Journal article
MRSA admission screening in a low prevalence setting - much ado about nothing?
- Witteck A Department of Infectious Diseases, Cantonal Hospital St. Gallen, CH-9007 St. Gallen, Switzerland. andrea.witteck@kssg.ch
- Rettenmund G
- Schlegel M
- 2011-07-08
Published in:
- Swiss medical weekly. - 2011
Genotype
Humans
Mass Screening
Methicillin-Resistant Staphylococcus aureus
Patient Admission
Patient Isolation
Practice Guidelines as Topic
Prevalence
Prospective Studies
Risk Factors
Staphylococcal Infections
Switzerland
Time Factors
Wounds and Injuries
English
OBJECTIVE
To prospectively evaluate new guidelines for MRSA admission screening and pre-emptive isolation implemented in response to a doubling of newly diagnosed MRSA patients in 2007.
DESIGN
One-year surveillance (04/2008-03/2009).
SETTING
Patients admitted to the tertiary-care hospital in St. Gallen (700 beds) and 10 affiliated public hospitals (890 beds) in Eastern Switzerland (MRSA rate 2.5% in isolates).
PATIENTS
Except for known MRSA carriers, all patients who underwent admission screening in accordance with the guidelines and all MRSA patients newly detected by a clinical sample were included.
METHODS
Depending on epidemiological factors (stay in a foreign hospital, a Swiss hospital with known high MRSA prevalence, or a chronic care facility) and personal risk factors (wound, tracheostoma, urinary catheter, IVDU), patients were risk stratified into screening and isolation, only screening or no screening at all. MRSA admission screening included nasal, throat and axillary/inguinal swabs, supplemented by wound swabs, urine and respiratory secretion whenever appropriate (conventional culture).
RESULTS
A total of 6/161 (3.7%) MRSA admission screenings yielded positive results (number needed to screen: 27). 2/32 (6.3%) pre-emptively isolated patients were positive (number needed to isolate: 16). Only 6/27 (22.2%) newly diagnosed MRSA patients were detected by admission screening, and the remaining patients were detected by clinical sample during hospitalisation. A total of 80% of the MRSA positive patients had wounds. Swabs of axilla/inguina did not increase the sensitivity of the admission screening.
CONCLUSIONS
In the setting of low MRSA prevalence, admission screening of patients at high risk for MRSA carriage detected only one out of five newly diagnosed MRSA patients, emphasising the importance of standard precautions for the prevention of MRSA transmission.
To prospectively evaluate new guidelines for MRSA admission screening and pre-emptive isolation implemented in response to a doubling of newly diagnosed MRSA patients in 2007.
DESIGN
One-year surveillance (04/2008-03/2009).
SETTING
Patients admitted to the tertiary-care hospital in St. Gallen (700 beds) and 10 affiliated public hospitals (890 beds) in Eastern Switzerland (MRSA rate 2.5% in isolates).
PATIENTS
Except for known MRSA carriers, all patients who underwent admission screening in accordance with the guidelines and all MRSA patients newly detected by a clinical sample were included.
METHODS
Depending on epidemiological factors (stay in a foreign hospital, a Swiss hospital with known high MRSA prevalence, or a chronic care facility) and personal risk factors (wound, tracheostoma, urinary catheter, IVDU), patients were risk stratified into screening and isolation, only screening or no screening at all. MRSA admission screening included nasal, throat and axillary/inguinal swabs, supplemented by wound swabs, urine and respiratory secretion whenever appropriate (conventional culture).
RESULTS
A total of 6/161 (3.7%) MRSA admission screenings yielded positive results (number needed to screen: 27). 2/32 (6.3%) pre-emptively isolated patients were positive (number needed to isolate: 16). Only 6/27 (22.2%) newly diagnosed MRSA patients were detected by admission screening, and the remaining patients were detected by clinical sample during hospitalisation. A total of 80% of the MRSA positive patients had wounds. Swabs of axilla/inguina did not increase the sensitivity of the admission screening.
CONCLUSIONS
In the setting of low MRSA prevalence, admission screening of patients at high risk for MRSA carriage detected only one out of five newly diagnosed MRSA patients, emphasising the importance of standard precautions for the prevention of MRSA transmission.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.4414/smw.2011.13217
- PMID 21735366
- Persistent URL
- https://sonar.ch/global/documents/186423
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