Protocol for CRA MRSA Screening
National Rollout in Scotland.
The logistics of MRSA screening
and prophylaxis can become complicated with patients who need to travel to a (sometimes distant) center days ahead of surgery, especially if culture-based methods are used to detect MRSA.
The average cost per patient for the MRSA screening
was US$11 (SD, 0), and the average cost per patient for the hand-made povidone-iodine nasal swabs was US$1 (SD, 0; Table 3).
Some tests may also be carried out such as MRSA screening
and blood tests.
As with many infections, this success can be attributed to a number of clinical measures - namely cannula packs, the meticulous care of invasive devices, MRSA Screening
(both admission and pre-admission screening) and appropriate and timely decolonisation of patients found to be MRSA positive."
Considering recommendations to move from universal to targeted MRSA screening
in hospitals in England (6), more active surveillance of any identified case-patients or carriers of MRSA in the community may be warranted.
Isolation of SA, MRSA screening
and anti-microbial susceptibility profile were done in the Pathology Department of the hospital according to Centre for Disease Control (CDC) guidelines.14 Samples were inoculated onto Mannitol-Salt Agar, followed by identification of SA by gram staining and biochemical tests such as catalase, coagulase and deoxyribonuclease (DNase).
Table 1: Organisms isolated in MRSA screening
of PG students Pre Exposed (28) Exposed (28) Organisms [June 2014] [Jan 2015] MRSA -- 09 MSSA 02 04 CONS -- 01 ASBs 06 05 Klebsiella sps 07 03 Citrobacter sps 01 -- Proteus sps -- 01 Escherichia coli 01 -- No growth 11 05 Table 2: Prevalence of S.
* Group 1: MRSA screening
followed by isolation of colonized patients
The differences between the US and Western Europe regarding the implementation of ASC can be explained by different determinants, including (1) public health considerations and priorities, (2) availability of on-site microbiology laboratories, (3) factors related to healthcare systems and the influence of the market-driven healthcare industry, (4) cultural factors (e.g., proactive prevention vs reactive control measures), (5) local infection control practices and knowledge, (6) available resources dedicated to hospital hygiene, (7) legal constraints (e.g., mandatory MRSA screening
in England), and (8) political commitment.
To date, current New Zealand MRSA screening
programmes do not include throat swabs as specimen of choice.
In addition, several states have passed or are considering legislation mandating the implementation of MRSA screening
programs to reduce the risk to patients.