NEW YORK, March 11 /PRNewswire-USNewswire/ -- A new study in the Journal of
the American Medical Association (JAMA) purports to show that screening for
MRSA (methicillin-resistant Staphylococus aureus), a simple skin or nasal
swab, is not effective in reducing MRSA hospital infections ("Universal
Screening for Methicillin-Resistant Staphylococcus aureus at Hospital
Admission and Nosocomial Infection in Surgical Patients," JAMA vol. 299, no.
10, March 12, 2008).
The findings of the authors will be seized upon by the Centers for Disease
Control and Prevention (CDC) and advocates of the do-nothing status quo. But
the study is seriously flawed -- rendering its findings meaningless.
Researchers used a 'rapid test,' but many patients were not tested until they
had already been in the hospital for twelve hours. Furthermore, the results
of the MRSA tests were not acted upon for another 221/2 hours on average.
Most patients had completed more than half of their hospital stay before their
results were known. Therefore, the precautions they needed -- isolation,
proper antibiotics, chlorhexidine baths -- were taken late or not at all.
Unbelievably, almost a third of surgical patients (31%) who tested positive
didn't get their test results until after their surgery. Therefore they too
didn't receive any of the precautions they needed. Some people carry MRSA
germs in their noses or on their skin without realizing it. The bacteria do
not cause infection unless they get inside the body -- usually via a catheter,
a ventilator, or an incision or other open wound.
No weekly MRSA testing was conducted, which is de rigour when conducting
universal screening to prevent patients colonized with MRSA from passing it on
to other patients in the hospital.
A previous study by the same lead author at the same location, The University
of Geneva Hospital, found that universal screening on admission with
preemptive contact precautions (the way it's supposed to be done) decreased
MRSA infections in the medical intensive care unit.
The study released today, says Betsy McCaughey, Chairman of the Committee to
Reduce Infection Deaths, "doesn't prove that MRSA screening is ineffective.
The study omits the precautions that are supposed to follow a MRSA positive
test result. It's like testing a recipe, but omitting half the ingredients or
test-driving a car without the tires."
Today's JAMA article provides false support for the CDC's persistent
do-nothing position on the dire problem of M.R.S.A. The CDC's lax guidelines
continue to give hospitals an excuse to do too little.
SOURCE Committee to Reduce Infection Deaths
Betsy McCaughey of Committee to Reduce Infection Deaths, +1-917-748-0227, or
+1-212-534-3047
