Outbreaks of methicillin-resistant
Staphylococcus aureus (MRSA) show signs of resolving owing to strict infection control at hospitals recently. Nevertheless, some MRSA carriers and infected patients are detected. There are several reports about infants with MRSA infection at neonatal intensive care units, but very few about infants who are MRSA carriers.
We have examined the MRSA carrier status of all patients before admission since September 1991. There were 5 infants who were MRSA carriers among 55 patients with cleft lip or palate, or both, who were examined before primary surgery. All cases involved complete cleft lip and palate. Hotz type palatal plates were inserted in 4 patients, and 4 patients had previously visited or been admitted to other hospitals, but we could not determine the route of infection. After application of povidone iodine to the oro-nasal cavity and to the palatal plates, we did not detect MRSA in any patient. Although MRSA had disappeared from the oro-nasal area, it was redetected in some cases.
We conclude that:
1) Before admission, some infants are MRSA carriers.
2) Examinations for MRSA are necessary to protect infants against nosocomial infections.
3) Povidone iodine is effective for MRSA carriers.
4) A Hotz type palatal plate is useful for the povidone iodine treatment of patients with cleft lip and palate.
5) To control hospital-acquired infections, MRSA carriers should be managed in a single room, even if MRSA is not detected.
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