BMJ Best Practice: MRSA

Extract from BMJ Best Practice

“This month’s topic is MRSA, one of BMJ BP’s most recently updated topics and an important cause of infection in both healthy people in the community and in people in healthcare facilities.

The prevalence of MRSA infection is increasing globally. MRSA is an important cause of infection in both healthy people in the community and in healthcare institutions, but the two presentations and therapies differ.

Children and younger adults are more commonly afflicted with community-acquired MRSA, while hospital-acquired MRSA is more common in older age groups. It is also important to distinguish MRSA colonisation from infection.

Read the brief summary of MRSA below and click the links to refresh your knowledge of its prevention, diagnosis, and treatment.

You can also review the available evidence on MRSA and find further reading here.


NICE Evidence in focus: Clostridium Difficile

These articles are available to view through NICE Evidence at and will require your Athens details.   Full-text articles may be ordered through our inter-library loan service.  Please contact us on 01625 661362 or email with your request.  

Understanding factors that impact on public and patient’s risk perceptions and responses toward Clostridium difficile and other health care-associated infections: A structured literature review.

Author(s) Burnett, Emma, Johnston, Bridget, Kearney, Nora, Corlett, Joanne, MacGillivray, Stephen
Citation: American Journal of Infection Control, 01 June 2013, vol./is. 41/6(542-548), 01966553
Publication Date: 01 June 2013
Source: CINAHL
Mortality in Clostridium difficile infection: a prospective analysis of risk predictors.

Author(s) Bloomfield, Maxim G, Carmichael, Andrew J, Gkrania-Klotsas, Effrossyni
Citation: European Journal of Gastroenterology & Hepatology, 01 June 2013, vol./is. 25/6(700-705), 0954691X
Publication Date: 01 June 2013
Source: CINAHL
The combined use of proton pump inhibitors and antibiotics as risk factors for Clostridium difficile infection.

Author(s) Kassavin, Daniel S., Pham, David, Pascarella, Linda, Yen-Hong, Kuo, Goldfarb, Michael A.
Citation: Healthcare Infection, 01 June 2013, vol./is. 18/2(76-79), 18355617
Publication Date: 01 June 2013
Source: CINAHL
Has Improved Hand Hygiene Compliance Reduced the Risk of Hospital-Acquired Infections among Hospitalized Patients in Ontario? Analysis of Publicly Reported Patient Safety Data from 2008 to 2011.

Author(s) DiDiodato, Giulio
Citation: Infection Control & Hospital Epidemiology, 01 June 2013, vol./is. 34/6(605-610), 0899823X
Publication Date: 01 June 2013
Source: CINAHL
Clostridium difficile Infection in Children.

Author(s) Sammons, Julia Shaklee, Toltzis, Philip, Zaoutis, Theoklis E
Citation: JAMA Pediatrics, 01 June 2013, vol./is. 167/6(567-573), 21686203
Publication Date: 01 June 2013
Source: CINAHL

‘Clean your hands’ study

British Medical Journal (BMJ)

Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene

This study evaluates the impact of the ‘Clean your hands’ campaign on rates of hospital procurement of alcohol hand rub and soap; reports trends in selected healthcare associated infections; and investigates the association between infections and procurement.

Hand hygiene campaign slashes hospital infection rates

Hand hygiene campaign slashes hospital infection rates

Extract from OnMedica – ‎50 minutes ago‎

A national hand hygiene campaign designed to reduce healthcare associated infections in hospitals across England and Wales has been highly successful, concludes a study published online today by the BMJ.

The CleanYourHands campaign has played an important role in almost halving rates of MRSA and C difficile infections between 2005 and 2009 and was the first such campaign in the world to be rolled out nationally.

The government campaign was rolled out from January 2005 to all acute NHS trusts in England and Wales following concern over high levels of infections and low levels of hand hygiene in hospitals.

NICE: Update Infection Control guideline

Infection: prevention and control of healthcare-associated infections in primary and community care

Clinical guidelines, CG139 – Issued: March 2012

 This clinical guideline (published March 2012) updates and replaces NICE clinical guideline 2 (published June 2003). It offers evidence-based advice on the prevention and control of healthcare-associated infections in primary and community care. New and updated recommendations address areas in which clinical practice for preventing healthcare-associated infections in primary and community care has changed, where the risk of healthcare-associated infections is greatest, and where the evidence has changed.

Infection prevention and control by e-learning aids medical students: publication in process

J Hosp Infect. 2011 Dec;79(4):368-70. Epub 2011 Sep 25.

Use of e-learning to enhance medical students’ understanding and knowledge of healthcare associated infection prevention and control.


Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland.


An online infection prevention and control programme for medical students was developed and assessed. There was a statistically significant improvement (P<0.0001) in the knowledge base among 517 students after completing two modules. The majority of students who completed the evaluation were positive about the learning experience.

Copyright © 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

[PubMed – in process]

News from NHS Networks: Infection management

New guidelines for the management of norovirus outbreaks in acute and community settings have been released.
 Norovirus image
An evaluation report on a new laundry system using ozone disinfection is available to help reduce healthcare associated infections. Ozone disinfection properties are well recognised and documented but its use for laundry is relatively new.

News from The Kings Fund: 29 November

Extract from The Kings Fund 29 November

NHS Confederation

Guidelines for the management of norovirus outbreaks in acute and community health and social care settings This guidance gives recommendations on the management of outbreaks of vomiting and/or diarrhoea in hospitals and community health and social care settings, including nursing and residential homes.

Royal College of Nursing (RCN)
Sharps safety: RCN guidance to support implementation of the EU Directive 2010/32/EU on the prevention of sharps injuries in the health care sectorThis guidance covers the law on sharps injuries, including the European Directive 2010/32/EU and its underlying principles as well as its requirements on health care providers. It includes information on preparing an organisation, introducing risk assessments, selecting and evaluating safety-engineered devices and what employers should be doing to comply with the directive. It also includes a checklist to help safety representatives assess organisational and ward/departmental level compliance with the directive.

Making the business case for ward sisters/team leaders to be supervisory to practice This guidance has been developed to help nurse leaders make the business case for ward sisters and team leaders to take up a supervisory role. It looks at the evidence nurse leaders need to complete the business case and is underpinned by the RCN definition of supervisory practice. It contains helpful and practical steps for making an effective case to ensure ward sisters and team leaders have dedicated time for improving the quality of care experienced by service users and patients.