Methicillin-resistant Staphylococcus aureus (MKSA)
infections have become a major problem in many US hospitals in the last ten
years.‘,’ Attempts to solve the problem have been hampered by many factors.
One of these factors is the difficulty in eradicating the organism from
colonized sites and thereby removing one of the reservoirs of endemicity.
Another complicating factor is the lack of consistency in the published
literature regarding what constitutes eradication and, therefore, when it is
appropriate to discontinue isolation of patients or work restrictions of
personnel. Even the decisions regarding when and how often to culture
personnel remain difficult to define.” Finally, although the Australian
experience illustrated an environmental component to an MRSA outbreak, the
role of the environment in MRSA infections remains unclear. The following
report describes the measures utilized to eradicate low-level MRSA skin
colonization in a long-term psychiatric patient and illustrates several
problems of-long-term MRSA carriage in institutionalized patients.