Operation > Studier > Tidig screening för MRSA skyddar inte mot sjukhusinfektion

Tidig screening för MRSA skyddar inte mot sjukhusinfektion

Experter råder screening till patienter för MRSA (meticillinresistenta Staphylococcus aureus) före vård eller tillträde till slutenvårdbehandling. Detta gör det möjligt att genomföra stränga hygieniska åtgärder för kontroll av MRSA i ett tidigt skede för att minimera risken för överföring. Enligt en studie från universitetet i Genève (JAMA 2008, 299 (10): 1149-1157) tycks inte universal screening på sjukhus minska andelen av nosokomiala infektioner hos kirurgiska patienter.

Förebyggande åtgärder minskar sjukhusinfektioner.

Within the hospitals of the University of Geneva, the researchers chose twelve wards with various surgical specialties to enroll in the study. Each ward was assigned to either the control or intervention group for a 9-month period. The groups then switched for a subsequent 9-month period.  All in all, 20,000 surgical patients were studied by the researchers. One half of the patients (control group) received standard infection control measures, whereas the other half underwent an additional DNA test  for rapid, early detection of MRSA upon or before admission to a surgical ward. After conclusion of the study, the authors did not find a significant difference between the control and intervention groups in the rate of nosocomial MRSA infections developed. Of the 93 infected patients in the intervention wards, 53 did not have MRSA upon admission but developed MRSA during hospitalization.

According to the researchers, one cause of this is, that from the time of notification of test results to the date of surgery there is not enough time left to take adequate preventive measures. Therefore, they recommend to apply this test only to patients who intend to undergo an elective surgical intervention involving a high risk of acquiring a nosocomial infection. As there is enough time before planned surgery to carry out suitable preventive measures.

Other researchers are warning to focus attention only to MRSA when targeting control measures, as this pathogen causes only 8 % of hospital-acquired infections and neglect the infection risk caused by other pathogens (JAMA 2008, 299 (10): 1190-1192). Interventions that will protect patients against all kinds of hospital infections include intensive and multifaceted hand hygiene programs, bundled interventions to reduce central venous catheter-related bloodstream infections, and surgical site infections. These measures are simple and cost-effective and have the benefit of reducing all infections, including those due to MRSA.