Hospital MRSA Testing Helps After All?

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Updated: 9/17 2:17 pm

March 17, 2008 -- For the second time in a week, researchers are debating whether all hospital patients should be screened for MRSA.

MRSA (methicillin-resistant Staphylococcus aureus) is on the rise, including in hospitals.

Last week, researchers reported that preadmission MRSA tests for some 10,000 surgery patients didn't slow MRSA's spread in a Swiss hospital. That study appeared in The Journal of the American Medical Association's March 12 edition.

But now, a new study shows a 70% drop in MRSA's in-hospital spread in three Illinois hospitals that gave MRSA tests to all patients upon hospital admission. The tests checked for the presence of MRSA bacteria, even in people with no signs of MRSA illness.

In the Illinois study -- and in the earlier Swiss study-- preadmission MRSA tests weren't used to keep anyone out of the hospital. Patients got the hospital care they needed, regardless of MRSA.

Before giving all patients an MRSA test, the Illinois researchers first gave MRSA tests only to intensive-care patients. That tactic yielded "disappointing results," write Evanston Northwestern Health Care's Ari Robicsek, MD, and colleagues.

But making preadmission MRSA screening standard for all patients -- and treating and taking precautions with MRSA cases -- cut MRSA's spread to other hospital patients.

The study is an "important step ... but it is just one step" toward curbing MRSA in hospitals, writes editorialist Ebbing Lautenbach, MD, MPH, MSCE, of the University of Pennsylvania's medical school.

"Unfortunately, the one-size-fits-all approach is probably not sensible for MRSA screening," Lautenbach says. He says that each hospital may need to design its own MRSA strategy.

Robicsek's study and Lautenbach's editorial appear in the March 18 edition of the Annals of Internal Medicine.

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