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MRSA surveillance was routinely done in Srinagarind hospital, a 713 bed university hospital since April 1993. There were 3 MRSA outbreaks during April 1993 to March 1994. The first outbreak occurred in Accidental and Emergency ward during October to November 1993 which 16 cases were involved . All of the patients were in the service of surgery. The second outbreak occurred in surgical ward. All 5 cases were in plastic surgery and burn team. The last outbreak was in the newborn unit, six infants were involved. The mortality rate of these outbreaks was six out of 27 cases. After outbreaks were identified, several interventions were used to control infection, such as patient isolation, emphasis on hand washing gloving , downing, growing and masking, prospective surveillance by sputum culture in patients who were on respirator and early discharging of MRSA cases. We also introduced identified to have nasal colonization with MRSA and 6 cases were successfully treated with topical mupirocin. All these outbreaks were under control by these combined control measures.
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