March 12, 2008

Screening Not Effective at Reducing Staph Infections

A new Swiss study has found that screening patients upon hospital admission does not reduce hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections.

Dr. Stephan Harbarth and colleagues at the University of Geneva performed a study evaluating the effect of a MRSA early detection program. They compared infection rates during an intervention period during which patients were screened at hospital admission to those in a control period during which patients did not receive admission screening. The study involved 21,754 surgical patients at a Swiss teaching hospital.

During the intervention period, a total of 93 patients developed hospital-acquired MRSA during their stay, equivalent to 1.11 per 1,000 patient days. However, only 76 patients developed the infection during the control period when admission screening was not conducted, equivalent to 0.91 per 1,000 patient days.

The admission screening identified 515 MRSA-positive patients, who were then isolated and treated for their infections.

The researchers concluded there was no significant difference between the number of patients acquiring MRSA infections during their hospital stay whether admission screening was performed or not.

Lead researcher Stephan Harbarth said, "The trial did not show an added benefit for widespread rapid screening on admission compared with standard MRSA control alone.

"To increase effectiveness, MRSA screening could be targeted to surgical patients who undergo elective procedures with a high-risk of MRSA infection."

In the UK, the government said admission screening is being phased-in but is only part of its anti-infection plans, according to a BBC News report. Other measures include deep cleaning of hospital facilities and hiring extra infection control personnel.

Professor Mark Enright, a leading MRSA expert from London's Imperial College, told BBC News that England had higher infection rates than Switzerland, which could make screening a little more effective.

But he added, "In my view the government would be better targeting the screening. The contamination of the hospital environment is more of a cause of infections than patients coming into hospital with it."

A Department of Health spokesman told BBC News, "MRSA screening is one part of a range of measures needed to ensure good hygiene and to drive down infection rates.


Photo Caption: This 2005 scanning electron micrograph (SEM) depicted numerous clumps of methicillin-resistant Staphylococcus aureus bacteria, commonly referred to by the acronym, MRSA; Magnified 4780x. (CDC)


On the Net:

University of Geneva

The study was reported in the journal of the American Medical Association. A summary can be viewed here.

Department of Health

Journal of the American Medical Association

Methicillin-resistant Staphylococcus aureus (MRSA) - Wikipedia