MRSA Screening Did Not Reduce Infections

Image: Alicia Cole, hospital infection victim, Courtesy, Alicia Cole

A new study in the Journal of the American Medical Association (JAMA) surprised researchers looking to reduce the rash of drug-resistant hospital infections that are an emerging public health concern.

The leading theory was that if you test patients who are positive for MRSA (methicillin-resistant staphylococcus aureus) and treat and then isolate them you can prevent the staph bacteria’s spread.

But in this study of a Swiss hospital, widespread screening of patients for MRSA did nothing to reduce the number of infections patients acquired in the hospital.  

In the study, more than 10,000 surgery patients admitted to a hospital in Geneva between October 2004 and May 2006 were screened for MRSA.  A control group of more than 10,000 were not screened before being admitted to the hospital.

The patients who tested positive were isolated, given antibiotics and scrubbed with disinfectants which would normally be thought to reduce the transmission of MRSA.

Approximately 93 patients acquired MRSA in the group of patients that was screened while 76 cases occurred in the control group.

"It wasn't what we expected. We were very surprised," said lead author Dr. Stephan Harbarth in a telephone interview Tuesday afternoon with the Chicago Tribune.

But critics of the study say it’s flawed. It didn’t take into account patients who had previously had surgery and were admitted patients who may have been carriers of the infection.

Last October a report found that about 19,000 people a year die from the common staph infection that has now acquired resistance to the drug most commonly used to kill it.   The question this study leaves unanswered is how to control the epidemic of MRSA which kills more people a year than AIDS.

Last year, Los Angeles area actress Alicia Cole went into the hospital for a simple procedure and nearly lost her life when a hospital acquired infection invaded her organs.

She is still recovering and her web site speaks to casting directors with hope they will be able to hire her soon.

Cole developed Necrotizing Fascitis which like Methicillin-resistant Staphylococcus aureus (MRSA), is a form of hospital acquired infection that is difficult to contain with antibiotics.

NF can be caused by Staph or more commonly the group A Streptococcal (GAS) bacterium, which also causes strep throat. It is a particularly aggressive bacterial infection that can rapidly spread through the blood destroying skin, fat and tissues and eventually can shut down the organs.

Last year Illinois became the first state to require that all at-risk patients entering a hospital be tested for MRSA.  So far pre-screening has cut MRSA infection rates in half. At Loyola University Medical Center, infections rates are down by 62 percent.

The cost-effectiveness of that procedure is now under scrutiny while lawmakers in California, New York, Maryland and Washington D.C. are  considering making pre-screening for MRSA a hospital requirement  along with reporting the infection rates.

Pennsylvania, Tennessee, New Jersey and Illinois have laws on the books to require screening. #