The Veterans Health Administration hospital in Pittsburgh, Pennsylvania checks a nasal swab for MRSA. Patients that test positive for the bacteria are then placed in isolation for their stay. The hospital subsequently saw a reduction in the number of MRSA infections by fifty percent, going from one case per thousand days of patient care to one case per 2000 days. The belief is that if more hospitals follow suit, then overall the cases of MRSA infections will be fewer and easier to treat.
The hospitals that have started screening feel that it is a good safety initiative, and helps to improve the quality of patient care. These programs come at a time when the number of MRSA infections is on the rise. In 1974, only two percent of staph infections were MRSA. This number increased to 22% in 1995 and a whopping 63% in 2004. The CDC estimates that approximately 126,000 patients are infected each year, with about 5,000 of those resulting in death.
Besides the risk to patients, MRSA costs billions of extra dollars in health care costs each year. New, faster tests may make it easier to identify MRSA and take appropriate action when patients are admitted.
It is thought that many hospital infections could have been prevented. In the long run, this could mean that testing for MRSA could end up saving the hospitals money, as well as reduce lawsuits, by decreasing the number of infections.
However, not everyone feels that universal MRSA screening is the best answer to the problem. Those against universal screening feel that there is not enough evidence to prove that universal screening is sufficient to reduce the number of MRSA cases. They say that the research done so far has been in response to MRSA outbreak situations, instead of randomized, controlled trials. Government-funded randomized trials suggests that screening and contact precautions alone is not enough to lower the rate of infections.
Another concern with some doctors is that patients in isolation may not get the same attention from doctors and nurses because of fear of contagions. This can lead to other health problems from neglect, including risk of falls or pressure ulcers. Some patients may also suffer from mental health issues like depression or anxiety because of the isolation.
Others feel that the focus should be on proper hand washing and infection control procedures instead of merely screening and isolating patients. Even in isolation, there is no guarantee that staff will follow procedures every single time without the proper training, which will increase the risk of cross contamination between patients.
Further investigation of MRSA testing and its affects on the number of infections will have to be done in order to determine the most effective course towards preventing the disease.