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Risk Prevention > Research and Science > Early screening for MRSA does not protect against nosocomial infections

Early screening for MRSA does not protect against nosocomial infections

Experts advise screening patients for MRSA (Methicillin-resistant Staphylococcus aureus) carriage before or on admission to inpatient treatment. This allows to implement strict hygiene measures for the control of MRSA at an early stage in order to minimise the risk of transmission. According to a study recently published by the University of Geneva (JAMA 2008, 299 (10): 1149-1157) universal screening at hospital admission does not seem to reduce the rate of hospital-acquired infections in surgical patients.

Preventive measures reduce nosocomial infections

Within the hospitals of the University of Geneva, the researchers chose twelve wards with various surgical specialties to enroll in the study. Each ward was assigned to either the control or intervention group for a 9-month period. The groups then switched for a subsequent 9-month period.  All in all, 20,000 surgical patients were studied by the researchers. One half of the patients (control group) received standard infection control measures, whereas the other half underwent an additional DNA test  for rapid, early detection of MRSA upon or before admission to a surgical ward. After conclusion of the study, the authors did not find a significant difference between the control and intervention groups in the rate of nosocomial MRSA infections developed. Of the 93 infected patients in the intervention wards, 53 did not have MRSA upon admission but developed MRSA during hospitalization.

According to the researchers, one cause of this is, that from the time of notification of test results to the date of surgery there is not enough time left to take adequate preventive measures. Therefore, they recommend to apply this test only to patients who intend to undergo an elective surgical intervention involving a high risk of acquiring a nosocomial infection. As there is enough time before planned surgery to carry out suitable preventive measures.

Other researchers are warning to focus attention only to MRSA when targeting control measures, as this pathogen causes only 8 % of hospital-acquired infections and neglect the infection risk caused by other pathogens (JAMA 2008, 299 (10): 1190-1192). Interventions that will protect patients against all kinds of hospital infections include intensive and multifaceted hand hygiene programs, bundled interventions to reduce central venous catheter-related bloodstream infections, and surgical site infections. These measures are simple and cost-effective and have the benefit of reducing all infections, including those due to MRSA.