Hospitals vs. MRSA: Pros and cons of screening all patients

Should hospitals screen all inpatients for the potentially deadly methicillin-resistant Staphylococcus aureus (MRSA) superbug?

Some infection control advocates say yes, pointing to the success of Veterans Affairs medical centers in controlling MRSA infections.

Others argue that there are less costly ways to prevent the spread of the bacteria, which is resistant to antibiotics and often causes life-threatening bloodstream infections, pneumonia and surgical site infections.

But it's hard to ignore the results of the VA's national MRSA Prevention Initiative. Prior to 2007, infection rates for MRSA at the Louisville (Ky.) VA Medical Center were 20 times higher than they are today, according to the Louisville Courier-Journal. But since the VA started screening every patient for MRSA, infection rates at the facility dropped to 0.09 infections per 1,000 bed days of care, compared with 1.89 infections per 1,000 in 2008.

"All hospitals should be doing this," Lisa McGiffert, director of the Safe Patient Project at Consumers Union, a national consumer protection organization, told the Courier-Journal. 

In addition to the screenings, the VA initiative calls for clinicians to wear gowns and gloves when caring for patients colonized or infected with MRSA; follow hand-hygiene guidelines; create an institutional culture change focusing on individual responsibility for infection; and establish an MRSA prevention coordinator at each medical center.

But many hospital officials interviewed by the Courier-Journal said they don't see the need to conduct widespread screening due to the cost (estimated at $55 per screening) and the fact that other infection-control methods, such as proper handwashing and wearing gowns and gloves, are as effective.

The call for routine screenings isn't the only controversial recommendation to control MRSA. Last month a report in Infection Control and Hospital Epidemiology urged hospitals to encourage doctors to adopt a new dress code. Researchers recommend that doctors avoid wearing long sleeves, wrist watches, neck ties and jewelry, and wash their white coats at least once a week in hot water and bleach.

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