MRSA screening in the vascular day-case population.

Area of Science:

• Infectious Diseases
• Healthcare Policy
• Surgical Patient Care

Background:

• UK government prioritized methicillin-resistant Staphylococcus aureus (MRSA) screening for day-case surgical patients starting April 2009.
• New operational guidance mandated universal screening for this patient group.
• This study aimed to assess MRSA prevalence and screening effectiveness in vascular day-case surgery.

Purpose of the Study:

• Quantify MRSA-positive cases within the vascular day-case surgery population over one year.
• Identify risk factors associated with MRSA in this cohort.
• Evaluate the impact of new Department of Health (DH) guidance on screening rates.

Main Methods:

• Prospective review of electronic records and laboratory culture results.
• Identification of screened patients and MRSA isolation.
• Assessment for delayed discharges or MRSA-related complications.

Main Results:

• Six patients (2.1%) screened positive for MRSA; five were previously known MRSA carriers.
• Only 0.36% of patients were newly identified as MRSA-positive.
• Screening rates increased from 35% to 72.5% post-April 2009, aligning with DH guidance.

Conclusions:

• The assumptions justifying expanded MRSA screening policy are disputed.
• Universal MRSA screening for all vascular day-case admissions is not cost-effective.
• Recommend selective screening for patients with prior MRSA identification or high-risk factors.