MRSA (Methicillin-resistant Staph aureus) Decolonization

What is MRSA decolonization?

Decolonization of MRSA is an attempt to remove the bacteria from places it can live on the body to help prevent future infections.

How do I decolonize MRSA?

1. Apply a thin layer of Bactroban® (mupirocin) ointment to the front of the nostrils. Do this two times a day for 5 days.
   1. To use the mupirocin ointment, put a small amount on one end of a cotton-tip swab (Q-tip®). Apply the medicine all around the inside of one nostril. Then, put the ointment on the other unused end of the cotton-tip swab, and apply the medicine inside the other nostril.

2. Bathe or shower daily with Hibiclens® (chlorhexidine) surgical soap. Wash from the neck down, with special attention to skin folds (armpits, groin, between buttocks).  Do this for 5 days. This is available over the counter.
   1. Do not use around the face or the eyes, as the soap can cause a chemical burn to the eyes.
   2. Do not use on open skin.
   3. If the soap excessively dries the skin, or if there is a history of eczema, use the Hibiclens® soap every other day for 5 applications. Use creams or lotions that do not interfere with Hibiclens®, like Cetaphil® Moisturizing Lotion or Eucerin® Original Lotion.

3. Wash or change sheets and pillow cases each day for 5 days during Bactroban® ointment application and Hibiclens® bathing. This reduces re-exposure to MRSA on skin cells which are shed while asleep.

4. Do not use Hibiclens® soap and Bactroban® ointment for more than 5 days. Using both for too long can cause antibiotic resistance.

When should I decolonize?

• When I have an active skin infection with MRSA
• If I am instructed to do so before scheduled surgery
• If I am a family member of someone who has had more than 1 MRSA skin infection, and they are currently being treated for an MRSA skin infection. Sometimes MRSA can be passed back and forth between close contacts, even if the contacts do not have any signs of active infection.
• If I am experiencing recurrnet skin infections due to MRSA

What can be done to prevent MRSA skin infections?

After the infection is treated and the skin is healed, dilute bleach baths can lower the amount of bacteria living on the skin and decrease the chances of getting infected again.

• Mix 1/4 cup of regular strength bleach in a 1/4 full bath tub (or about 12 gal of water since a full bath tub contains 50 gal of water), and soak for 15 minutes twice a week. Rinse with clean water afterwards, pat dry, and apply creams/lotions to avoid skin irritation. Do not get your eyes or mouth near the dilute bleach water.

• Use dilute bleach baths for 3 months or so.

• If bleach baths dry or irritate the skin, use the bleach baths less frequently, or even stop their use.

• Bleach baths can be done on a regular basis, since bacteria have not developed resistance to bleach.

What if I am pregnant?

Hibiclens® bathing and bleach baths should not pose a problem but let your OBGYN physician or provider know before you do this.

Is there anything I can do around my house to prevent MRSA infections?

Clean high touch surfaces with an antibacterial wipe. These include:

• light switches
• door knobs
• toilet seats
• faucet handles, and
• bath tubs.

Clean the bathtub after use by someone with MRSA infection to lower the chance that the next person gets MRSA.

Do NOT share personal items that touch the skin. These include bath and hand towels and razors.

Make sure that any clothing that touches the skin is machine washed and dried daily. Do NOT put back on that favorite pair of jeans lying on the floor! Wash items in the hottest water possible and dry in a hot dryer. Use bleach in the wash cycle if possible.

Do the instructions apply to methicillin-sensitive Staph aureus decolonization?

 Yes, especially if skin infections with methicillin sensitive Staph aureus occur repeatedly.

1. Hibiclens bathing and Bactroban ointment can be used in preparation for surgery even if you do not have a history of MRSA infection or colonization. Discuss this with your surgeon.

Questions?

This information is not specific to your child, but provides general information. If you have questions, please call the clinic.

Reviewed 11/2022

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