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Universal Screening for MRSA in Hospitals Made Little Difference
Date:3/11/2008

nvasive MRSA infections in the United States in 2005. More than 4 million individuals in the United States may be carriers of the pathogen, and as many as 1.2 million U.S. hospital patients may be infected each year with MRSA.

Although medical experts and policymakers have called for universal screening at hospitals, no trial has looked into the matter.

This study, conducted between July 2004 and May 2006, involved 21,754 surgical patients at a Swiss teaching hospital. Researchers compared two control strategies for MRSA: rapid screening upon hospital admission plus standard infection control measures versus standard infection control measures only.

Patients on 12 surgical wards with different specialties were assigned to one group for nine months then switched to the other for another nine months.

The rate of surgical-site infections and hospital-acquired infections did not differ drastically between the two groups. The authors estimated that 30 patients would have to be screened at admission to detect one previously unidentified MRSA carrier.

One future option might be to target screening to surgical patients undergoing elective procedures with a higher risk of MRSA infection, the authors stated.

The study raises another important issue about the distinction between community-acquired and hospital-acquired infection, and whether universal screening might be more effective in the future.

"If you do screening on admission in the future, will it start to make a difference to MRSA transmission in the medical setting if the distinction continues to break down?" asked Philip Alcabes, an associate professor of urban public health at Hunter College School of Health Sciences in New York City. "That remains a question worth asking."

And existing procedures are nothing to scoff at in terms of effectiveness. "Standard infection control procedures do seem to work," said Alcabes. "It's a good idea,
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