The Japanese Journal of Clinical Dialysis Vol.22 No.2(2-2)

Theme Intractable Infection in Hemodialysis Patients -- Current Diagnosis and Treatment
Title Strategy to control MRSA infection in surgical patients
Publish Date 2006/02
Author Hidekazu Sano Department of Surgey, Sapporo City General Hospital
Author Keisa Takeda Department of Surgey, Sapporo City General Hospital
Author Masato Nakai Department of Surgey, Sapporo City General Hospital
Author Yoko Saito Department of Infection Control and Prevention, Sapporo City General Hospital
Author Suzuka Ishizumi Department of Infection Control and Prevention, Sapporo City General Hospital
Author Junichi Yamada Department of Pharmacy, Sapporo City General Hospital
[ Summary ] Hemodialysis patients are susceptible to severe postoperative infectious complications due to methicillin-resistant Staphylococcus aureus(MRSA). This is because they tend to have impaired immune functions and relatively high MRSA colonization rates. Prevention is known to be the most important strategy. MRSA is mainly transmitted by contact, so that contact precautions, such as handwashing and hand antisepsis, wearing gloves and gowns, are significant measures. For the treatment of MRSA infections, vancomycin, teicoplanin and arbekacin are the most available and effective anti-MRSA agents. To control severe MRSA infections, concentrations of an anti-MRSA agent in the blood should be attained at the treatment level as early as possible. Initial administration requires sufficient dosage, and therapeutic drug monitoring is necessary to adjust dosage adequately. For MRSA wound infections, irrigation with normal saline is the most essential indication.
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