Hardy, K. (Katherine), Price, Charlotte L, Szczepura, Ala, Gossain, Savita, Davies , Ruth, Stallard, Nigel, Shabir, Sahida, McMurray, Claire, Bradbury, Andrew and Hawkey, Peter M.. (2009) Reduction in the rate of methicillin-resistant Staphylococcus aureus acquisition in surgical wards by rapid screening for colonization : a prospective, cross-over study. Clinical Microbiology and Infection, Vol.16 (No.4). pp. 333-339. ISSN 1198-743X

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Abstract

Identification of patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) and subsequent isolation and decolonization is pivotal to the control of cross infection in hospitals. The aim of this study was to establish if early identification of colonized patients using rapid methods alone reduces transmission. A prospective, cluster, two-period cross-over design was used. Seven surgical wards at a large hospital were allocated to two groups, and for the first 8 months four wards used rapid MRSA screening and three wards used a standard culture method. The groups were reversed for the second 8 months. Regardless of the method of detection, all patients were screened for nasal carriage on admission and then every 4 days. MRSA control measures remained constant. Results were analysed using a log linear Poisson regression model. A total of 12 682/13 952 patient ward episodes (PWE) were included in the study. Admission screening identified 453 (3.6%) MRSA-positive patient ward episodes, with a further 268 (2.2%) acquiring MRSA. After adjusting for other variables, rapid screening was shown to statistically reduce MRSA acquisition, with patients being 1.49 times (p 0.007) more likely to acquire MRSA in wards where they were screened using the culture method. Screening of surgical patients using rapid testing resulted in a statistically significant reduction in MRSA acquisition. This result was achieved in a routine surgical service with high bed occupancy and low availability of isolation rooms, making it applicable to the majority of health-care systems worldwide.

Item Type:	Journal Article
Subjects:	R Medicine > RD Surgery Q Science > QR Microbiology R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Clinical Sciences Research Institute (CSRI) Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Social Sciences > Warwick Business School Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Staphylococcus aureus infections, Methicillin resistance -- Research, Drug resistance in microorganisms, Medical screening -- Research, Communicable diseases -- Prevention
Journal or Publication Title:	Clinical Microbiology and Infection
Publisher:	Wiley-Blackwell Publishing Ltd.
ISSN:	1198-743X
Date:	20 July 2009
Volume:	Vol.16
Number:	No.4
Number of Pages:	7
Page Range:	pp. 333-339
Identification Number:	10.1111/j.1469-0691.2009.02899.x
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Great Britain. Dept. of Health (DoH), Becton-Dickinson (B-D), Heart of England NHS Foundation Trust (HENHSFT)
Grant number:	0190014 (DoH)
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URI:	http://wrap.warwick.ac.uk/id/eprint/3222

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