Featured Research

from universities, journals, and other organizations

MRSA Screening At Hospital Admission Not Linked To Reduced Rates Of Infection In Surgical Patients

Date:
March 14, 2008
Source:
JAMA and Archives Journals
Summary:
New findings do not support the recommendation for universal screening on hospital admission for methicillin-resistant Staphylococcus aureus (MRSA) to reduce the rate of hospital-acquired infections in surgical patients.

New findings do not support the recommendation for universal screening on hospital admission for methicillin-resistant Staphylococcus aureus (MRSA) to reduce the rate of hospital-acquired infections in surgical patients.

Individuals who carry antimicrobial-resistant disease-producing agents such as MRSA places patients at high risk of infection. Early identification of patients with MRSA and subsequent prevention of patient-to-patient spread through infection control measures are believed to be important interventions to control MRSA. "Experts and policy makers, nationally and internationally, recommend universal admission screening as a means to control MRSA. However, no controlled trial has tested the hypothesis that rapid MRSA screening may improve patient outcome by decreasing MRSA cross-transmission and increasing the adequacy of pre-operative prophylaxis [disease prevention]," the authors write.

Stephan Harbarth, M.D., M.S., and colleagues with the University of Geneva Hospitals and Medical School, Geneva, Switzerland, conducted a study to evaluate the effect of a early MRSA detection strategy on MRSA infections acquired in a hospital (nosocomial ) among 21,754 surgical patients at a Swiss teaching hospital. There were two MRSA control strategies: rapid screening on admission plus standard infection control measures vs. standard infection control alone.

Twelve surgical wards including different surgical specialties were enrolled according to a pre-specified protocol, assigned to either the control (n = 10,910) or intervention (n = 10,844) group for a 9-month period, then switched to the other group for another 9 months. During the screening intervention periods, patients admitted to the intervention wards for more than 24 hours were screened before or on admission by a molecular technique for rapid, early detection of MRSA. Overall, 10,193 (94 percent) of the intervention group patients were screened with the rapid test during the intervention periods. Median (midpoint) time from admission screening to notification of test results was 22.5 hours.

Admission screening during the intervention periods identified a total of 515 MRSA-positive patients among the screened patients (5.1 percent). The majority of patients (n = 337 [65 percent]) had not been previously identified as MRSA carriers and would have been missed without systematic screening on admission. The authors estimate that to detect 1 previously unidentified MRSA carrier on admission, 30 patients would have to be screened.

A total of 93 patients (1.11 per 1,000 patient-days) developed nosocomial MRSA infection in the intervention periods compared with 76 patients (0.91 per 1,000 patient-days) in the control periods. The rate of MRSA surgical site infection and nosocomial MRSA acquisition did not change significantly. Fifty-three of 93 infected patients (57 percent) in the intervention wards were MRSA-free on admission and developed MRSA infection during hospitalization.

"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 MRSA infections in a large surgical department. To increase effectiveness, MRSA screening could be targeted to surgical patients who undergo elective procedures with a high risk of MRSA infection. In such cases, earlier identification would allow sufficient time for optimal preoperative handling, including preoperative decontamination and adjustment of surgical prophylaxis. 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 authors conclude.

Journal reference: JAMA. 2008;299[10]:1149-1157.

Editorial: Preventing MRSA Infections

In an accompanying editorial, Daniel J. Diekema, M.D., of the University of Iowa Carver College of Medicine and Iowa City Veterans Affairs Medical Center, Iowa City, and Michael Climo, M.D., of the Virginia Commonwealth University Medical Center and Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Va., write that more research is required regarding controlling MRSA infections.

"While awaiting more and better data, what should clinicians do to control MRSA in hospitals" The first part of a tiered approach should include careful assessment of MRSA within the local health care environment. Hospitals should first adhere to established infection control principles and pursue patient safety initiatives known to reduce morbidity and mortality from all health care--associated infectious pathogens. Despite the attention rightly focused on MRSA, this pathogen causes only 8 percent of hospital-acquired infections in the United States, according to the most recent data from the National Healthcare Safety Network."

"Interventions that will address those 8 percent plus the other 92 percent of hospital infections include intensive and multifaceted hand hygiene programs; 'bundled' interventions to reduce central venous catheter--related bloodstream infections, ventilator-associated pneumonia, and surgical site infections; and 'source control' in the form of chlorhexidine [an antiseptic] bathing of intensive care unit patients. These interventions are simple and cost-effective and have the benefit of reducing all infections, including those due to MRSA. If health care--associated infections can be reduced to near zero with bundled interventions, MRSA infection rates should fall concordantly."

Editorial reference: JAMA. 2008;299[10]:1190-1192.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Cite This Page:

JAMA and Archives Journals. "MRSA Screening At Hospital Admission Not Linked To Reduced Rates Of Infection In Surgical Patients." ScienceDaily. ScienceDaily, 14 March 2008. <www.sciencedaily.com/releases/2008/03/080311165926.htm>.
JAMA and Archives Journals. (2008, March 14). MRSA Screening At Hospital Admission Not Linked To Reduced Rates Of Infection In Surgical Patients. ScienceDaily. Retrieved September 2, 2014 from www.sciencedaily.com/releases/2008/03/080311165926.htm
JAMA and Archives Journals. "MRSA Screening At Hospital Admission Not Linked To Reduced Rates Of Infection In Surgical Patients." ScienceDaily. www.sciencedaily.com/releases/2008/03/080311165926.htm (accessed September 2, 2014).

Share This




More Health & Medicine News

Tuesday, September 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

Newsy (Sep. 2, 2014) The U.N. says the problem is two-fold — quarantine zones and travel restrictions are limiting the movement of both people and food. Video provided by Newsy
Powered by NewsLook.com
Get on Your Bike! London Cycling Popularity Soars Despite Danger

Get on Your Bike! London Cycling Popularity Soars Despite Danger

AFP (Sep. 1, 2014) Wedged between buses, lorries and cars, cycling in London isn't for the faint hearted. Nevertheless the number of people choosing to bike in the British capital has doubled over the past 15 years. Duration: 02:27 Video provided by AFP
Powered by NewsLook.com
Can You Train Your Brain To Eat Healthy?

Can You Train Your Brain To Eat Healthy?

Newsy (Sep. 1, 2014) New research says if you condition yourself to eat healthy foods, eventually you'll crave them instead of junk food. Video provided by Newsy
Powered by NewsLook.com
We've Got Mites Living In Our Faces And So Do You

We've Got Mites Living In Our Faces And So Do You

Newsy (Aug. 30, 2014) A new study suggests 100 percent of adult humans (those over 18 years of age) have Demodex mites living in their faces. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins