Methicillin-resistant Staphylococcus aureus in patients with spinal cord injury.

During the past decade, methicillin-resistant Staphylococcus aureus (MRSA) has become a major cause of nosocomial and community-acquired infections in the United States. A retrospective chart review of MRSA-positive cases from January 1990 to December 1994 was done to assess the extent of the problem, the factors associated with MRSA acquisition, and the effectiveness of a Center for Disease Control (CDC) protocol to treat MRSA infection in a population with spinal cord injury (SCI). Seventy-four percent of the patients acquired MRSA during their hospitalization. Urine was the most common site of colonization, and 73 percent of the patients with positive urine cultures managed their bladders with indwelling catheters. Implementation of the CDC protocol in 1991 was associated with a decrease in the MRSA incidence rate in subsequent years. Other simple methods of treatment, such as bladder irrigation, were also effective. To control the spread of MRSA, a continual concerted effort by hospital staff through education and implementation of the MRSA protocol is necessary.