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Pre-Op MRSA Decolonisation — SCE Infectious Diseases MCQ

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EasyInfection Prevention & ControlPre-Op MRSA DecolonisationSCE Infectious Diseases

A 65-year-old man with known MRSA nasal colonisation is scheduled for elective hip replacement. MRSA decolonisation is planned. What is the standard pre-operative decolonisation protocol?

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Correct answer: A — Nasal Mupirocin 2% ointment TDS for 5 days PLUS Chlorhexidine 4% body wash (including hair) daily for 5 days — starting 5 days before surgery

Pre-operative MRSA decolonisation has been shown to significantly reduce MRSA surgical site infections. The standard protocol (NICE NG125) is: topical nasal Mupirocin 2% ointment TDS to both nostrils for 5 days PLUS Chlorhexidine 4% body wash (applied to all body areas including hair) daily for 5 days, both starting 5 days before the scheduled surgery. The surgical prophylactic antibiotic should also be adjusted to cover MRSA (e.g. adding IV Teicoplanin or Vancomycin at induction). Post-operative screening confirms decolonisation success.

Reference: NICE NG125 2020 – Surgical site infections; UKHSA 2024 – MRSA screening