Infection control: MRSA decolonisation: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Infection control: MRSA decolonisation

Sample item

A patient scheduled for elective cardiac surgery has a nasal screening swab positive for MRSA. Which pre-operative measure is most appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Intranasal mupirocin with chlorhexidine body washes

The anterior nares are the main reservoir of Staphylococcus aureus, and decolonisation with intranasal mupirocin, often with chlorhexidine bathing, reduces surgical site infection. Appropriate perioperative prophylaxis also includes vancomycin for MRSA carriers. Oral vancomycin is not absorbed and does not act on the nares, and rifampicin alone rapidly selects resistance.

Option by option

  • A. Cancel the surgery permanently

    Carriage is manageable by decolonisation, so permanent cancellation is not necessary.

  • B. Oral vancomycin for five days

    Oral vancomycin is not absorbed and does not eradicate nasal carriage.

  • C. Intranasal mupirocin with chlorhexidine body washes (correct)

    Mupirocin to the nares with chlorhexidine bathing lowers carriage and surgical site infection risk.

  • D. Oral rifampicin as a single drug

    Rifampicin as a sole agent leads to rapid resistance.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is C, Intranasal mupirocin with chlorhexidine body washes. The anterior nares are the main reservoir of Staphylococcus aureus, and decolonisation with intranasal mupirocin, often with chlorhexidine bathing, reduces surgical site infection.

Why is "Cancel the surgery permanently" not the answer?

Carriage is manageable by decolonisation, so permanent cancellation is not necessary.

Why is "Oral vancomycin for five days" not the answer?

Oral vancomycin is not absorbed and does not eradicate nasal carriage.

Why is "Oral rifampicin as a single drug" not the answer?

Rifampicin as a sole agent leads to rapid resistance.

What concept does this question test?

It tests Infection control: MRSA decolonisation in Microbiology. Appropriate perioperative prophylaxis also includes vancomycin for MRSA carriers. Oral vancomycin is not absorbed and does not act on the nares, and rifampicin alone rapidly selects resistance.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infection control: MRSA decolonisation?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.