Staphylococcus aureus (including MRSA)
Please note: This is for information only.
Refer to local guidelines for treatment recommendations.
- A Gram-positive coccus that is often found colonising on the skin of the anterior nares, axilla, and perineum.
- The methicillin (flucloxacillin) resistant version (MRSA) is a particular infection control hazard.
- S. aureus in general, (MRSA or MSSA) is a common agent of nosocomial infections in hospitals.
- Currently, between 40-50% of healthcare-associated S aureus infections are due to MRSA, but <5% of true community S aureus infections
Main clinical infections:
- Skin and soft tissue infections (impetigo, cellulitis)
- Surgical ward infections
- Venflon infections
- Intravascular catheter infections (often with bacteraemia).
- Severe systemic infections in deep foci such as endocarditis, osteomyelitis, myositis, and fasciitis.
MSSA: Usually sensitive to:
- 1st and 2nd generation cephalosporins
- Fusidic acid
- Seek microbiology advice for synergistic drug combinations in severe infections.
MSSA: Usually resistant to:
MRSA: (multiple-resistant organism): Usually sensitive to:
- Vancomycin (1st line choice for i.v. therapy)
- Doxycycline (1st choice for p.o. therapy in less severe infections)
- Gentamicin (Gentamicin resistance in MRSA is thankfully uncommon in Nottingham.)
- Fusidic acid
MRSA: Usually resistant to:
- All beta-lactam antibiotics (e.g. penicillins, flucloxacillin, cephalosporins, co-amoxiclav, imipenem),
- Quinolones (e.g. ciprofloxacin and levofloxacin),
- Macrolides (erythromycin, clarithromycin)