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Updated: Aug 17, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
An investigation of MRSA infection in a hospice
Simone Ali1, Nigel Sykes, Petra Flock
1St Christopher's Hospice, London. simone.ali1@southdowns.nhs.uk
Abstract:
This study investigated the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage and infection among patients admitted to a hospice. Under the existing policy at this hospice, only patients admitted from hospital wards where MRSA is known to be present are screened for MRSA prior to transfer. Hence the investigators were keen to study patients transferred from settings other than this. One hundred and twenty patients, all either from the community or from hospital wards without known MRSA, were entered into the study ('study group') and were swabbed for MRSA on admission to the hospice. Swabbing was continued at weekly intervals until discharge or death. Of the 120 patients, seven (5.8%) were MRSA positive on admission. A further four patients who were negative on admission showed MRSA on later swabs. Another two patients developed symptomatic infections during admission that were proven to be due to MRSA, but neither of these had shown MRSA on any swabs taken during the study. During the study period, a separate group of 156 patients was swabbed routinely before transfer from hospital wards where MRSA was known to be present in accordance with hospice policy ('non-study group'). Of these patients, 11 (7.1%) were found to be colonized with MRSA but none developed associated symptomatic infection. It appears that the risk of symptomatic infection with MRSA in hospice patients is low, and the burden placed on this vulnerable group by conventional eradication regimes may be disproportionate to any benefit derived.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) carriage is present in hospice patients, but symptomatic infections are rare. Current screening policies may not be cost-effective for this vulnerable population.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Geriatric Medicine
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant healthcare challenge.
- Hospice patients represent a vulnerable population with unique infection risks.
- Current MRSA screening policies in hospices primarily target high-risk transfers.
Purpose of the Study:
- To determine the prevalence of MRSA carriage and infection in hospice patients admitted from lower-risk settings.
- To evaluate the effectiveness of existing MRSA screening protocols in a hospice environment.
- To assess the risk-benefit ratio of MRSA eradication therapies in hospice care.
Main Methods:
- Prospective study of 120 hospice patients admitted from the community or low-risk hospital wards.
- MRSA screening via swabbing on admission and weekly intervals.
- Comparison with a control group of 156 patients transferred from known MRSA-positive hospital wards.
Main Results:
- On admission, 5.8% of the study group (low-risk admissions) were MRSA positive.
- An additional 3.3% (4/120) of the study group developed MRSA colonization during their stay.
- Two patients developed symptomatic MRSA infections, though not detected by swabs.
- In the control group (high-risk admissions), 7.1% (11/156) were MRSA positive on admission with no symptomatic infections.
Conclusions:
- The incidence of symptomatic MRSA infection in hospice patients appears low.
- Current MRSA screening and eradication protocols may impose a disproportionate burden on hospice patients.
- Further research is needed to optimize MRSA management strategies in palliative care settings.
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