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Infection Control - MRSA Policy (Methicillian Resistant Staphylococcus Aureus) Introduction Normally MRSA does not present a risk for patients in non surgical hospitals. CDNZ (Communicable Disease New Zealand) guidelines (Jan 1992) state, case-control studies have found no significant difference between types of infections and case fatality rates resulting from MRSA compared to Methicillian Sensitive Staphylococcus Aureus. The organism Staphylococcus Aureus is a Gram-positive coccus present in the normal flora of the nose in 30% of individuals, and of the perineum in 15%. It can be transiently carried on the hands and survives well in the environment on skin scales and in the dust. Staphylococcus Aureus can cause boils and abscesses on healthy people and, after Gram-negative organisms, is the most common cause of wound infections. Newly appointed staff Staff who have worked in any overseas hospital within the previous six months or in an NZ hospital department with an MRSA outbreak within the previous six months should have an MRSA screen before starting employment. A MRSA swab screen consists of: One nasal swab (used to swab both anterior nares); Swabs from any sites of possible infection such as skin lesions venous access sites etc. Hand washing with antiseptic hand wash (Chlorohexidine) on commencement of duties and prior to any invasive procedures with careful drying of hands afterwards; The use of gloves for any client contact for personal cares, bed linen and toilet equipment; Protection must be applied to any open wounds or cuts on hands at all times; Regular dusting of rooms and vacuuming; Thorough hand washing again on completion of shift; It is important to note that good skincare practise includes the application of hand cream regularly. Management of clients found positive for MRSA 1. Hand washing is the most important procedure in controlling the spread of the organism. 2. Body substance isolation procedure should help to control spread, in a non surgical hospital or rest home. 3. Patients at risk include those with: Bed sores, varicose ulcers or immune deficiency states. Infection Control - MRSA Policy (Methicillian Resistant Staphylococcus Aureus) A client who is known to be MRSA positive and has a colonised wound should always be nursed until cleared by three negative swabs, each taken at least 48 hours apart. Treatment CDNZ states that the following regimen has been successful in the treatment of nasal carriage, carriage on unbroken skin, or carriage in small lesions: 1. Application of mupirocin (Bactroban to the anterior nares and infected/colonised areas (e.g. perineum) three 2. Use of antiseptic washes for all washing of skin and bathing. 3. Washing hair twice weekly in an antiseptic wash. Use of this regimen for 5 days should be considered for patients with uncomplicated carriage of MRSA. Transfer of patients If a known MRSA positive patient is transferred to a hospital or health care facility (e.g. X-ray or physiotherapy) then the receiving facility must be informed in writing that the client is MRSA positive. ________________________________________________ This policy statement is not exhaustive and will be reviewed annually.


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Protective role of nitric oxide in indomethacin-induced gastric ulceration by a mechanism independent of gastric acid secretion

Pharmacological Research, Vol. 43, No. 5, 2001 doi:10.1006/phrs.2001.0801, available online at on PROTECTIVE ROLE OF NITRIC OXIDE IN INDOMETHACIN-INDUCED GASTRIC ULCERATION BY A MECHANISM INDEPENDENT OF GASTRIC ACID SECRETION MAHMOUD M. KHATTABa, MOHAMED Z. GADb,∗ and DALAAL ABDALLAHa aPharmacology Department, Faculty of Pharmacy, Cairo University, Egypt, bB

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