The prevalence of methicillin resistant Staphylococus aureus in orthopaedics in a non-selective screening policy

The aim of this study was to assess the true incidence and prevalence of MRSA colonisation and infection in the elective and trauma orthopaedic population in Rotherham District General Hospital.

This prospective study non-selectively screened 690 consecutive trauma and elective orthopaedic patients over three months in 2005.

Of these, 27 were positive for either colonisation or wound infection with MRSA. Of those, 13 were previously known to have been colonised with MRSA and the 14 others were unexpectedly either colonised or subsequently developed wound infections. The new cases would not have been identified using any current selective screening protocol, as they did not fall into a high-risk category. Many were young, had no co-morbidities and no contact with hospitals in the past. Our study seems to indicate that selective screening will miss a significant number of cases.

We conclude that MRSA screening for all orthopaedic patients is needed when admitted to hospital, as colonisation is no longer confined to what has been previously identified as high-risk groups. The consequences of a subsequent MRSA infection have significant implications, socially, financially and clinically.