MRSA screening 'not worthwhile' for surgical patients
MRSA screening is not worthwhile for surgical patients, study suggests
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Wednesday, 12, Mar 2008 12:01
Screening all surgical patients for MRSA is not worthwhile to reduce the rate of hospital-acquired infections (HCAIs), new research suggests.
People who carry MRSA place other patients at risk of infection and early identification of the infection is seen as an important measure to control its spread.
In the UK some hospitals now test everyone who is being admitted to see if they have MRSA bacteria on their body and the government plans to introduce MRSA screening for all elective admissions by March 2009.
But a study published today in the Journal of the American Medical Association (JAMA) says this may not be effective at reducing MRSA-spread among surgical patients.
Researchers from the University of Geneva Hospitals and Medical School evaluated the effect of an early MRSA detection strategy on MRSA infections acquired in a hospital among 21,754 surgical patients at a Swiss teaching hospital.
Two MRSA control strategies were put in place: rapid screening on admission plus standard infection control measures; and standard infection control alone.
Twelve surgical wards including different surgical specialties were assigned one of the strategies for nine months before swapping to the other strategy for nine months.
During the intervention periods a total of 515 MRSA-positive patients were identified among the screened patients.
The researchers estimate that to detect one previously unidentified MRSA carrier on admission, 30 patients would have to be screened.
A total of 93 patients developed MRSA infection in the intervention periods compared with 76 patients in the control periods.
The rate of MRSA surgical site infection and MRSA acquisition did not change significantly.
Fifty-three of 93 infected patients in the intervention wards were MRSA-free on admission and developed MRSA infection during hospitalisation.
"Overall, our real-life trial did not show an added benefit for widespread rapid screening on admission compared with standard MRSA control alone in preventing nosocomial [hospital acquired] MRSA infections in a large surgical department," the researchers conclude.
They suggest that effectiveness could be increased if MRSA screening is targeted to surgical patients who undergo elective procedures with a high risk of MRSA infection.
"Finally, we suggest that surgical services and infection control teams should carefully assess their local MRSA epidemiology and patient profiles before introducing a universal screening policy," the researchers conclude.