Staphylococcus aureus: a review of the literature.

Staphylococcus aureus has a long association with nosocomial infection. Problems date from the 1950s, although methicillin-resistant Staphylococcus aureus (MRSA) did not emerge until the following decade. Initially the pathogenicity of antibiotic-resistant strains was underestimated, and is still sometimes questioned, but today most authorities consider MRSA a serious threat, especially given current preoccupation with cost-effectiveness within the health service: nosocomial infection is associated with increased expenditure and may be regarded as a hallmark of indifferent nursing and medical care. This review documents the emergence of MRSA and recognition of the ensuing problems throughout the 1980s and early 1990s, with suggestions for nursing activities which could contribute towards improved control. Lessons learnt during outbreaks are seen to be of value, but there is also a need for staff at ward level to review routine practice continually so that awareness of activities likely to result in cross-infection is maintained. The use of protective clothing emerges as less important than handwashing, which may be periodically audited to maintain standards.