IngentaConnect Impact of rapid molecular screening for meticillin-resistant Stap...

Authors: Keshtgar, M. R. S.; Khalili, A.; Coen, P. G.; Carder, C.; Macrae, B.; Jeanes, A.; Folan, P.; Baker, D.; Wren, M.; Wilson, A. P. R.

Source: British Journal of Surgery, Volume 95, Number 3, March 2008 , pp. 381-386(6)

Publisher: John Wiley & Sons, Ltd.

Abstract:

Background:

This study aimed to establish the feasibility and cost-effectiveness of rapid molecular screening for hospital-acquired meticillin-resistant Staphylococcus aureus (MRSA) in surgical patients within a teaching hospital.

Methods:

In 2006, nasal swabs were obtained before surgery from all patients undergoing elective and emergency procedures, and screened for MRSA using a rapid molecular technique. MRSA-positive patients were started on suppression therapy of mupirocin nasal ointment (2 per cent) and undiluted chlorhexidine gluconate bodywash.

Results:

A total of 18 810 samples were processed, of which 850 (4·5 per cent) were MRSA positive. In comparison to the annual mean for the preceding 6 years, MRSA bacteraemia fell by 38·5 per cent (P < 0·001), and MRSA wound isolates fell by 12·7 per cent (P = 0·031). The reduction in MRSA bacteraemia and wound infection was equivalent to a saving of 3·78 beds per year (£276 220), compared with the annual mean for the preceding 6 years. The cost of screening was £302 500, making a net loss of £26 280. Compared with 2005, however, there was a net saving of £545 486.

Conclusion:

Rapid MRSA screening of all surgical admissions resulted in a significant reduction in staphylococcal bacteraemia during the screening period, although a causal link cannot be established. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Impact of rapid molecular screening for meticillin-resistant Staphylococcus aureus in surgical wards