Screening for meticillin-resistant Staphylococcus aureus (MRSA) colonisation among patients admitted to hospitals in England is to become more focused.
Currently MRSA screening is mandatory for all admissions. However, new guidance from the expert Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI), published by the Department of Health (DH) on 18 August 2014, recommends that only two types of patients will be screened from now on:
- Those admitted to high-risk specialty units (defined in the guidance as vascular, renal, dialysis, neurosurgery, cardiothoracic surgery, haematology, bone marrow transplant, orthopaedics and trauma departments, as well as all intensive care units);
- Those previously identified as having been colonised or infected with MRSA.
The new guidance has been produced in the light of the NOW study (National One Week Prevalence Audit of MRSA Screening), which found that compliance with the mandatory screening process was poor (61%) and that the prevalence of MRSA among new admissions was low (1.5%). Researchers therefore looked at a number of different screening strategies and concluded that the simplest and most cost-effective one was to target high-risk specialty patients, among whom the risks from MRSA infection are greatest.
For the strategy to be effective, the guidance adds: “Trusts should make every effort to ensure very high levels of screening in the patient groups identified.”