80% are MRSA??? that much?
or 80% are staphylococcus, some of which MRSA? unless it is in somebody 
working in a hospital or with other co-morbidities which mean taking a lot of 
antibiotics, i can't figure out how 80% of wound cultures are MRSA...

staphylo is a pretty common agent of skin infection, but it doesn't need any 
type of agressive therapy. i would reccomend alcohol in a very small cotton 
pad many times a day, or otherwise water saturated with salt (common salt) 
also in a cotton pad.
alcohol is safe for the baby as long as she let's it evaporate well. and anyway 
it is away from the areola.

it is very controversial to culture wounds. if you take a swab from a wound 
you mainly find colonizing agents. you have to make a culture with more 
invasive procedures to have the agent. for the normal healthy person most of 
the times it is not necessary.

maybe you have more MRSA in america because there is a lot more use of 
antibiotic ointments then in europe, that i know... as we are at the subject, 
one shouldn't use antibiotic ointments, they just promote resistance to 
antibiotics and many times are involved in skin allergic reactions. better to use 
antispetics like alcohol, salty water or other things (chlorhexidine and such).

in your patient with mrsa in wound, if it was really healing too slowly, 
mupirocin ointment should help. but most of the times an antispetic is more 
then enough.

hope i could help.
m. pina, MD

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