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Universal MRSA Screening May Not Be Best Course

  From "AMA Morning Rounds", March 12 2008

Study suggests MRSA screening at hospital admission may not curb infection rates.

Reuters (3/12, Stern) reports that testing "all incoming hospital patients for" methicillin-resistant Staphylococcus aureus (MRSA) "and isolating those infected did not curtail its spread, and proved costly," according to a study published in the Journal of the American Medical Association.

        Stephan Harbarth, M.D., and colleagues at the University of Geneva Hospitals in Switzerland "screened 10,193 surgery patients admitted to the University of Geneva Hospitals between October 2004 and May 2006," according to the Chicago Tribune (3/12, Graham). Approximately "10,000 surgery patients w[ere] admitted without the tests" in order to serve as a control group. The "patients who tested positive for the bacteria" were placed "in isolation, scrubbed...with disinfectants, and" received "special antibiotics."

        The researchers found, however, that "93 patients developed MRSA in the screening group -- 1.11 per 1,000 patient days -- compared to 76 -- 0.91 per 1,000 patient days -- in the control group," the BBC (3/12) adds.

        The researchers said that "[o]ne implication of the trial...is that early detection alone will not be enough to reduce hospital-acquired MRSA infections," added MedPage Today (3/11, Smith). In an accompanying editorial, Daniel Diekema, M.D., of the University of Iowa College of Medicine, and Michael Climo, M.D., of Virginia Commonwealth University, said that "the finding of this study calls into question the notion of active surveillance as a way to block MRSA infections." They wrote, "There exists no one-size-fits-all solution to the problem of MRSA prevention."

        According to HealthDay (3/11, Gardner), the study authors suggested that "[o]ne future option might be to target screening to surgical patients undergoing elective procedures with a higher risk of MRSA infection."

        Modern Healthcare (3/11, DerGurahian) adds that, according to the researchers, "[s]urgical services and infection-control teams should carefully assess their local MRSA epidemiology and patient profiles before introducing a universal screening policy." WebMD (3/11, Hitti) also covered the story.

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