (axilla), groin, perineal area and skin folds. Leave for 1 minute then rinse off. Dry thoroughly using a clean towel.

Wash hair with the antiseptic solution and rinse at least twice within the 5 day period.

Do NOT dilute the antiseptic solution in bath water.

Clean towels, clothes and bedding should be used after each body wash.

If any irritation occurs discontinue use and seek advice from the appropriate clinician.

Notes: